Two Cancers in Five Years: The Unbeatable "Lynch" Optimist | Patient Story

Author | Chanchan
Reviewer | Guangguang
Editor | Xianning

On an ordinary morning in August 2024, in a park in Yueyang, Hunan, 61-year-old Mumu’s father was enjoying a leisurely walk as usual. A sudden dizzy spell made him collapse. Rushed to the hospital and diagnosed with a sudden cerebral infarction, he was unexpectedly pulled into a cancer vortex, beginning a long and arduous journey against the disease.

Part I: Lynch Syndrome Diagnosed Through Colon Cancer

The family's "entanglement" with cancer was quietly seeded by fate over thirty years ago. In 1992, Mumu’s father underwent a partial gastrectomy for a duodenal ulcer. Doctors specifically advised regular gastroscopy follow-ups, but his easygoing and independent nature led him to dismiss it. Over time, this crucial advice was gradually forgotten in their peaceful daily life.

In September 2015, Mumu was diagnosed with Stage IIB colon cancer. In the clinic, the term "Lynch syndrome" from the colon cancer treatment guidelines first connected the dots with the colon cancer history of several of her father’s uncles: "I vaguely felt back then that the cancer in our family wasn't a coincidence."

Time jumped to July 2019. Mumu’s father sought medical help for rectal bleeding and was diagnosed with early-stage rectal cancer, undergoing laparoscopic surgery. This episode made Mumu more vigilant. In 2020, she learned about a public welfare genetic testing program for Lynch syndrome led by Prof. Ding Peirong’s team at Sun Yat-sen University Cancer Center. Through the "Panda Group," she signed up. The results confirmed her suspicion: Mumu is a Lynch syndrome patient. This hereditary condition significantly increases the risk of colorectal cancer, stomach cancer, and other malignancies, often with an earlier onset.

Mumu immediately shared the results with her father, warning him of the cancer risk. "But he remained remarkably open-minded, as if it didn't concern him, staying optimistic and carefree," Mumu said.

[ Mumu's father before his cancer diagnosis ]

This "live for today" attitude meant that even after rectal cancer surgery, he continued to smoke, drink, and stick to his love for spicy food.

In late February 2024, before the festive New Year atmosphere had fully faded, Mumu’s father was hospitalized for acute gastric bleeding. The alarm bell rang again. Yet, after brief treatment, he still ignored the advice for "regular follow-ups," until the August stroke incident brutally unveiled the reality of hereditary cancer.

Part II: Stomach Cancer Triggered by "Lynch"

On August 18, 2024, Mumu’s father was urgently hospitalized for a cerebral infarction. Considering his colon cancer history, Mumu suggested tumor marker tests. The results showed CA199 at 1500 U/mL, nearly 40 times the normal limit (≤37 U/mL).

"With CA199 this high, something is definitely wrong." Mumu insisted on further examinations. Aware of the medical resource gap in third-tier cities, after the acute stroke phase, she advised her mother to take her father from Yueyang to the First Affiliated Hospital of Sun Yat-sen University in Changsha. The final PET-CT indicated "uneven thickening of the gastric wall on the greater curvature of the stomach body with abnormally high glucose metabolism; a lymph node at the root of the mesentery with abnormally high glucose metabolism, highly suggestive of stomach cancer with mesenteric lymph node metastasis."

[ PET-CT Report ]

When the shocking word "cancer" appeared again, Mumu, who had mentally prepared herself, felt a mix of sorrow and relief: sorrow that it wasn't just a stroke, relief that she hadn't let her guard down this time. "This result was somewhat expected. Ever since learning about our Lynch family history, I felt this day would eventually come. But this time, I absolutely won't let my father suffer needlessly." Even recalling it calmly now, her resolve remains firm.

She recalled the 2019 rectal cancer treatment—"not exactly smooth," Mumu said. Due to limited local medical resources, her father endured a difficult journey seeking care. To get an accurate pathological diagnosis, he underwent multiple colonoscopies within a single month. The final result: villous adenomatous hyperplasia with high-grade intraepithelial neoplasia. Following medical advice, he underwent laparoscopic anterior resection of the rectum. Postoperative pathology revealed "villous tubular adenoma with well-differentiated adenocarcinoma, invading the submucosa, two tumors."

