Year 9 with an 11cm Liver Metastasis from Advanced Low Rectal Cancer: I Want to Grow Up Slowly with My Son | Patient Story

This article recounts the cancer journey of Teacher Xiao Zhu Zhuoma from the Panda Liver Metastasis Group 7, following her diagnosis of advanced low rectal cancer with liver metastasis. Now peacefully and happily entering her ninth year, she still feels some inevitable anxiety before each follow-up, yet she continues to face every aspect of life fearlessly.

"I never felt that having cancer was something to be ashamed of. From the moment I fell ill, my friends and family knew. I didn't hide it. My illness is my own business, unrelated to others, and I haven't done anything wrong. Why should I feel ashamed?"

Facing the growing number of group members adding "Xiao Zhu" to their names to "catch good luck," she hopes everyone can bear the fruit of healing on their cancer journey and move forward toward a beautiful life. She will also continue to accompany her son as he grows up, not missing any important milestones: holding his little hand as he enters primary school, staying up late with him during middle school, and seeing him off with a suitcase to a new city for college.

「 1. The Awkward "Heavy Bleeding" 」

2016 was a special year for the young Xiao Zhu Zhuoma. She experienced another joyful transition in life, becoming a mother to a sweet, soft little angel. Immersed in the joy of new motherhood, she diligently breastfed her son. Nursing mothers are often exhausted, and physical fatigue combined with mental tension can occasionally lead to breakdowns or hysteria. Yet, these "emotionally sensitive moments" usually have to be managed alone, just as they were for the new mother, Xiao Zhu Zhuoma.

The autumn of 2016 was no different from the dozens she had experienced before. In the lingering September heat of the south, she went out on errands as usual, but this trip took an unlucky turn. While walking, she suddenly felt a damp, sticky sensation on her lower body. Looking down, she realized her outer pants were soaked in blood, front and back. Enduring her embarrassment, she hurriedly searched for a nearby restroom. She never expected her period to cause such heavy bleeding at this time. Only when she squatted in the stall did she realize the bleeding was coming from the wrong place: large blood clots were continuously passing from her anus. She initially thought it was hemorrhoidal bleeding, as "nine out of ten pregnancies bring hemorrhoids" is a common saying.

However, her family remained uneasy. Accompanied by them, she visited the Suzhou Traditional Chinese Medicine Hospital. Unexpectedly, after the examination, the doctor advised her to seek consultation at the First Affiliated Hospital of Soochow University. Following a digital rectal exam in the outpatient clinic, the doctor immediately contacted her family, informing them that she needed to register with the General Surgery Department for an ultrasound and colonoscopy.

Even at this point, Xiao Zhu Zhuoma did not realize the severity of the situation. "Actually, I had surgery for a meningioma in my junior year of college in 2008. Although it was benign, doctors recommended radiotherapy to prevent recurrence. My father went to Shanghai to consult specialists, and they ultimately decided against it. I only learned about this years later. Because of this medical history, I couldn't purchase commercial insurance. Back then, I just thought I was so young and didn't overthink whether there might be a more serious issue," she recalled with a smile.

「 2. From a Nursing Mother to a Stage IV Colorectal Cancer Patient 」

The tests were quickly scheduled. During the standard colonoscopy, although Xiao Zhu Zhuoma remained fully awake, the endoscopist who had already spotted the intestinal mass said little. After quietly completing the procedure, she soon waited outside the ultrasound room. When it was her turn, the doctor didn't speak to her directly. However, this time, the ultrasound doctor made a phone call to a surgeon right in front of her. The content of that call caused Xiao Zhu Zhuoma, who walked out of the examination room in a daze, to break down in tears at the busy entrance: she had a massive tumor on her liver, and it didn't look good.

Based on the colonoscopy and ultrasound results, the general surgeon promptly arranged further imaging. The results indicated a malignant rectal tumor invading the pelvic wall, with pelvic lymph node and liver metastases. There was only one lesion on the liver, but it measured a full 11 centimeters. The colonoscopy pathology revealed adenocarcinoma located 6 centimeters from the anus, and the previous heavy bleeding was caused by tumor prolapse. Given her advanced stage, the doctor ordered genetic testing and immunohistochemistry, and recommended immediately starting a XELOX chemotherapy regimen combined with bevacizumab while awaiting the results.

[ The last breastfeeding session the day before chemotherapy ]

「 3. Severe Radiation Enteritis 」

Even after being admitted and lying in the hospital bed waiting for chemotherapy, Xiao Zhu Zhuoma still felt detached. By today's internet slang, she is a "calm person." This temperament stems from an ordinary, uneventful life and perhaps her innate nature. Facing a stage IV cancer diagnosis just past her thirties, aside from that breakdown outside the ultrasound room, she quietly followed the doctors' arrangements and her family's comfort. The only two things that filled her with profound guilt and helplessness were her infant son, who was just a month away from weaning, and her mother, who had to care for her while also looking after her own father, who was already battling leukemia.

Faithfully undergoing treatment was her greatest way to repay her family, so she abruptly weaned her son and was hospitalized immediately. Fortunately, the side effects of the first two chemotherapy cycles were manageable. The real nightmare began when the surgeon suddenly scheduled radiotherapy.

