2016年5月23日星期一

Letting go and never giving up are both ways to say I love you


By Dr. Xu Kecheng,Chief President of Fuda Cancer Hospital 

Recently, I read an online article titled “letting go is also one way to say I love you”, written by a professor of surgery at a cancer hospital in Beijing. The article is focused on the topic of whether doctors should persuade patient out of treatment when there is no treatment available. The article tells about the story of how the professor of surgery encountered a patient’s father. The patient is a 16-year-old girl who was suffering from advanced colon cancer with liver metastases. The parents have sold off all their valuables to raise money for their daughter’s treatment. The professor found himself to be in a dilemma as the patient only has a couple of month to live even if she underwent operation and hence the couple might lose both their daughter and the money. The professor had a candid communication with the father and in the end he persuaded the father to “bringing his daughter back home...”

The professor believed that letting go is also one way to say love to advanced cancer patients who have undergone untold suffering from sickness.

I don’t know the real situation of the girl so that I’m not poised to make any comment. Cancer is a type of heterogeneous disease as the same type of cancer might have different characteristics and therapeutic effects on different patients. It’s not at all unusual for an advanced cancer patient to survive several years or even longer after undergoing comprehensive treatments. I understand what the professor was thinking about. It must be very difficult and painful for the doctor to give up treatment on such a patient.

Medicine is a combination of science, technology and craftsmanship. As patients are very different from each other in thoughts and backgrounds, doctors should take into consideration not only the feasibility and limitations of treatment but also the patient’s (including his/her relatives’) expectations, mental status and financial status.

About one month ago, I was confronted with a test of whether I should persuade the parents to bringing their daughter back home. The patient, 8 years old, is called Airin from Ipoh, Malaysia.

On March 28, Dr. Mu Feng, Vice President of FUDA, took me to visit Airin at room 319. Airin was hairless (caused by chemotherapy) with a pale face. Her intercostal space was deeply pitting and her abdomen was like a small boat. The right leg was as thin as a deadwood with the circumference standing at 5.5cm while the left leg wrapped by gauze was as thick as a bucket with the circumference of the oval tumor standing at 61.5cm. The superficial skin was in dark purple with part of the skin ulcerated. The CT scan showed a giant tumor in left shank. Pathological result from Malaysian Hospital showed malignant spindle cell tumor. My suggestion was that Airin should have a CT and MRI reexamination to check the structure of blood vessels and have her general nutrition status improved.


Before surgery, the tumor in left shank of Airin was shocking 
Two days after her admission, we held the first round of consultation for Airin. On the consultation, different people put forward different views. Some doctors suggested amputation with their reasons listing as follows: (1) As the patient was at a state of systemic failure, called dyscrasia in medicine, the patient could not be able to tolerate tumor resection; (2) The tumor, being malignant in nature, has grown for two years and has been growing very fast in the recent few months. It is invading and compressing inward the blood vessels and is breaking the skin. It is almost impossible to remove the tumor; (3) The blood vessels and nerves of the left shank might have been invaded. It is of no significance to remove the tumor if the left lower limb is dysfunctional after the surgery; (4) The patient had been hospitalized at several hospitals in Malaysia and Guangzhou, the doctors from which all believed that the only way out is amputation.

Others suggested that the tumor should be removed so as to preserve the left lower limb. Their reasons are as follows: (1) The CT/ MRI showed the tumor is relatively well defined; (2) Children’s tissue grows strongly. As long as part of blood vessels and nerves are preserved, patient will have a fast postoperative recovery; (3) The tumor grows on the left shank. As long as tourniquet is applied at the lower segment of thigh during the surgery, no massive haemorrhage will be caused; (4) We have completed several cases of resecting tumor while preserving the limb.

Several hours later, the patient’s condition worsened with high fever, increased heart rate, low blood potassium which stands at 2.5 mEq/L. White blood cell stood at 19000. Neutrophilic cell stood at 86%. CT scan showed pericardial effusion and diffused inflammation in lungs. The patient was transferred to the ICU.

A second round of consultation was held to analyze the reasons behind her worsened condition. Firstly, it might be caused by worsened infection, pulmonary infection in particular; secondly, tumor necrosis leads to large amount of toxicity being absorbed and further causes systemic sera. The two conditions are both fatal. At that moment, the problem was not whether the operation could be performed or not but how to save the child’s life. In general conditions, to rescue the child was almost challenging the impossible.

