If Hardship Is Life's Truth: Nourishing Hope with Optimism as a Late-Stage Lung Metastasis Patient | Patient Story

Hello to all the little bears in the Panda Group. I am Cao Cao, a middle-aged woman who remains optimistic and pure-hearted.

Initially, I hesitated to document my difficult cancer journey in writing. However, thanks to the encouragement from Yunduo, an administrator of the Panda Lung Metastasis Group, I have gathered the courage to share my emotional and medical journey with you all through this article.

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Author | Cao Cao (Lung Metastasis Group 1)

Editors | Guangguang, Xianning

「 I. That Unforgettable Day 」

In March 2024, the damp chill of a late spring cold snap still lingered in the south. While on a business trip, I suffered from severe stomach pain that left me unable to eat anything. Over four days, I successfully lost 7 jin (about 3.5 kg). On my way back, I even joked with my colleagues about how easy the weight loss was.

Yet, deep down, I felt something was wrong. Even with acclimatization issues, it shouldn't have caused such drastic weight loss and eating difficulties. So, during my trip, I quickly asked a colleague to help schedule a gastroscopy and colonoscopy, so I could go straight to the hospital for a check-up upon returning home.

On Saturday, March 18, 2024, I arrived at the hospital at the scheduled time. After thorough preparation, I lay on my side on the procedure bed as instructed by the nurse. The doctor told me I would just need to take a nap. True to his word, I was wheeled in and soon wheeled back out to the ward.

I don't know how much time passed. Half-asleep, the doctor came to my bedside and said they planned to immediately remove a section of my intestine. Hearing this, I jolted awake. After processing his words, my mind went blank: Why would a colonoscopy require intestinal surgery?

I urgently asked my family for details about the colonoscopy. They comforted me, saying it would be fine, but added that if surgery was needed, we should go to Shanghai. My alarm bells rang. I knew it wasn't that simple, so I quickly decided to travel to Shanghai for a consultation the following Monday.

「 II. So, I Have Colon Cancer 」

Despite my repeated questions, my family ultimately didn't tell me what had happened. Though I suspected something was wrong, my instinct drove me to keep reassuring myself that it was probably nothing serious.

I went to Shanghai Xinhua Hospital and booked an appointment with Dr. Wang Zhongchuan in the Colorectal Surgery Department. After reviewing my scans and records, he simply comforted me, saying I was young and that we would fight this together. Dr. Wang quickly admitted me and began preoperative preparations. It was only after settling into the ward and observing my roommate's condition that I realized I had cancer.

"It can't be, it can't be. It's just a growth in my intestine. It could be benign!"

I kept comforting myself.

"Even at worst, if it is cancer, it must be early stage. Don't be afraid, it's fine! How could someone as kind and caring as me get cancer? It can't be!"

But reality slapped me hard. I was diagnosed with sigmoid colon cancer, adenocarcinoma. The tumor had infiltrated the subserosal fibrofatty tissue, invaded nerves, showed tumor emboli in the vessels, and metastasized to pericolic lymph nodes. The postoperative pathological staging was: pT3N1M0, Stage IIIB.

When all illusions shattered with this diagnosis, my world plunged into darkness. I cried bitterly, questioning heaven's unfairness!

Why me? Why me? Why me?

In the first half of my life, I was kind to others, never fought for anything, always considered others' feelings, never made things difficult for anyone, and always put others first. I never imagined I would get this disease. My heart felt profoundly unbalanced. All my dissatisfaction, indignation, and complex emotions erupted in that moment.

「 III. The Chemotherapy I Had to Face 」

After a month of postoperative recovery, I began adjuvant chemotherapy in late April. The regimen was FOLFOX, administered once every 14 days for a total of 12 cycles.

Because my baseline health was weak and my white blood cell count was below normal, I started using short-acting white blood cell-boosting injections from the very first cycle, followed by long-acting injections after each session to maintain my levels.

The initial cycles went relatively smoothly. Aside from poor appetite and fatigue caused by side effects, my body gradually recovered a few days after each treatment.

However, after the sixth cycle, my platelet count suddenly dropped to 60. In chemotherapy, a drop in platelets is often more challenging to manage than a drop in white blood cells. Before every subsequent cycle, I had to take oral hetrombopag combined with TPIAO injections to meet the blood count requirements for chemotherapy, which also delayed my treatment schedule by a week each time.

「 IV. The Chemotherapy That Had to Be Interrupted 」

I struggled to maintain my blood counts, but during the ninth cycle, I still experienced a severe allergic reaction: sudden breathing difficulties and widespread redness. My family immediately called the doctor. After observation and diagnosis, the doctor determined that the cumulative toxicity of the chemotherapy drugs had caused an oxaliplatin allergy, and I had to stop the medication immediately.

Ultimately, I only completed 8 out of the planned 12 cycles and was soon discharged. The doctor said platelets would normally recover naturally within half a month without medication, but mine remained stuck between 50 and 70.

