Uncle Wang: He Completed Treatment for Gastric Cancer with Liver Metastasis | Patient Story
In January 2022, based solely on a plain CT scan and gastroscopy, my father underwent a gastrectomy in our hometown, removing three-fifths of his distal stomach, before distant metastasis was even confirmed.
After surgery, the surgeon privately told my mother that my father already had multiple diffuse liver metastases, with an estimated survival of only about six months. "I suggest skipping chemotherapy to spare him the suffering; just give him sugar water as a placebo," he said.
Having studied and worked in the US for years, I was completely unaware that my family had arranged surgery so quickly. Following recommendations from a Chinese expat forum, I joined a patient support group and began learning extensively about the disease and treatment options.
I resigned from my job in Silicon Valley and accompanied my father on a journey to seek medical care in Beijing, Shanghai, and Guangzhou.
From that moment on, the gears of fate began to turn anew.
Author | Wang Wei (Narrated by a family member)
Editor | Wu Jiu
In March 2022, after the local hospital removed three-fifths of his distal stomach, my father began first-line postoperative treatment. The local oncologist prescribed "oxaliplatin + capecitabine + PD-1 (Opdivo)." Although the pathology report clearly stated "HER2 (2+)," the doctor never mentioned it.
That month, I decided to return to China to accompany him, planning to stay until June before heading back to the US. However, it was during the strictest pandemic lockdown, requiring a one-month hotel quarantine to get home.
From the quarantine hotel, I repeatedly called to insist they perform a FISH test. I knew that if HER2 amplification was confirmed, several more targeted drugs would become available, which would be a stroke of luck for advanced gastric cancer.
Throughout 2022, my father continued oxaliplatin-based first-line therapy with excellent results. After just two cycles, the largest liver metastasis shrank from 3.8 cm to 1.5 cm, and many smaller lesions disappeared completely.
After three cycles, due to an infection, we discontinued oxaliplatin and switched to maintenance therapy with targeted drugs, immunotherapy, and capecitabine. Perhaps because of his strong constitution, his quality of life remained high during chemo, with side effects limited mostly to numbness in his hands and feet and hand-foot syndrome.
Although first-line therapy worked well, after reviewing extensive literature, I clearly understood the prognosis for advanced gastric cancer. By late 2022, I resolutely quit my Silicon Valley job and moved back to China with my family. My mindset was, "I must at least accompany my father through his final journey."
We maintained first-line therapy until January 2023. As CEA levels gradually rose and an MRI revealed new liver lesions, it signaled resistance to first-line treatment.
I immediately took my father to Beijing to see Director S at Peking University Cancer Hospital. She is a top authority in gastrointestinal oncology in China and was incredibly kind. After reviewing his case, she told him in front of us that we should aim for a cure. Though I knew it was largely encouragement, such words from a leading expert are incredibly precious for advanced cancer patients.
She offered two options: join a HER2 clinical trial or use "RC48 + PD-1." After careful consideration, we enrolled in a Phase III anti-HER2 trial (KN026 + paclitaxel) near our hometown. The trial had experimental and control groups, but to this day, we still don't know which one he was assigned to.
During the trial, CT scans consistently showed stable disease. However, in August 2023, a CT reported a new 1.5 cm lesion, and rising CEA levels confirmed clinical resistance.
Looking back, I realize the significant gap in radiology expertise between top-tier and local hospitals. During the trial, CT reports on the liver were often vague, using phrases like "possible metastasis to be ruled out."
To clarify the findings, I took my father to Zhongshan Hospital in Shanghai for a targeted MRI of the new lesion. The MRI confirmed a single new 1.9 cm lesion, contradicting the local hospital's previous description of "multiple" lesions.
I promptly consulted Director Y of the liver surgery department at Zhongshan Hospital. Compared to colorectal liver metastases, gastric cancer liver metastases are more aggressive and carry higher risks, so liver resection is generally not recommended. After reviewing our scans and comparing them with images from March 2022 before first-line therapy, Director Y noted the excellent response to chemotherapy and agreed to make an exception for surgery.
However, both my mother and the trial's medical oncologists opposed surgery, citing his age (71) and the risk of explosive disease progression post-op.
I was hesitant but unwilling to give up, knowing that all drugs eventually face resistance. Following standard guidelines would likely lead to a similar outcome. I then consulted Director C at Fudan University Shanghai Cancer Center, who shared cases of gastric cancer patients with liver metastases who achieved near-cure after liver resection due to excellent chemo response. He said nothing is absolute and, after reviewing my father's case, did not oppose surgery, which greatly boosted my confidence.
Considering my father's strong desire for active treatment, we ultimately chose surgery. In October 2023, Director Y performed a minimally invasive liver resection. The surgery was successful, and his recovery was swift.
However, the treatment journey is never smooth. A follow-up MRI one month post-op revealed a new 1.5 cm liver lesion. When I shared this news with my father, he was deeply disheartened.
We returned to Director S in Beijing, who again recommended trying "RC48 + PD-1." In December 2023, after three cycles, my father experienced severe side effects: excruciating joint pain in both feet, muscle soreness, and sleep disruption, requiring tramadol for relief. We had to discontinue the treatment after three cycles.
Assuming treatment had failed, we were surprised when follow-up scans in February 2024 showed the lesion continuously shrinking, and CEA levels dropped rapidly back to normal. By early March, a new MRI confirmed the original lesion had disappeared. My father was tumor-free!