Such a difficult choice it was. There was no ground for blame even if doctors ask the parents to bring their daughter back home. Even if there was any accident happened on passage, it will be understood as natural degradation. We shoulder no responsibility whatever happens to the girl. However, the hospital’s reputation might be jeopardized if there is any accident happened during the surgery, even if a simple amputation.

The parents understood the misgivings of doctors. Airin’s father said, Airin was able to think like an adult. She never smiled ever since the doctor told them the only way out was amputation. She also said, she would like to go back home if she had to undergo amputation. He asked the doctors to rest assured, saying that they have prepared for the worst. That was to bring their daughter back home. Her parents burst out of tears when they said this to me.

I was so anxious about what decisions we should make: letting go or never giving up. As the president of FUDA, I required the medical team to change another way of thinking and change the impossible become the possible.

At 12:30, April 1, after nearly 20 hours preoperative operation, the operation started. After 5 hours’ operation, the tumor was completely removed. The tumor was 32 in length, 29 cm in width, 17 cm in thickness and 3.9 kg in weight.

Half a month later, Airin was discharged with her hand holding flowers presented by doctors and nurses. On April 27, Dr. Mu Feng, who was the first doctor to have received Airin, and I made a special trip to Penang, Malaysia. We were amazed to find that Airin, with the companion of her parents, had been waiting for us at the VIP access in the airport. We were even more pleased to see that Airin was able to stand for a while. In the morning of April 30, hundreds of people gathered at Airin’s house in Ipoh to celebrate her rebirth. With the scarf on her head, Airin nestled into my arms and said with a smile, “Grandpa, thank you! I love you!”

I'm gratified and tears welled up in my eyes. It is from never giving up that love is originated.

President Xu and the party paid visits to patients in Malaysia. Airin’s family went all the way to the airport to greet the party. Around 20 days after the surgery, Airin was able to stand for a while.

 Airin nestled into President Xu's arms and said with a smile, “Grandpa, thank you! I love you!”

2016年5月17日星期二

A retired doctor from Macau developed a liking for FUDA via NanoKnife

At 9:00 a.m., April 29, 2016, President Niu Lizhi, Director Xu Jiongyuan, Dr. Shi Hongxia, and other medical workers were making their routine rounds. Right after they walked into room 512, Mrs. Huang from Macau eagerly reported her husband’s condition to the doctors. “Today is the best day for my husband over the past half a year. In the morning, he told me unexpectedly that he wanted to have something to eat and he ate a half bowel of porridge delivered by the caregiver. It’s a great thing for him to be able to eat.”

How come Mr. Huang is contented with having just a half bowel of porridge? His story should be traced back to half a year ago. 

“Stomachache” covered up the fact that he was having pancreatic cancer

Mr. Huang, 73 years old, told us that his family has been in the business of textile for many years but he did not carry on his family’s business. Instead, he chose to pursue an utterly different occupation-being a doctor. After graduated from Guangzhou Medical School (currently Guangzhou Medical University), he has been engaged in medicine for about half a century. Once served as a radiologist Kiang Wu Hospital in Macau, he opened up his own examination center later. At present, he has retired from his work for a couple of years.

Last May, Mr. Huang started to have upper abdominal pain. In the beginning, He did not pay any attention to it and had it treated as gastritis for a period of time but the treatment showed futile. As the disease progressed, he had aggravated abdominal pain, which had radiated to the back. He couldn’t eat and sleep due to the severe pain. Last August, he received abdomen CT scan, which showed a mass sizing 4.3cmx3.5cm. He was confirmed to have pancreatic cancer.

Decisively rejected chemotherapy

When asked about Mr. Huang’s condition, Mrs. Huang had tears welled up in her eyes. “As he had abdominal pain very often, we had thought that he was just having stomachache but stomach medicine produced no effect. Then I went with him to the hospital for examination. The blood tests showed high bilirubin and high white blood cell. Further examination evidenced that he should have been suffering from pancreatic cancer. I was reduced into despair as I know pancreatic cancer is really hard to treat.”

As a doctor, Mr. Huang knew very well the malignancy of pancreatic cancer. Being called the King of Cancer, pancreatic cancer is primarily treated with operation. However, he has missed the prime time for operation as the mass in pancreas had grown to over 4cm. Doctors in Macau suggested him to do chemotherapy but he refused. He said, “The major treatment goals for cancer are to remove the tumor, alleviate the pain and prolong patient’s lifespan. Though chemotherapy is an option, it is not producing any actual benefits to pancreatic cancer patients; instead, it is only causing such side effects as nausea and vomiting, which will inflict greater pain to patients.” Hence, Mr. Huang has been adopting TCM treatment, at the same time, hoping he could find more appropriate and effective treatments.