Even today, recalling this experience makes her heart race. "The radiation enteritis came on too suddenly. I started vomiting and having diarrhea uncontrollably until I couldn't even stand. I threw up everything I ate and had diarrhea even from drinking water. Finally, I was rushed to the emergency room by ambulance overnight. After contacting my attending surgeon, he immediately halted my anti-tumor treatment and arranged for me to recuperate at a rehabilitation hospital for a while. Once admitted, I endured a painful week of fasting and water deprivation, sustained only by IV fluids. The doctor explained this was to allow my disrupted intestines to recover."

「 4. Chemotherapy Works VS. Hitting a Treatment Bottleneck 」

By the time she was discharged, it was late October. After this severe bout of radiation enteritis, Xiao Zhu Zhuoma decisively transferred to the medical oncology department, which had more chemotherapy experience. Around this time, her genetic and immunohistochemistry results came back: microsatellite stable (MSS) with a wild-type profile and no mutations, making cetuximab the preferred targeted therapy. However, after evaluating her previous treatment response, the medical oncologist deemed the chemotherapy effective and decided to keep the original regimen. Thus, she began another six cycles of XELOX combined with bevacizumab.

After six cycles, imaging showed the liver tumor had shrunk by half, from 11 centimeters down to about 6 centimeters. This remarkable response delighted everyone. The doctor then devised a new plan: four cycles of FOLFOX combined with cetuximab, aiming for maximum tumor conversion. "But the higher the expectations, the greater the disappointment. After four cycles, another imaging assessment showed no change in the liver tumor. This was completely different from my previous drug sensitivity. We were all deeply discouraged, and my attending physician suggested we consult an interventional radiologist."

「 5. A Turn of Events and Successful Surgery 」

Consulting the interventional radiologist yielded a completely different opinion from the medical oncology team. After carefully reviewing the scans, the interventional doctor concluded that the liver tumor had almost no blood supply, making interventional therapy unsuitable, and recommended proceeding directly to surgery.

In April 2017, Xiao Zhu Zhuoma finally underwent surgery. After surgical evaluation, a synchronous resection was performed. The operation went very smoothly, and thanks to the natural advantage of her youth, her recovery was also smooth. Everything seemed to be moving in a bright direction. If not for the grueling postoperative chemotherapy, she would have been even more overjoyed at her rebirth.

[ Recovering after surgery ]

「 6. To Stop Treatment or Maintain: That Is the Question 」

In May 2017, amidst the vibrant spring, her one-month postoperative check-up went smoothly. Considering the previous massive liver tumor, doctors recommended continuing the original chemotherapy regimen post-surgery. From May to July, through late spring and into the scorching summer, Xiao Zhu Zhuoma endured five cycles of high-intensity chemotherapy. She suffered from severe mouth ulcers that prevented eating, and an intensely itchy rash covering her entire body that she couldn't scratch or touch. The humid heat of the south made her physical discomfort even worse. Even her "calm" demeanor completely broke down under the torment. "I was mentally very resistant to chemotherapy, but local doctors recommended continuing it. So, I visited Director Zhu Xiaodong at Fudan University Shanghai Cancer Center. I was hoping I could maintain treatment with cetuximab monotherapy, but Director Zhu told me it was either conventional chemotherapy maintenance or simply stopping treatment altogether."

Xiao Zhu Zhuoma decided to take a brave leap: stop treatment and enter follow-up.

Fortunately, Xiao Zhu Zhuoma became a miracle herself. From her surgery in 2017 to the present, every follow-up has gone smoothly. She has not experienced a single recurrence during this time. Healing seems to have taken root and blossomed quietly within her.

[ Follow-up in 2018 ]

「 7. My Nine Years 」

"For the first three years after my colorectal cancer surgery, I basically couldn't live a normal life. Having diarrhea over ten times a day made me afraid to take buses or taxis. When I had to go out, I always chose the subway because stations have restrooms everywhere. Fortunately, starting in the fourth year, this situation gradually improved. Now, I can even travel long distances with my family."

"When I was diagnosed, my son hadn't been weaned yet. I remember lying in the hospital bed when a fellow patient in the same room told me, 'You must undergo treatment properly, so you can watch your child enter primary school, middle school, and go to college.' Perhaps a child truly gives a mother infinite strength. This kind of spiritual power is truly magnificent."

"My decision not to work was made after considering various factors. On the contrary, I believe that stage IV cancer patients, when their treatment is stable and their physical strength allows, can consider finding a suitable job to realize their life value. There's nothing wrong with that. Although I don't work now, I have fallen in love with learning English. I study and progress alongside my son."

Teacher Xiao Zhu Zhuoma slowly shares her true thoughts in the calmest tone. Today, she is occasionally active in the Panda Liver Metastasis group, offering sincere advice to fellow patients who need it. Facing the growing number of group members adding "Xiao Zhu" to their names to "catch good luck," she hopes everyone can bear the fruit of healing on their cancer journey and move forward toward a beautiful life. She will also continue to accompany her son as he grows up: holding his little hand as he enters primary school, staying up late with him during middle school, and seeing him off to a new city for college.

[ Summer vacation travel photos in 2025 ]

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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Shen Lin, Peking University Cancer Hospital: 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 Metastasis

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

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