After consulting Director G at Fudan Cancer Center, he said my father could stop treatment and only needed follow-ups every two months. He told my father, "A miracle has happened in your body." At that moment, my eyes welled up with tears.
To date, my father has survived 26 months since diagnosis. He lives a normal life, handling grocery shopping and cooking on his own. This Spring Festival, he even joined me on an RV trip from Jiangsu to Guangzhou, keeping up perfectly even on mountain hikes.
I deeply admire my father. Non-patients can hardly grasp the thoughts and psychological burdens of those with advanced cancer. Although our journey was relatively smooth compared to many, we still faced peritonitis, abdominal infections, half a month of fasting in the hospital, and the devastating news of early post-op recurrence. He endured it all.
Finally, here are some reflections from accompanying my father through over two years of treatment:
1. Top hospitals in China offer excellent care and continuously improving patient experiences, despite long wait times, especially at top centers in Beijing, Shanghai, and Guangzhou. Finding a reliable doctor is crucial.
2. There are many paths for advanced cancer treatment, and a family member's ability to learn and research is vital.
3. China's new drug development is advancing rapidly, though it largely follows global trends. Biomedicine truly holds immense promise in our century.
4. Doctors in China have very limited time per patient, unlike the US. If patients or families cannot clearly and quickly present their questions, doctors may give rushed conclusions or avoid further discussion. Learning to communicate efficiently with doctors is essential.
The chart above is one I created myself, which I use as my primary material when communicating with doctors. A single page clearly outlines my father's entire treatment history and has earned praise from several physicians.
For patients with advanced cancer, the will to live plays a significant role in treatment outcomes. If one resigns to fate and pursues passive treatment, the outcome is rarely favorable. Conversely, when families and patients move forward together, embracing life positively, miracles can happen.
I hope everyone achieves a positive outcome.
▼ Prevention is the highest wisdom ▼
Patient Stories | Click text to jump
A Middle-Aged Man in Beijing Fights Advanced Colon Cancer | The Anti-Cancer Black Magic of Panda Star | A Ming: Accompanying My Mother Through Two Years of Colon Cancer with Liver & Lung Metastasis | Qing Cao: Sharing Treatment for Colon Cancer with Liver Metastasis | Sibling Love: Four Years of Treatment for Colon Cancer with Liver Metastasis | Xiao Li: A Patient's Self-Narrative on Fighting Cancer | Sister Xiu Xiu: Treatment Journey for Colon Cancer with Liver & Ovarian Metastasis | Brother Guo: Tenacious Treatment for Colon Cancer with Peritoneal Metastasis | Nao Nao: Self-Rescue Journey After Recurrence of Colon Cancer at 27 | Sister Tu Dou: Seven-Year Anti-Cancer Journey for Colon Cancer with Lung & Brain Metastasis | Anti-Cancer Girl Yuan Yuan: Living with a Smile | Jin Xia: Four-Year Treatment for HER2-Positive Gastric Cancer | The Grumpy Grandpa's Fight Against Gastric Cancer | Mickey: Treatment Journey for Advanced Gastric Cancer at 31 | Summary from a Colon Cancer Patient's Family (Including Care Guide) | Alison: Treatment for HER2-Positive Advanced Colon Cancer | From Stage IV Gastric Cancer to Complete Remission | 78 Liver Metastases Do Not Mean a Death Sentence | The Advanced Cancer Patient Who Entered the ICU Due to Infection Is Now Tumor-Free | Panda Group Story: Wei Hua 1 | From Diagnosis to Recurrence | Panda Group Story: Yang Yong | As Heaven Moves Vigorously, the Gentleman Strives Unceasingly | The Cruel Truth Behind Treatment Value: Why Some Patients Are Not Advised to Seek Care in Beijing, Shanghai, or Guangzhou | Anti-Cancer Blogger Feng Zi Passes Away: Who Will Care for Young Patients Fighting Cancer Alone? | Old Chen: Experience Participating in a CAR-T Clinical Trial, Over Three Years with Colon Cancer Liver & Lung Metastasis | Sister Yang Guang: Life Should Not Lose Its Color Due to Illness
Doctor-Patient Communication | Click text to jump
Shen Lin, Peking University Cancer Hospital: 2023 Advances in Immunotherapy for Colon Cancer | Step-by-Step Guide for Colon & Gastric Cancer Patients on How to Seek Medical Care
Xing Baocai, Peking University Cancer Hospital: Doctor-Patient Communication on Colon Cancer Liver Metastasis
Chen Gong, Sun Yat-sen University Cancer Center, Guangzhou: Can Surgery Be Performed Immediately After Colorectal Cancer Diagnosis? | On Surgery for Colorectal Peritoneal Metastasis | Treatment Strategies for Colorectal Liver & Lung Metastasis | Maintenance Therapy and Neoadjuvant Chemotherapy for Colon Cancer | Patient Group Case Analysis Q&A (Part 1) | Patient Group Case Analysis Q&A (Part 2)
Cai Guoxiang, Fudan University Shanghai Cancer Center: Patient Group Communication Q&A Record
Wang Fenghua, Sun Yat-sen University Cancer Center, Guangzhou: Patient Group Communication Record
Xiao Jian, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou: Chemotherapy, Targeted Therapy, and Immunotherapy for Advanced Gastric Cancer
Yao Hongwei, Beijing Friendship Hospital: Required Examinations for Rectal Cancer Patients and How to Read Reports
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