Recorded on the 756th day since my grandfather's diagnosis.
Our family's treatment approach may not hold much reference value for most patients with metastatic colorectal cancer. Because treatment for elderly patients is often unconventional and highly personalized.
This submission mainly serves to document a difficult yet courageous chapter in our lives.
—————
Author｜Xiaoying
Editor｜XiaohanMy grandfather is the best old man in the world! For the first 85 years of his life, he was a healthy, robust, optimistic, and highly sociable little old man. Until June 2022, when I hadn't visited our hometown in a long time, I noticed he had visibly lost weight.He even stopped urging me to get married on WeChat,telling me he didn't have the energy anymore,because his stomach was uncomfortable,and he was having diarrhea over ten times a day.Sensing something was wrong,I immediately arranged for him to have a gastroscopy and colonoscopy.The colonoscopy confirmed a tumor in his sigmoid colon,highly likely malignant.We quickly transferred him to a local tertiary hospital.By then, he was already experiencing a partial bowel obstruction,making defecation extremely difficult.We initially planned to have the tumor removed in the colorectal surgery department,but preoperative CT and MRI scansbrought even worse news.I still remember my dad calling me that day,saying the doctor told him the tumor had metastasized to the liver.It was stage IV,with an estimated survival of about a year.I completely broke down,unable to stop crying.The colorectal surgery departmentwanted to immediately transfer him to oncology for chemotherapy.As family members, we knew nothing about the disease,we just wanted to keep it from him,and were terrified of chemotherapy,so we turned to acquaintances for help.He was transferred to the gastroenterology departmentto monitor the partial obstruction.Confused and unsure,we paid 20,000 RMB out-of-pocket for an intestinal stent,and once the obstruction was relieved, he was discharged.Through another acquaintancewe found an oncologist,who I later learned specialized in radiotherapy.In our confusion,we also spent 12,800 RMB on a genetic test.After the genetic test results came back,this "kind doctor" recommended immunotherapy for my grandfather, despite him being a wild-type,MSS, low-TMB patient.He prescribed envafolimab,which cost 12,000 RMB per dose out-of-pocket.Knowing nothing at the time,we gritted our teethand took him to an outside clinic for the injection.Looking back after the treatment,I started feeling something was off.SoI immediately consulted a doctor friend in Shenzhen.Though he was cautious with his words,I could read between the lines thatwe had likely been misled.By then, over a month had passed since diagnosis,and we still hadn't received standardized treatment.Eventually, we found a reliable oncologistat a local hospital where my friend was interning.This time,the medical oncologist was quite professional.He first had us get a PET-CT at a higher-level hospitalto rule out extrahepatic metastases;thenproposed a palliative regimen of cetuximab plus capecitabine.In hindsight,the regimen was too conservative,leading to imaging improvement after two cycles,but the subsequent four cycles failed to control the tumor,and it progressed before surgery.The turning point came in September.One day,while scrolling through Xiaohongshu,I stumbled upon a post about the "Panda Group"amidst countless posts exposing fraudulent TCM practitioners.Guided by fate,I somehow joined the group.As soon as I entered the "Liver Metastasis Group 5",I shared our situation and asked for help.The admins Miemie and Daqi,along with members Mr. G, Qingcao, Da Zhou, and Guangguang,not only patiently answered my questions,but also offered warm comfort.They quickly reignited a small flame of hope in me.Through learning,I realized that treatment concepts in cities like Beijing, Shanghai, and Guangzhouwere more advanced,and I refused to give up on my grandfather.Following the group's recommendations,we went to the Sixth Affiliated Hospital of Sun Yat-sen University in Guangzhou,to consult Directors Deng Yanhong,Cai Jian, and Pan Weidong.We also took him to Sun Yat-sen University Cancer Center,to see Professor Chen Gong.All confirmed that his physical condition was good enough,and he should receive active treatment.Director Pan Weidong immediately agreedto arrange hospitalization after a few chemotherapy cycles,considering simultaneous liver and bowel resection.Once again, thank you to the Panda Group,and the professors at the Sixth Affiliated Hospital,for giving me hope in despair.Later, in November, my grandfather was admittedto the Sixth Affiliated Hospital. After an MDT consultation,it was initially decided that the primary tumor should be removed.Due to the overly mild chemotherapy regimen,the liver metastases progressed and formed tumor thrombi,making simultaneous resection impossible.Director Cai Jian performed the bowel surgery with excellent anastomosis,the stoma and intestinal fistula we had worried about never occurred,and his recovery was relatively smooth.After discharge, he could eat and drink normally,without