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Colon cancer patient with liver metastasis developed resistance to chemotherapy and target medicine

how to survive in this case?


Colorectal cancer is one of the most common malignant tumors in China, ranking the third in patient number among other malignant tumors. According to statistics released by the National Cancer Center, around 388,000 new cases of colorectal cancer were reported in 2015, of which around 187,000 patients died.

Distal metastasis is the main cause of death. Liver is the most common metastasis site. Approximately 15%-25% colorectal cancer patient was diagnosed with liver metastasis at the same time while 50% patients might suffer from liver metastasis during the progression of cancer. What’s a worse, the patient with liver metastasis may have poor prognosis. Now the key to help colorectal patients survive is to solve the problem caused by liver metastasis.


Losing hope when drug resistance occurs

When we first saw Mr. Fan at our hospital (Guangzhou Fuda Cancer Hospital, also known as Fuda), he was watching TV with his “brother” (his child’s father-in-law). He looked healthy so if we were not told about his condition in advance, we couldn’t recognize him – a postoperative sigmoid colon cancer patient with liver metastasis. Two years ago, Mr. Fan found out that CEA was higher than normal range during a physical examination. Following the guidance of a local gastrointestinal doctor, he received enteroscopy. “The result showed a pretty big polyp in large intestine. I think it’s not a good thing.”


▲Mr. Fan and his “brother”

Later, Mr. Fan underwent radical operation of sigmoid colon. Pathological report showed adenocarcinoma. After operation, he started chemotherapy. In June 2019, he went through CT scan which indicated multiple liver metastases. With the help of target medicine and chemotherapy, his tumor was under control. “I felt better at that time but I suspended treatment because of COVID-19.”

Mr. Fan told us that he had pain on his shoulders and couldn’t lift his arms in April 2020, for which he received examination at a local hospital. “I thought it was just frozen shoulder and didn’t expect that CEA went up to as high as almost 700ng/mL.” He was assailed by the result so he immediately underwent treatment which was proved to be less effective. “At that time, the biggest liver metastasis is 8.5×6.3cm, and I have already developed drug resistance so chemotherapy or target medicine was useless for me.”

Mr. Fan always says that if there is a way to survive, just go for it but if not, let it be. When he noticed the story of Peng Ximei who was saved by Professor Xu Kecheng on CCTV Health Channel, he decided to visit Prof. Xu. “This may be the last stop of my treatment journey and I would like to ask for Prof. Xu’s opinion if I still have a chance to survive.”


Effective treatment and a nourished diet

With the company of his “brother”, Mr. Fan visited Prof. Xu in Guangzhou. “Prof. Xu told me that there was a way to help me, which gave me great confidence.” After discussion with his family, he was admitted to our hospital in August 2020.

Mr. Fan received related examinations upon admission, which showed that liver metastasis was slightly bigger than before and CEA was significantly higher. In this case, our experts arranged interventional chemotherapy and target medication for him. After several cycles of treatment, his CEA level was kept under control and liver metastasis was smaller than before, shown by ultrasound and CT scan. “It’s good news to me. It means the treatment is effective and I still have a chance to survive.” He told us that he smoothly underwent cryosurgery on liver metastasis in November 2020, performed by Dr. Zhou Liang.

“Other patients like me, only have some 6 months left but I have already went through 6 months!” Mr. Fan was satisfied with the current result. He said that he had given up before, but Prof. Xu gave him a light of hope.

Since the treatment was effective, Mr. Fan’s face turned from grey to ruddy. The nourished diet at Fuda also played an important role. “Since I was diagnosed with cancer, my family strictly monitored my eating. I can’t choose the food I want but I can eat anything nutritional here.”


▲Prof. Xu visited Mr. Fan during ward round.

Just as Prof. Xu said before, a nourished diet is one of the most important parts of rehabilitation. Malnutrition will lower the quality of life, weaken the treatment effect, increase possibility of complication and shorten patients’ life.

Nutrition doesn’t necessarily depend on supplements. Enough protein, proper amount of fat and carbohydrates, vitamin-rich food and roughage such as fresh vegetable and fruits are recommended. If we can “eat well, gain weight, look healthy and have energy”, we can effectively control cancer; even though cancer can’t be eliminated, we can “coexist with it” with less pain.

 “Five feelings, Five rare things, Five characteristics”

Mr. Fan has been admitted to our hospital for several times and each time he comes with his “brother”. “My children are busy working and can’t come with me. My “brother” has been retired so he comes to me when I call him.” Thanks to his “brother”, he doesn’t feel lonely during treatment.

"He’s always talking about my drinking problem." Because of illness, Mr. Fan restrained himself from excessive drinking, but his “brother” was still worried about him so he invited Mr. Fan’s in-charge doctor to warn Mr. Fan against drinking alcohol. Mr. Fan said that others thought they were real brothers who watch TV at home and go fishing together. They have experienced a lot on the anti-cancer road.

Upon leaving, his “brother” wrote down what he thought about Fuda during his stay -- "five feelings", "five rare things" and "five characteristics". He said that serious illness and pressure in all aspects will make the patient or his/ her family members impatient or restless, and that’s why patients need treatment at hospital. At Fuda, he saw advanced medical technology and good care. Only when we achieve mutual trust, communication and cooperation between doctors and patients, can we improve patients’ condition.


▲The original copy of letter

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