Rare Duodenal Cancer with Multiple Liver Metastases: How to Defy the Odds (Part 2) | Patient Story
This article is an official interview by the Panda Group with Mr. Xiao Gao, a member of the Hepatobiliary & Pancreatic Support Group. It focuses on his mother's late-stage treatment journey for duodenal adenocarcinoma with multiple liver metastases. After neoadjuvant therapy, she became eligible for surgery. Despite postoperative complications, she has recovered and is now in the post-treatment observation phase (over six months post-surgery, in good condition).
Author | Guangguang
Editor | Xianning
[Continued from Part 1] Rare Duodenal Cancer with Multiple Liver Metastases: How to Defy the Odds (Part 1) | Patient Story
「 VIII. Hesitation and Preparation Before the Consultation 」
Although Xiao Gao had thoroughly researched Dr. Wang Hongguang’s information online and already considered him for his mother’s surgical evaluation, the rise of various new media has made exaggerated or distorted content a common, almost pathological norm for traffic. Xiao Gao couldn’t help but wonder: what is the actual clinical skill of such a highly visible internet-famous doctor? A truly capable surgeon should already have overflowing clinics and operating rooms—how would they have time to film short videos?
After careful consideration, the still-uneasy Xiao Gao thought of his older sister, a medical school graduate whose classmates now work at major hospitals, including the Cancer Hospital of the Chinese Academy of Medical Sciences. He reasoned that peer evaluations would be far more reliable than the flashy academic titles online. Fortunately, after consulting several doctors, they all spoke highly of Dr. Wang, confirming his solid expertise.
With his mind finally at ease, Xiao Gao began preparing for the consultation trip to Beijing.
Given the local hospital’s rather definitive statements that there was “no surgical chance” and that “recurrence was inevitable even if surgery were performed,” Xiao Gao knew they had no room for retreat. They had to choose the best possible doctor, because if the surgery failed, his mother might lose her last chance at survival.
Xiao Gao has always deeply respected his mother’s own treatment preferences. He shared Dr. Wang’s videos with her, explaining that a new option had emerged: she might actually be eligible for surgery, and the doctor’s reputation had been verified. To ease her concerns, he carefully outlined the potential surgical risks, but also emphasized that success could mean a chance at a complete cure.
At that time, his mother, usually decisive and strong-willed, was suffering greatly from chemotherapy side effects. After a brief moment of thought, she immediately said, “Better short pain than long pain.” She and her son quickly reached an agreement, firmly deciding to fight one more time for a chance to live.
[ Traveling with parents during pre-op chemo to distract from side effects. Photo by Xiao Gao ]
With his mother's consent, Xiao Gao formally began preparing for the Beijing consultation. Using a medical record template provided by the Panda Group, he quickly organized his mother’s initial diagnosis documents. Following Dr. Wang’s video instructions, he knew he needed to bring the latest CT, MRI scans, and tumor marker results. Right after his mother’s fourth chemotherapy cycle, he had her undergo the necessary tests at the local cancer hospital. Even more encouragingly, the notoriously hard-to-book appointment was secured on the first try. Xiao Gao felt this was a sign that things were moving in the right direction. However, reality quickly tested him once he boarded the high-speed train.
「 IX. A Twisted and Turned Consultation Journey 」
Believing that thorough preparation would guarantee a smooth outcome, life instead threw a frustrating curveball: shortly after the train departed, Xiao Gao’s phone broke.
Seeing the failed message “Train has departed, don’t worry.” sent to his wife, recalling how he had just convinced her not to accompany him to Beijing, and realizing he had no cash, he felt trapped. Worst of all, the phone contained crucial medical files for the consultation. It was already late Sunday night, and the appointment was scheduled for Monday morning. He immediately realized borrowing money was unlikely, as few people carry cash nowadays. His only option was to borrow a phone, inform his wife of the situation, and have her take the earliest flight to Beijing to meet him at the station.
Fortunately, he successfully borrowed a phone. After explaining everything, his wife sprang into action. Hanging up, Xiao Gao sat in the carriage, staring at his broken phone that wouldn’t turn off or on, flashing all night as he endured a long, sleepless vigil.
His wife’s flight arrived in Beijing around 4 AM. As the sky began to lighten at 6 AM, the quiet carriage finally saw his phone, which had been flashing in sync with his anxious heart all night, finally shut down as the battery died. Just then, it miraculously powered back on and returned to normal function.
Speechless but relieved, Xiao Gao quickly contacted his wife to meet directly at the hospital. After taking a taxi and successfully checking in for Dr. Wang’s clinic, he thought he could finally proceed with the consultation. However, to his surprise, Dr. Wang frowned upon reviewing the local scans Xiao Gao had brought.
He stared at the digital scans on the laptop his wife was holding, carefully comparing them with the printed films Xiao Gao was holding up. He remained silent for a long time. About five minutes later, Dr. Wang, while lightly joking about the whole family traveling for the consultation, told Xiao Gao that while the local hospital’s imaging equipment was certainly up to standard, he could not find the multiple liver metastases Xiao Gao had described after carefully reading the films. In short, the local hospital’s radiology report did not match what the actual images showed.
