Hope and Perseverance Through 9 Years of Advanced Gastric Cancer - Xixi | Panda Group Patient Story Sharing
Cancer treatment is a challenging journey. Regardless of its duration or how smoothly it goes, every step we have taken so far is filled with courage and perseverance. Sharing these valuable treatment experiences aims to bring encouragement and inspiration to friends facing similar challenges, while also allowing us to reflect on our own treatment journeys.
Summary｜Oolong Tea
Proofreading｜Guangguang
[ Live Broadcast Date: December 17, 2024 ]
Let's first review Xixi's family's treatment journey:
My mother was diagnosed with gastric cancer in November 2015, with a postoperative stage of T4aN2M0. She underwent the SOX regimen for six months, followed by oral S-1 for another six months. In April 2019, the cancer recurred with bilateral ovarian metastasis, leading to the surgical removal of her ovaries and uterus. Postoperative chemotherapy included oxaliplatin + paclitaxel + S-1 + apatinib, along with four sessions of intraperitoneal cisplatin perfusion. After eight chemotherapy cycles, treatment concluded, and she continued oral apatinib until late 2022. In August 2023, she developed an intestinal obstruction and was diagnosed with peritoneal metastasis. After a bypass surgery to relieve the obstruction, she joined a clinical trial for Claudin 18.2 at Peking University Cancer Hospital. She has since received three infusions.
My mother was diagnosed with gastric cancer in November 2015 at just 48 years old. At diagnosis, it was already T4aN2M0, a diffuse poorly differentiated adenocarcinoma with signet ring cells, classified as stage III gastric cancer.
Back then, mobile internet wasn't as advanced. Right after her diagnosis, we relied on acquaintances to arrange immediate surgery at a top-tier hospital in our city. Post-surgery, she completed six cycles of the SOX chemotherapy regimen, followed by six months of oral S-1 before concluding treatment.
After three stable years, just as our family thought she was cured, the April 2019 follow-up shattered that peace. Her CA19-9 tumor marker soared above 300, and imaging revealed bilateral ovarian metastasis.
Consequently, in May 2019, my mother underwent another surgery to remove her ovaries and uterus. Due to the metastasis and advanced stage, the medical oncologist intensified the chemotherapy regimen, combining oxaliplatin, paclitaxel, S-1, and apatinib, along with four sessions of intraperitoneal cisplatin perfusion.
Each chemotherapy session was a physical and mental ordeal for my mother: severe gastrointestinal reactions left her unable to eat for nearly a week, with constant vomiting and extreme weakness that kept her bedridden. Yet, despite this, she persevered with remarkable willpower to complete all eight cycles.
After half a year of treatment, her condition stabilized, and she transitioned to oral apatinib for maintenance therapy. However, the side effects of apatinib were significant. Her blood pressure remained consistently high, requiring antihypertensive medication. She also experienced frequent diarrhea and severe thyroid hormone imbalance, necessitating continuous use of Euthyrox.
In May 2022, I joined the Panda Group. Seeing so many patients and caregivers continuously learning and lighting the way for their own or their loved ones' cancer journeys made me realize how little I had done for my mother's treatment. I shifted my mindset from "just follow the doctor's orders" to actively studying relevant knowledge within the group.
By late 2022, due to her severe hypertension, we consulted her doctor and discontinued the targeted therapy. However, fate seemed unwilling to let us off easily. After August 2023, my mother began experiencing symptoms of partial intestinal obstruction. Since her May follow-up showed normal tumor markers and imaging, we didn't think much of it. Local doctors suspected bowel adhesions from previous abdominal surgeries and perfusions, so they opted for conservative treatment.
By October, the partial obstruction had progressed to a complete blockage. My mother lost over 10 kilograms and showed no signs of improvement. The doctors decided that even if it were adhesions, surgery was necessary to relieve them. During the operation, however, they discovered peritoneal metastases—numerous white, millet-like nodules. The bowel obstruction was actually caused by metastatic tumors in the small intestine blocking the passage. The surgeons could only perform a bypass to initially resolve the obstruction.
In that moment, I knew our cancer-fighting journey had once again begun on a difficult path.
Thanks to two years of learning in the Panda Group, I had gained a basic understanding of this disease.
After this recurrence, beyond the initial brief panic, I was able to quickly organize my thoughts. On one hand, I applied for immunohistochemistry testing on the peritoneal metastasis nodules obtained during surgery. On the other hand, I traveled north to Peking University Cancer Hospital to secure an appointment with Vice President Dr. Zhang Xiaotian to seek new treatment options.
The immunohistochemistry results surprisingly indicated dMMR, but subsequent PCR genetic testing unfortunately confirmed MSS, meaning she was not one of the lucky ones with microsatellite instability. Therefore, Dr. Zhang recommended testing for the Claudin 18.2 target, suggesting that if the expression was high, she might be a better candidate for a CAR-T clinical trial.
After testing, my mother's Claudin 18.2 expression at 2+ or higher reached 95%. Fortunately, we successfully enrolled in the CT-041 clinical trial group run by a Shanghai-based company.
In January 2024, she underwent leukapheresis for trial enrollment and bridging chemotherapy. The first infusion was administered on February 26, with post-infusion evaluations showing stable disease. The second infusion followed on July 26, and the third on November 29.
To date, her condition has remained stable.
Since this treatment requires no other interventions besides the infusions, my mother's quality of life remains quite high. We are very satisfied with the treatment outcomes achieved through the trial.
Through these years of fighting cancer, I have two key insights to share with everyone:
Maintaining an optimistic mindset is the first step toward success. My mother has always had an excellent attitude. Since her diagnosis in 2015, she has faced treatment positively. Despite her late stage, diffuse poorly differentiated adenocarcinoma with signet ring cells, and relatively young age—all high-risk factors—comments about a "short survival time" never discouraged her. Now, nine years later, having experienced two metastases, we still choose to move forward bravely. Only by persevering can we create our own miracles once again.
Throughout the treatment process, one memory stands out most vividly. After her final chemotherapy session, due to work commitments, I had to rush to catch a high-speed train home to avoid missing work the next day. At 6 PM, right after her IV was removed, my mother hurried with me to the station. Feeling dizzy, she lost her footing and fell down the stairs, hitting the left side of her face. Her nose bled continuously, and half her face was bruised and swollen.
At that time, chemotherapy had also caused her to lose all her hair. She asked me if she looked terribly ugly and had lost all dignity. For the first time, I couldn't hold back my tears and cried in front of her. I began to question whether such painful treatment was truly worth it. However, after treatment concluded, until August 2023, my mother's quality of life was quite good; she could travel and go shopping.
Looking back now at those painful early treatments, I feel they were profoundly meaningful. Without that initial perseverance, there would have been no subsequent quality of life. Over these years, she also got to see me get married and have children, fulfilling one of her greatest wishes.
Finally, I want to thank the Panda Group platform. It not only provided me with numerous avenues to learn but also connected me with many fellow patients, such as our enthusiastic group administrator, Cici.
Often, the difficulties and psychological burdens encountered during treatment are hard to share with colleagues or friends, as they struggle to truly empathize. However, group members, having mostly shared similar experiences, deeply understand my anxiety and have provided immense emotional support, which is incredibly precious to me.
I also welcome anyone to ask me questions anytime. I will gladly answer what I know. As someone who has walked through the rain, I hope to hold an umbrella for others.
To protect patient privacy, names used in this article are pseudonyms.
Images featuring the patient's portrait have been authorized by the patient and may not be used without permission.