Unfortunately, TCM was not able to control the tumor progression. He was not able to sleep and eat and had his weight reduced from 83kg to 46kg. In the middle of March, he found that he was having clay colored stool and dark brown urine as well as the symptom of jaundice. The relevant examinations showed that he was having pancreatic cancer with lymph nodes metastases, which was accompanied by obstructive jaundice. He received common bile duct stenting at Kiang Wu Hospital. During his hospitalization, he went through infection and fever.

Getting to know Fuda Cancer Hospital via NanoKnife

Prof. Zhu at Kiang Wu Hospital recommended NanoKnife that is available at Guangzhou Fuda Cancer Hospital. As the President of the Macau Society of Surgery, he is well connected with the medical community in mainland China. In October 2015, He invited Niu Lizhi, President of Fuda Cancer Hospital to deliver a speech on NanoKnife at an academic conference held in Macau. He also made a special trip to Fuda Cancer Hospital to investigate the therapeutic effect of NanoKnife for pancreatic cancer.

Having accepted Prof. Zhu’s suggestion, Mr. Zhu came to Fuda Cancer Hospital for treatment on April 18 with the company of Prof. Zhu and Prof. Luo. Thus, he became the first pancreatic cancer to be treated with NanoKnife in Macau.

Upon admission, Mr. Huang completed relevant checkups, which found that the pancreatic tumor had grown to the size of 6.3cmx3.7cmx5cm. He had intense pain, high tumor marker and high white blood cell. Considering the rapid tumor progression, the medical team at Fuda Cancer Hospital had had several rounds of discussion on his treatment plan and finally decided to perform PTCD and Irreversible Electroporation for him on April 20. Prof. Zhu and Prof. Luo also participated in the procedure.

According to Prof. Niu Lizhi, due to the special location of pancreas (surrounded by intestinal canal, bile duct, nerves, blood vessels, etc.), conventional operation or thermal ablation would easily injure these organs and tissues. NanoKnife, after being approved for clinical application, has become a safer and more effective treatment for pancreatic cancer as the important tissues and organs such as bile duct, blood vessels, nerves, intestinal canals can be kept intact during the procedure.

As the mass in pancreas was quite big, the ablation was done in four times. The CT scan one week after NanoKnife showed that the mass shrank from 6.3cm to 5.5cm. Tumor marker decreased from over 600 to 500. The postoperative recovery is good.
 
The couple spoke highly of the medical staffs at FUDA


As his condition is improving day by day, Mr. Huang curled up a long-lost smile

What the couple said most frequently to the medical workers at FUDA are “thank you” and “I appreciate it”. During his hospitalization, the couple has been confronted with things quite unexpected. They never thought that doctors at FUDA are having such great technologies. After received NanoKnife, Mr. Huang has had his pain greatly relieved and he is able to sleep and eat. They never thought that medical workers at FUDA are so considerate. Prof. Niu is always making rounds two times a day and asked about his condition even when he was on business trip. They never thought that medical workers are so patient-oriented. Medical workers, including president, doctors, nurses and cleaners, are so refined and courteous to patients.

On April 30, Mr. Huang was discharged from Fuda Cancer Hospital. He will continue to receive some consolidation therapy in Macau. We believe he will make a good recovery.

2016年5月4日星期三

The story of Yang Suhui

Yang Suhui, 56 years old, is a native of Taizhou, Zhejiang province. On June 25, 1991, her 4-year-old son Xu Jianfeng went lost near Southern Mansion, Guangzhou. She has embarked on the road of looking for her son for over 20 years. Even though she has been disappointed many times and gone through divorce, unemployment, fraud, she never thought of giving up. She had thought that she could spend the rest of her life looking for her son, but she never expected that she is left with little time.

At the end of 2014, Yang Suwen was diagnosed with middle stage lung cancer. The illness did not let her give up; instead it only strengthened her determination to find her son. As long as there is a piece of clue, she would travel all the long way to different places across the country with medicine. She is determined to race against with death and find her son before she fells.

However, life is cruel. Long time running has aggravated her condition. Last week, Yang Suhui was diagnosed with advanced lung cancer with bone metastases. When her life is going to fall apart, her best hope is to hear her son call her “mom” again.