worrying about obstruction anymore.The only setback was during a follow-up visit,when the pandemic restrictions were first lifted,and he caught COVID, spiking a fever of 40°C.After the New Year, when we had a port-a-cath installed and were preparing for chemotherapy,he suddenly experienced a heart issue,rushed to the CT room for scans at 3 AM,leaving me drenched in cold sweat.Aside from that,his overall physical comfort remained quite good.The surgery significantly improved his quality of life.Eighty days post-surgery,without chemotherapy,the liver metastases naturally progressed.The number of tumors grew to seven,with the largest tumor thrombus being particularly troublesome,measuring approximately 4.5 x 1.9 x 2.4 cm.Following the MDT recommendations from Director Pan and the medical oncology department,we challenged a reduced-dose FOLFOX plus cetuximab regimen at his advanced age of 85.After four cycles, follow-up scans showedthat all other liver tumors had disappeared,leaving only this tumor thrombus.During the second MDT, Director Cao Wuteng from radiology mentionedthat tumor thrombi in colorectal liver metastases are actually very rare,and their viability after chemotherapy is hard to assess.We once again faceda difficult question common for elderly patients:should we opt for surgery?Director Pan explained that resection would requirea right hepatectomy.Since both my grandfather and our family opposed another major surgery,we chose conservative treatment.Following the radiation oncology department's advice during the MDT,we proceeded with palliative radiotherapy for the tumor thrombus.
He tolerated radiotherapy well,and follow-up imaging showedthe thrombus remained very stable.However, the good times didn't last long.During a follow-up scan of segment S8 post-radiotherapy,a new nodule appeared.Given the combined chemoradiotherapy,and his pre-existing mild heart issues before radiation.We followed the doctor's adviceto observe first whilecompleting a total of eight cycles of FOLFOX plus cetuximab.Although our family's journey never reached a tumor-free state,we are fortunate thatmy grandfather remains relatively robust,and the chemotherapy side effects have been manageable.Under the care of Director Pan's departmentand with various nutritional supplements,his condition has stayed fairly stable.This has been our greatest comfortthrough repeated challenges and ongoing treatments.After two months of observation,we opted for ablation in November 2023of the new S8 nodule.As always, my grandfather tolerated the procedure well,and no complications arose.However, two months post-ablation,the tumor margins recurred.This time, I decided to fully disclose his condition to him,because I feltit was timefor him to decide his own treatment direction.After discussing his condition with him,my grandfather thought for a long timeand we talked extensively.One sentence he said I will never forgetHe told me,"The book of life is so wonderful;I want to turn a few more pages."Therefore, in subsequent treatmentsbalancing his physical comfortwith standardized care,we have continued treating him while living with the tumor.The good news isthat after four cycles of a second-line reduced-dose bevacizumabplus FOLFIRI regimen,the recurrent tumor was brought under control again.Looking back over these 700-plus days,one surgery,one ablation,six radiotherapy sessions,up to 25 chemotherapy cycles,countless tests,endless hospital visits,I have had my moments of despair.I know my grandfatheris a sensitive and somewhat pessimistic old man,who often feels he is a burden to us.Yet, day by day,as the seasons change,we have unknowinglywelcomed another new year.This resilient old man has turned to page 86 of his life,and is ready to begin writing page 87.So here,what I want to share with everyone is:As long as there is life,as long as there is hope,we must grit our teeth,strive a little harder,and be a little stronger!Finally, I want to thank the Panda Group,especially Liver Metastasis Group 5,as well as Xiao Wang,Lulu, Da Wan, and all the group members,for the strength and emotional support they have given me.During our medical journey,many fellow patients at SYSUCC and the Sixth Affiliated Hospitalalso offered tremendous support.Members like Juan Yuan, Wei Ju,and Bai Zong from the Guangdong-Guangxi group, as well as Sister Hui, Xiao Ji,Kiki Jiang, Huihui, and Jianbao's mom from the Sixth Affiliated Hospital.In our time of mutual encouragement and supportwe not only learned relevant knowledge,but also gained precious friendships.Disease is indeed ruthless,but it has also taught me the value of cherishing the present.Life is unpredictable,we cannot foresee the future,we can only cherish every day spent with our loved ones,and fully experience the beauty of life.Sometimes, for our loved ones,curing the disease may not bethe most important thing; companionship and loveare the true remedies!To this day,I have walked this 756-day anti-cancer journey with my grandfather.I hope this path can extend a little further,and then a little further still.I also wish everyone and their familiesgood health and daily happiness in the days to come!
