February 21, 2009, I received a call from an oncologist friend from the Cancer Hospital of Peking University. He told me that Professor Cheng, (not his real name) of Tsinghua University was suffering from abdominal liposarcoma and that he would be coming to seek treatment in our hospital. I thought this friend of mine was joking with me. The next morning, he phoned me again telling me solemnly that this was not a joke. At the same time, he sent me a text message (SMS) saying “Professor Cheng will arrive at 7:00p.m. Please arrange for ambulance to fetch him from the airport and to get ready a room for him. Please examine and provide him the treatment ASAP.” At 8:00p.m that night, Professor Cheng was admitted into our hospital. Professor Cheng was tall, slender with a bulging stomach. From his medical records, we learned that Professor Cheng had abdominal liposarcoma resection in August 2008. During this February recurrence was detected. The CT scan done on February 2 in Beijing showed that there were four tumours in his abdomen about 7-9 cm in size. According to Professor Cheng, he had no food intake for the last five days; if this were to continue, he would soon collapse.
CT examination was done the following day after his admission; it showed that the tumours had grown to 15-17cm in size and pleural effusion and ascites were detected. We were faced with a new challenge - all the previous challenges we faced involved ordinary people, but now this patient was a VVIP. Professor Cheng, 59 years old, was an alumnus of Tsinghua University, and his father was one of the most renowned professors of the university. Professor Cheng was a well known economist, and a senior financial consultant of China. He was the independent directors of six listed companies, and chairman of the board of supervisors. On his second day of admission, my phone rang almost non-stop. These phone calls came from Beijing and all over the country; some were from professor Cheng’s friends, some top senior officers of the Guangdong Province, my superior, and people whom I did not know. Streams of visitors came. My friend who accompanied Professor Cheng told me that Professor Cheng had done extensive research on economics and was a potential candidate for the Nobel Prize. Many of his students were leaders in different economics fields at the national level. As many as 300 people had wanted to come to see Professor Cheng, but the number had to be limited to 24 only. He passed me a message from the secretary of a certain Provincial Communist Council which said, “Please try your best to heal Professor Cheng. I am even willing to scarify my life just to save him!”
I told my oncologist friend who recommended Professor Cheng to our hospital on the enormous pressure I was under. He told me earnestly, “Professor Xu, I have great confidence in you. Many medical specialists in Beijing have confidence in you, too. We know your hospital has been faring well and is in high reputation. We in Beijing have failed to treat Professor Cheng, but we believe that he stands a good chance to recover here!”
We worked up the treatment plan for Professor Cheng. On 24th February, 1000ml of pleural effusion were drained out. On the 26th February, we started immunotherapy and vascular invasive therapy. On the following two days, Professor Cheng had fever at 38.2 degree Celsius but he had good appetite and was given some liquid food. However, on 1st March, Professor Cheng had high fever - 39.2 degree Celsius. In view of his fever, it seemed that we would have to cancel the operation scheduled on the next day. We conducted a comprehensive examination on Professor Cheng - no infection was detected, CD4 cells, CD8 T cells and NK cells were at high level. Most importantly, Professor Cheng felt that he was feeling very much better than previously, and it seemed that the abdominal tumours had ceased growing. It was on the same day that he had exceptional good appetite and had just had a bowl of noodles. I phoned to consult my oncologist friend in Beijing. He told me that cancer cells would follow a cycle of multiplication and necrosis. If the immunology system was strong, the rate of cancer cells dying would be higher than their multiplication rate. What Professor Cheng was experiencing now was the result of the immunotherapy. I was greatly relieved and decided to proceed with the operation as scheduled; we would shoulder all the responsibilities for any eventuality
2nd March 9a.m., we commenced the operation. Anaesthesia was smoothly performed. When laparotomy was performed, it was discovered that his abdomen was entirely covered by tumours. After conventional ligation and hemostasis, we resected and removed the tumours piece by piece. For unresectable tumours, we applied cryoablation to freeze them in-situ. For small tumours that escaped cryoablation, we injected photosensitizers followed by photodynamic therapy and intraperitoneal hyperthermia. During the operation 1200ml of blood were transfused and the total weight of tumours removed was 5kg. When the news on the successful operation was relayed to Tsinghua University, hundreds of Professor Cheng’s students were jubilant and shouted at the top of their voice “Professor Cheng, We await your return!” The minister of the related ministry also sent a congratulatory message on the successful operation and wished Professor Cheng well. We had overcome another ultimate challenge.
Professor Zhao Fengrui of the China Academy of Medical Sciences, a thoracic surgeon who had been accompanying Professor Cheng all this while had this to say: “Fuda Cancer Hospital has accomplished a feat that none in Beijing dare to challenge!” Before Professor Cheng was discharged, a team of representatives from Tsinghua Univesity led by the secretary of the Communist party committee of the university visited our hospital. I told the secretary that it was indeed a great honour to our hospital for having the highest ranking officer of a top leading university in China to visit a small hospital like our’s. To this, he replied, “It is not the size that matters. The crucial factor is the special features that a hospital has. You have healed Professor Cheng miraculously and this is the best contribution you have rendered.”
All the five ultimate challenges we cited earlier and the healing of Ximei were the most soul-touching incidents. We are not boasting how good our hospital is or how skilful we are. Our success (or preliminary success) in all these cases are probably due to the following factors.
1. Humanity Factor:
All these patients were in a helpless state. As medical professionals, our primary duty is to save patients’ lives. If we do not lend them a helping hand, who will?
2. Thinking Factor
At times, we have to be philosophical in our thinking. A particular therapy by itself may not work but a combination of different therapies may prove effective. It has been said that giving medical treatment is both a science and an art, and this is possibly what it means.
3. New Technology Factor
We utilize new technology to the fullest. In recent year, advancement in medicines has brought about what we call “Comprehensive medicine”, “Alternative medicine” and “Translational medicine”. There is an emergence of what is called ‘New Style Medicine”. We should make good use of medical advancement and technological advancement to treat our patients.