Given my condition, the doctor reluctantly advised me to conclude the chemotherapy. I then began follow-up visits every three months.

During this period, I constantly searched online for information related to my condition. By chance, I discovered the Panda Group and immediately joined this supportive community. After joining, I learned a lot of professional knowledge about colon cancer and finally gained a more systematic and comprehensive understanding of my illness.

「 V. Lung Metastasis Found During Follow-up 」

Because I hadn't completed the full chemotherapy course, I always felt uneasy. When it was time for my follow-up, I booked an appointment early. Fortunately, the first follow-up showed my tumor markers were within normal ranges. However, a plain chest CT soon revealed new nodules in my lungs, suspected to be metastases.

My attending doctor told me not to be too nervous. He explained that the nodules were currently too small to definitively characterize, and since my CEA levels were normal, we could just continue monitoring them.

Following his advice, I decided to put my worries aside. I gradually returned to work, ate regularly, exercised for half an hour daily, went to bed by 9:30 PM, avoided excessive phone use, and maintained a disciplined routine. As time passed, I felt everything was improving, and my mood lifted.

Amid this fulfilling life, my second follow-up arrived. While waiting for the results, I prayed constantly. But just like before, reality crushed my hopes. The worst outcome occurred: my tumor markers had risen, and the chest CT showed the nodules were growing.

The doctor recommended a PET-CT scan to further clarify the nature of the lung nodules. The results still indicated multiple bilateral lung nodules with increased metabolic activity, suspected metastases. Subsequently, my doctor initiated a multidisciplinary team (MDT) consultation. The MDT confirmed lung metastasis, identifying 7 visible nodules on the scans, with the largest measuring 7mm.

Xinhua Hospital recommended immediate surgical resection. My mind had already crashed from the news of lung recurrence and metastasis, labeling me a late-stage cancer patient. I could only hear the doctors urging immediate surgery and scheduling. It wasn't until I got home that I snapped out of it. I quickly consulted the group members about treatment options for multiple lung metastases and where to seek care. They promptly replied, advising against immediate surgery and suggesting I consult a medical oncologist first. I am deeply grateful to the Panda Group for their crucial support at this turning point, which helped clarify my treatment path.

I immediately transferred to Fudan University Shanghai Cancer Center to consult Professor Chen Zhiyu in the Medical Oncology Department. I began a new round of chemotherapy: bevacizumab + oral capecitabine, on a 21-day cycle. After taking capecitabine for 10 days at home, I developed a severe swelling and allergic reaction in my hands and feet. The doctor advised stopping the medication immediately and switching to bevacizumab + fluorouracil chemotherapy on a 14-day cycle.

Due to the impact of previous chemotherapy doses, my spleen enlarged and my platelet count dropped. Before each cycle, I still had to take avatrombopag + TPIAO to raise my platelets to normal levels before proceeding with chemotherapy.

「 VI. The Hard-Won Ablation 」

After five cycles, my tumor markers continued to decline. Seeing my good response, Dr. Chen recommended I immediately consult the Interventional Radiology Department to assess whether the lung tumors were suitable for ablation. Through Dr. Chen's referral, I met Professor He Xinhong in Interventional Radiology. After reviewing my case, she immediately scheduled my surgery for the following month.

Currently, my treatment is progressing in a positive direction. I firmly believe that as long as I hold onto an unyielding spirit, I can walk further on the path to overcoming cancer.

「 VII. Endless Gratitude 」

Finally, I want to thank the Panda Group again. Thank you to the volunteers for your selfless guidance, which has helped many patients like me find the right treatment direction on our cancer journeys. The Panda Group has become our most reliable and solid backing, bringing us countless warmth.

Lastly, I want to share a message with my fellow warriors: You are not fighting alone! You are stronger than you imagine. Every step of our perseverance is strength, and every glimmer of light gathers here. We are all here, walking with you to believe in the light!

To protect patient privacy, the 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.

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Doctor-Patient Communication | Click text to jump directly

Peking University Cancer Hospital Shen Lin: Step-by-Step Guide for Colon and Gastric Cancer Patients on How to Seek Medical Care

Peking University Cancer Hospital Xing Baocai: Doctor-Patient Communication on Colon Cancer Liver Metastasis

Sun Yat-sen University Cancer Center, Guangzhou Chen Gong: Whether Surgery Can Be Performed Directly After Colorectal Cancer Diagnosis | On Surgery for Colorectal Peritoneal Metastasis | On Treatment Strategies for Colorectal Liver and Lung Metastasis

The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou Xiao Jian: Chemotherapy, Targeted Therapy, and Immunotherapy for Late-Stage Gastric Cancer

Beijing Friendship Hospital Yao Hongwei: Examinations Rectal Cancer Patients Need and How to Read the Reports

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