Editor: We are long-term collecting treatment stories and emotional reflections from Panda Group members, using words as an outlet for emotions.
<Small Donation Channel>
Certified by Charity China
▼Prevention is the Highest Wisdom▼
Black Tech for Easy Colorectal Cancer Screening | Fecal DNA | Early Screening Without Colonoscopy | Panda & Friends
Patient Stories | Click text to jump directly
Notes from a Middle-Aged Beijing Man Fighting Advanced Colon Cancer | The Anti-Cancer Black Magic of Panda Star | A Ming: Accompanying My Mother Through Two Years of Treatment for Colorectal Cancer with Liver and Lung Metastases | Qingcao: Sharing Treatment for Colorectal Cancer with Liver Metastases | Deep Sibling Bond: 4 Years of Treatment for Colorectal Cancer with Liver Metastases | Xiao Li: A Patient's Self-Account of Fighting Cancer | Sister Xiuxiu: Treatment Journey for Colorectal Cancer with Liver and Ovarian Metastases | Brother Guo: Tenacious Treatment Path for Colorectal Cancer with Peritoneal Metastases | Nao Nao: Self-Rescue Path After Recurrence of Colorectal Cancer at Age 27 | Sister Tudou: 7-Year Anti-Cancer Journey for Colorectal Cancer with Lung and Brain Metastases | Yuan Yuan: A Beautiful Young Woman Fighting Cancer, Living with a Smile | Jin Xia: 4-Year Treatment Path for HER2-Positive Gastric Cancer | The Grumpy Grandpa's Fight Against Gastric Cancer | Mickey: Treatment Path for Advanced Gastric Cancer at Age 31 | Summary from an Advancing Colon Cancer Patient's Family (Including Care Guide)| Alison: Treatment for HER2-Positive Advanced Colorectal 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 Member Story: Wei Hua 1 | From Diagnosis to Recurrence|Panda Group Member 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 Treatment in Beijing, Shanghai, or Guangzhou|Anti-Cancer Blogger Fengzi Passes Away: Who Will Care for Young Patients Fighting Cancer Alone? | Panda & FriendsOld Chen: What It's Like to Participate in CAR-T Clinical Trials, Over Three Years with Colorectal Cancer Liver and Lung Metastases, Anti-Cancer Veteran|Sister Yangguang: Life Should Not Lose Its Color Due to Illness
Doctor-Patient Communication | Click text to jump directly
Shen Lin, Peking University Cancer Hospital:Advances in Colorectal Cancer Immunotherapy 2023 |Step-by-Step Guide for Colorectal and Gastric Cancer Patients on How to Seek Medical Care
Xing Baocai, Peking University Cancer Hospital:Doctor-Patient Communication on Colorectal Cancer Liver Metastases
Chen Gong, Sun Yat-sen University Cancer Center:Can Surgery Be Performed Immediately After Colorectal Cancer Diagnosis? | On Surgery for Colorectal Peritoneal Metastases | On Treatment Strategies for Colorectal Liver and Lung Metastases | Maintenance Therapy and Neoadjuvant Chemotherapy for Colorectal Cancer | Patient Group Case Analysis Q&A (Part 1)| Patient Group Case Analysis Q&A (Part 2)
Cai Guoxiang, Fudan University Shanghai Cancer Center:Record of Patient Group Communication and Q&A
Wang Fenghua, Sun Yat-sen University Cancer Center:Record of Patient Group Communication
GuangzhouThe Sixth Affiliated Hospital of SYSUXiao Jian:Chemotherapy, Targeted Therapy, and Immunotherapy for Advanced Gastric Cancer
Yao Hongwei, Beijing Friendship Hospital:Necessary Examinations for Rectal Cancer Patients and How to Read Reports
▽Click to read the original article and join the support group