Yang Suhui’s story has attracted broad attention from the society after reported by media such as Guangzhou Daily. After read relevant coverage, Xu Kecheng, the Chief President of Fuda Cancer Hospital, decided to lend a helping hand to the mom who is racing against death. He noted that FUDA will appropriate 50,000RMB from Fuda Boai Fund to pay for her medical bill so she can receive treatment at the hospital without worries of financial burden.

Prof. Xu Kecheng, the Chief President of FUDA, is doing physical examination for Ms. Yang Suhui

In the morning of April 6, Yang Suhui was admitted into Guangzhou Fuda Cancer Hospital. Prof. Xu paid a visit to her and encouraged her with his own example. He said, “I was diagnosed with liver cancer 10 years ago. After treatment, I am living a normal life. If I can make it, you can make it as well.”

When it comes to treatment, she expressed her heartfelt wishes-she doesn’t want to do chemotherapy. It turned out that she has been receiving conservative treatment ever since the onset of her disease for fear that chemotherapy would make her lose hair and change her appearance. “I’m afraid my son cannot recognize me when he sees me…”

To meet her wishes, Xu Kecheng noted that a team of specialists will be organized to make treatment plan based on her condition. A comprehensive treatment plan that includes cryo-ablation, vascular intervention and so on will be made to minimize her pain. For now, Yang Suhui is having advanced stage lung cancer. The tumor in right lung is pressing the trachea with blockage in bronchus. Fortunately, Fuda once admitted a patient who has similar condition as Yang Suhui. After treatment, the patient has survived for about 10 years.

Prof. Xu Kecheng said frankly that according to her current condition, the treatments to be applied are not likely to eliminate all the cancer cells but the treatments are able to control the spread of cancer cells and prolong her lifespan.

Yang Suhui held hands tightly with Prof. Xu Kecheng and expressed her appreciation to FUDA for the care and assistance she has received. Reporters from Guangzhou Daily, Southern Metropolis Daily, Nanfang TV, Today’s News of Guangdong TV, Guangzhou TV have covered the benevolent gesture of Fuda Cancer Hospital.

Xu Kecheng, the Chief President of Fuda Cancer Hospital, interviewed by several media of Guangzhou


Xu Kecheng Being-Towards-Death Documentary of A Great Doctor and Patient

2016年5月2日星期一

Guangzhou Fuda Cancer Hospital helped me realize my three wishes

In the afternoon of April 19, 2016, room 516, Fuda Cancer Hospital Tianhe Branch was very lively with birthday song and laughter coming out. April 19 marks Mr. Zhong’s 62th birthday and also Mrs. Zhong’s lunar birthday. The birthday is particularly meaningful as this is the first time for them to celebrate an overlapped birthday over the past 40 years and more. Nurses of the 5th ward prepared a cake for the couple, planning to give them a special surprise. When the cake was served in front of them, the couple’s faces were full of surprise, touch and appreciation. They have never thought they would celebrate such a warm and unforgettable birthday in the hospital.

After receiving comprehensive treatments at FUDA, Mr. Zhong has had improved condition. The birthday also marks a new beginning for him. Director Xu Jiongyuan, attending physician Shi Hongxia, resident doctor Zhan Si, head nurse Zhan Xiao all presented to wish him a very happy birthday. With a happy smile, Mr. Zhong put his palms together devoutly and made his birthday wish. He said, “I would like to thank you for your comprehensive treatment and thoughtful care, without which I wouldn’t be able to recover so well. I also have had my three wishes come true at FUDA as I am able to drink, eat and have a shower. ”


Mr. Zhong celebrated his birthday in the ward

Mrs. Zhong told us that she and her husband are both retirees from a large-scale tramway company in Guangzhou. They have supported each other for 40 years since their marriage. In 2014, Mr. Zhong retired from the company that he had served for several decades. He had planned to enjoy his retirement and travel around with his wife and daughter. Unfortunately, Mr. Zhong started to have frequent abdominal pain in September last year. As he has had a medical history of gallstone for more than 20 years, he had thought it was the gallstone that had caused abdominal pain. He took anti-inflammatory drug for gallstone but the pain showed no remission. In the end, his abdomen was so painful that he couldn’t take it anymore. He went for physical examination at a local hospital with his wife. The physical examination came out. The doctor told his wife that Mr. Zhong was suspected to be suffering from pancreatic cancer and he was advised to do further examination at a major hospital. “The diagnosis was like a thunderbolt out of a clear sky. The world seemed to have collapsed around me. But I have to hold in and hide the diagnosis from him. I’m afraid the diagnosis may knock him down.”Mrs. Zhong noted. After learning the diagnosis, Mr. Zhong’s son-in-law contacted a major hospital at once.