Dr. Wang immediately decided to order a new Primovist-enhanced liver MRI and a full-body PET-CT at his own hospital to rule out any other potential metastases, and then reassess surgical eligibility based on the new results. He believed the initial neoadjuvant therapy had likely been quite effective, but he absolutely could not proceed with surgery blindly without a clear understanding of the tumor’s exact status based on the current scans.
After hearing Dr. Wang’s explanation, despite the high out-of-pocket cost of the PET-CT, Xiao Gao and his wife did not hesitate to pay. The scans were successfully scheduled for ten days later.
On the day of the scans, due to work commitments, Xiao Gao could not accompany them. His mother went to the cancer hospital with his father and successfully completed the imaging.
「 X. Another Tough Choice: Chemo or Surgery 」
Due to the delay from the second round of scans, the date for his mother’s next chemotherapy cycle was approaching rapidly. This left Xiao Gao torn between continuing with the fifth cycle or pausing to wait for the lengthy surgery scheduling process. He booked another appointment with Dr. Wang to discuss the scan results and next steps, and also wanted his mother to meet her future surgeon in person.
“The first thing Dr. Wang Hongguang said when he saw my mother was, ‘This elderly lady looks so healthy, she doesn’t seem sick at all.’ My mother smiled and replied, ‘Doctor, I’m here to ask you to perform the surgery.’” Xiao Gao recalled with a smile. “Then he asked me if the patient herself was fully aware of her condition. My mother answered directly, ‘Doctor, I know everything, because my son has hidden nothing from me.’ He then told me that duodenal surgery carries high risks. I said, ‘Doctor, I know there’s a certain perioperative mortality risk. Although it’s statistically low, if it happens to us, it’s 100%. But Doctor, please rest assured, if my mother doesn’t make it off the operating table, I will take full responsibility for the risk and consequences.’”
[ Traveling with parents during pre-op chemo to distract from side effects. Photo by Xiao Gao ]
「 XI. Navigating the Dilemma: Choosing the Hospital Campus 」
Thanks to Xiao Gao’s thorough preparation and study of Dr. Wang’s videos, he answered every pre-consultation question perfectly. Dr. Wang immediately issued an admission slip and informed him that surgery would likely be scheduled in about ten days, as he operates on Thursdays and the main campus only has three or four available beds. Additionally, the main campus has strict limits on hospital stay duration and a very fast patient turnover rate. However, duodenal surgery like his mother’s carries a high risk of postoperative complications and a slower recovery. This would disrupt bed turnover, and to manage complications, the hospital would likely transfer her to an affiliated medical alliance hospital, which lacks the capacity to handle emergencies effectively.
Dr. Wang patiently explained that, after careful consideration, he decided to schedule the surgery at the Langfang campus. To reassure the family, he explained that he serves as the Director of Hepatobiliary Surgery at the Langfang campus and is in charge there. The campus is newly renovated, offering a more comfortable environment with the latest facilities. If postoperative complications arise, she could remain there for proper management.
After hearing this, Xiao Gao faced another difficult choice. He agreed that Dr. Wang’s reasoning perfectly matched his mother’s situation, but the biggest drawback was that one of his main reasons for choosing Dr. Wang—his expertise in laparoscopic ultrasound and ICG fluorescence imaging—would not be available at the Langfang campus (as the campus had just opened and lacked these specific intraoperative devices).
Xiao Gao immediately voiced his concern, reasoning that if it were merely a debulking or tumor-shrinking procedure, or if the surgery couldn’t achieve complete resection due to equipment limitations, it would be suffering for nothing. Dr. Wang promptly addressed this, explaining that during the initial assessment without seeing the patient, he couldn’t decide between staged or simultaneous resection. Now, seeing his mother’s robust condition, he believed a simultaneous resection of the duodenum and liver was feasible. However, a simultaneous resection would require open surgery, not laparoscopy. Therefore, the missing laparoscopic equipment was less critical. He added that the surgical approach might still change intraoperatively based on actual findings.
Xiao Gao immediately grasped Dr. Wang’s point: if his mother underwent simultaneous resection via open surgery, Dr. Wang’s “laparoscopic expertise” wouldn’t be the deciding factor anyway, as a large L-shaped incision would be necessary. Furthermore, the latest PET-CT showed the primary duodenal tumor had no metabolic uptake, meaning it was inactive. The liver metastases showed slight uptake, indicating residual activity. Dr. Wang’s primary concern was managing the liver lesions.
After this consultation and Dr. Wang’s detailed explanation, and considering the indefinite wait for a bed at the main campus, Xiao Gao finally made his decision: they would proceed to the Langfang campus.
「 XII. Victory Achieved: Surgery Concludes Successfully 」
At 7:40 AM on August 13, 2024, Xiao Gao’s mother was wheeled into the operating room as the first case of the day. Xiao Gao, his father, his wife, and a local friend of his mother waited anxiously outside. Recalling the pre-operative discussion about potential intraoperative changes requiring immediate family consultation, and seeing other families being called in one after another, their anxiety peaked.