In late November, 2015, Mr. Zhong was admitted into the major hospital. After he completed relevant examinations, doctors told his family that conventional operation was not an option and NanoKnife was the only way out. Soon, Mr. Zhong underwent NanoKnife in the hospital. Postoperative pathological result showed B-cell non-Hodgkin lymphoma of the pancreas. He also underwent percutaneous transhepatic cholangial drainage after NanoKnife.

However, the procedure was not successful. Mr. Zhong couldn’t eat or sleep due to abdominal pain and abdominal distension half a month after the procedure. “I was in so much pain and disappointed. All I want was to be able to have a sip of water, eat a bowel of porridge, have a shower and have a good sleep. These have been my best wishes since my operation three months ago. ”.

Mrs. Zhong recalled tearfully, “He couldn’t eat or sleep and could only cuddle up for one or two hours. Many of his wardmates asked in curiosity, “Why he cannot sleep on his back?”Mrs. Zhong wiped off her tears and continued, “Since his illness, he has lost his weight from 60 kg to 44.5 kg. Seeing him in so much pain, we began looking for other hospitals to see if there is any treatment available that could alleviate his symptoms. I’m ready to spend all our savings as long as he could get healed.”

“It is my elder sister who recommended us to have a try at Fuda Cancer Hospital. She lives nearby and was told that FUDA has been very good in treating cancer.”Mrs. Zhong saw a glimmer of hope.

The morning of February 20, 2016 was the set time for Xu Kecheng, President of Fuda Cancer Hospital, to hold free consultation for cancer patients. Mrs. Zhong came to FUDA very early that day and she was really anxious while waiting to see President Xu. She made an uttermost effort to calm herself down. “I had a mixed feeling that day, wondering how President Xu would comment on my husband’s condition.”After studied Mr. Zhong’s medical report, President Xu said, “We are relieved to see that the tumor is localized at the head of pancreas. We will try our best to treat your husband.”

After consulting President Xu, Mrs. Zhong felt much relieved. In the evening of February 20, Mr. Zhong went through admission procedure at FUDA. What President Xu said aroused his will to fight against cancer. Mr. Zhong said, “I have long been tortured by the disease. It is with President Xu’s encouragement that I have the confidence to fight against cancer. I will hold what President Xu said close to my heart. I would like to express my appreciation to doctors and nurses at FUDA for their patience and care shown to me. ”

After receiving treatment at FUDA, Mr. Zhong’s symptoms have been greatly alleviated. The attending doctor Shi Hongxia performed peritoneal drainage and pleuracentesis for him. Moreover, Mr. Zhong underwent DC-CIK immunotherapy, interventional chemotherapy and molecular targeted therapy. After the current phase of treatment, Mr. Zhong felt “my intestines are working and I can eat porridge now.”

“Chief President Xu Kecheng and President Niu Lizhi come to visit me not long after my admission. They encouraged me to be confident in the face of cancer. My attending physician Shi Hongxia has always been patient and careful in explaining to me the upcoming procedure.” Mr. Zhong said with a smile. He said with a relived smile that he couldn’t able to have such a good recovery without the treatment at Fuda Cancer Hospital.

Zhan Xiao, head nurse of 5th ward, said, “It pains us to see that Mr. Zhong had three drainage tubes on his body upon admission. Seeing him in such pain, our nurses spent over half an hour cleaning tubes for him and helped Mrs. Zhong wash Mr. Zhong. We felt really relieved to see that Mr. Zhong is improving day by day.”

Mr. Zhong signed, “I underwent untold suffering from the disease before I came to Fuda Cancer Hospital. I haven’t had a shower for three months. I really wanted to have a shower to make myself feel better. It was even a luxury for me to have a shower before my admission. However, medical staffs at FUDA has not only realized my wish of having a shower but also made me able to eat and walk. For me, that can be said to be the biggest happiness.”

Mrs. Zhong further added, “The generous help and care from doctors, nurses and caregivers have made me feel warmly welcome. We are very satisfied with their elaborate service.”

In the afternoon of April 13, when Prof. Xu Kecheng, Dr. Niu Lizhi and other doctors were making routine rounds, Prof. Xu said to Mr. Zhong, “Congratulations! You have had a very good recovery. You can be discharged soon.”Mr. Zhong expressed his joy effusively while shaking hands with the two presidents.


The First Case of Cryosurgery on Cardiophrenic Angle Tumor in the World

The First Case of Cryosurgery on Cardiophrenic Angle Tumor in the World

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