Therefore, even though the surgery lasted nearly seven hours, no one dared to leave the operating room door for long. They were especially mindful of the largest liver lesion, which was wrapped around the middle hepatic vein (previously deemed too difficult or inoperable by local doctors, but Dr. Wang had calmly called it “a minor issue”). Dr. Wang had mentioned she might go directly to the ICU post-op. However, their brave and resilient mother was ultimately blessed by fate: the surgery went smoothly, her vital signs remained stable, and she was transferred directly to a regular ward.
Dr. Wang’s post-operative update revealed: upon visual inspection, two liver lesions were addressed (one large lesion + one small lesion at the liver edge). Subsequent pathology confirmed the liver metastases were inactive, and the primary duodenal site showed only minimal residual well-differentiated adenocarcinoma.
Faced with this better-than-expected outcome, Xiao Gao finally allowed himself a moment of long-awaited relief. Reflecting on all the hardships, he felt they had paved the way for this positive result. His heart was filled with excitement and joy. This relief would have lasted much longer, had it not been for the subsequent onset of postoperative complications, which once again tested the family’s psychological resilience. [To be continued]
To protect patient privacy, names used in this article are pseudonyms.
Images containing patient portraits have been authorized by the patients and may not be used without permission.
< Small Donation Channel | Certified by Charity China >
< Black Tech for Easy Colorectal Cancer Screening | Fecal DNA | Non-Colonoscopy Early Screening >
Patient Stories | Click text to jump
Beijing Middle-Aged Man's Journal Fighting Late-Stage Colon Cancer | Panda Star's Anti-Cancer Magic | A Ming: Two Years Accompanying My Mother Through Colon Cancer with Liver and Lung Metastases | Qingcao: Sharing Treatment for Colon Cancer with Liver Metastases | Sibling Bond: 4 Years of Treatment for Colon Cancer with Liver Metastases | Xiao Li: A Patient's Self-Narrative of Fighting Cancer | Sister Xiuxiu: Treatment Journey for Colon Cancer with Liver and Ovarian Metastases | Brother Guo: Resilient Treatment Path for Colon Cancer with Peritoneal Metastases | Naonao: Self-Rescue Journey After Recurrence of Colon Cancer at 27 | Sister Tudou: 7-Year Anti-Cancer Journey with Colon Cancer, Lung, and Brain Metastases | Anti-Cancer Girl Yuanyuan: Living with a Smile | Jinxia: 4-Year Treatment Path for HER2-Positive Gastric Cancer | Grumpy Grandpa's Fight Against Gastric Cancer | Mickey: Treatment Path for Late-Stage Gastric Cancer at 31 | Summary from a Colon Cancer Patient's Family (Including Care Guide) | Alison: Treatment for HER2-Positive Late-Stage Colon Cancer | From Stage IV Gastric Cancer to Complete Remission | 78 Liver Metastases Did Not Mean a Death Sentence | The Late-Stage Cancer Patient Who Entered the ICU Due to Infection Is Now Tumor-Free | Panda Group Story: Weihua 1 | From Diagnosis to Recurrence | Panda Group Story Yang Yong | As Heaven Moves Vigorously, the Gentleman Strives Unceasingly | The Harsh Truth Behind Treatment Value: Why Some Patients Are Not Advised to Seek Care in Beijing, Shanghai, or Guangzhou | Anti-Cancer Blogger Fengzi Passes Away: Who Will Care for Young Patients Fighting Cancer Alone? | Lao Chen: Experience Participating in a CAR-T Clinical Trial, Over Three Years with Colon Cancer, Liver, and Lung Metastases | Sister Yangguang: Life Should Not Lose Its Color Due to Illness | Diagnosed with Colon Cancer at 16 Weeks Pregnant: Her Struggle and Rebirth | What Kind of Life Do You Want to Live? Running a Marathon with the Best Results After Colon Cancer Surgery | Real Record of Treatment for Colon Cancer with Peritoneal Metastases
Doctor-Patient Communication | Click text to jump
Peking University Cancer Hospital Shen Lin: 2023 Progress in Colorectal Cancer Immunotherapy | Step-by-Step Guide for Patients on How to Seek Care
Peking University Cancer Hospital Xing Baocai: Doctor-Patient Communication on Colorectal Liver Metastases
Sun Yat-sen University Cancer Center Chen Gong: Whether Surgery Can Be Done Immediately After Diagnosis | On Surgery for Colorectal Peritoneal Metastases | 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)
Fudan University Shanghai Cancer Center Cai Guoxiang: Patient Group Communication Q&A Record
Sun Yat-sen University Cancer Center Wang Fenghua: Patient Group Communication Record
Sun Yat-sen University Sixth Affiliated Hospital Xiao Jian: Chemotherapy, Targeted Therapy, and Immunotherapy for Advanced Gastric Cancer
Beijing Friendship Hospital Yao Hongwei: Examinations Rectal Cancer Patients Need and How to Read Reports
▽ Click "Read More" to Join the Support Group