[ 2019 Rectal Cancer Treatment Record ]

Although it was early-stage with no metastasis, a temporary stoma was created during surgery. Mumu’s understanding of a "stoma" was vague then, only knowing it was "an opening on the belly for bowel movements." When her father was wheeled out of the OR, the wound covered by a transparent stoma bag looked like an ugly patch, stinging Mumu’s eyes. From that day on, the man who loved cleanliness and socializing began to shy away from wearing short sleeves in summer, afraid others would see the "abnormality" on his belly.

Fortunately, with his naturally optimistic nature, Mumu’s father gradually accepted the bodily changes through repeated stoma care and successfully underwent stoma reversal surgery half a year later. But Mumu knew the pain from repeated colonoscopies, the inconvenience of the stoma, and the physical toll had become hidden sorrows in her father’s heart.

She always felt that if she had known more about medical care back then and found a more professional hospital sooner, her father wouldn't have suffered so much. "It was my fault. If I had persisted more and consulted another doctor back then, would things have been different?" This thought, like a thorn, had been lodged in Mumu’s heart for years.

In 2024, facing her father’s second cancer diagnosis, Mumu decisively declared: "I will take him to the best hospital for treatment!" She refused to let "ignorance" and "hesitation" cause him any more suffering.

Part III: The Difficult Gastroscopy

In September 2024, through recommendations from fellow patients in the Panda Group, Mumu resolutely took her father to consult Dr. Qiu Haibo at Sun Yat-sen University Cancer Center, even without a registered appointment. She successfully got him added to the outpatient list. "Dr. Qiu, my father has Lynch syndrome and a history of rectal cancer. His CA199 is now over 1500. Please take a look." She handed over all his medical records and reports.

Considering his history and the recent PET-CT, Dr. Qiu first ordered a gastroscopy to clarify the condition and save costs. However, Mumu never expected that this routine procedure in China would become a major hurdle.

[ First Gastroscopy Report at SYSUCC ]

Due to his stroke history and ongoing anticoagulant medication, taking biopsies during gastroscopy carried a high risk of severe bleeding. When the endoscopy doctor saw "stroke medication" on the chart, they immediately refused: "We can't do it. If severe bleeding occurs or a new stroke is triggered, no one can bear the responsibility." Despite Mumu’s repeated explanations of the urgency, the doctor stood firm. Helplessly, they went to the First Affiliated Hospital of Sun Yat-sen University to try their luck.

There, after evaluation, the doctor agreed to attempt a standard gastroscopy. Yet, the process was still not smooth: the endoscope explored the stomach for a long time, and multiple biopsies were taken, but the pathology report came back "no cancer cells found."

"The imaging clearly suggested stomach cancer, so how could they miss it on biopsy? It felt like a bucket of cold water was poured over me. I was extremely anxious, fearing we'd miss the treatment window," Mumu recalled. Holding onto a sliver of hope, she returned to SYSUCC with her father, communicated repeatedly with a doctor, and finally pleaded: "We understand the risks and are willing to sign the informed consent. We will bear all consequences. We just need a clear diagnosis." Perhaps moved by her persistence, the doctor finally agreed and successfully obtained the lesion tissue.

Just as their hearts settled, a new twist emerged: the pathological molecular diagnosis showed "Microsatellite Stable (MSS)," which contradicted the "Microsatellite Instability-High (MSI-H)" typically seen in Lynch syndrome patients. "The director saw the report and immediately said 'This isn't right,'" Mumu remembered clearly. Dr. Qiu instantly called the pathology department to request a re-evaluation. "He said that based on the family history and clinical picture, Lynch-related stomach cancer is highly suspected. We can't conclude based on a single test."

[ Different Results from Two Immunohistochemistry Tests ]

After pathology confirmed primary stomach cancer, Dr. Qiu formulated a "neoadjuvant therapy + surgery" plan. To avoid delaying treatment during the molecular re-evaluation, they first arranged one cycle of "chemotherapy + immunotherapy" combination treatment. The subsequent re-evaluation confirmed the professor's judgment: MSI-H. This result meant immunotherapy would likely be highly effective. From then on, Mumu’s father began single-agent immunotherapy, frequently traveling between Hunan and Guangzhou.

Part IV: The Emergency Halted Surgery

In February 2025, after three cycles of neoadjuvant therapy, imaging showed tumor shrinkage and no enlarged lymph nodes, meeting surgical criteria. Dr. Qiu immediately scheduled the surgery, determining a total gastrectomy was necessary—due to the tumor location and Lynch syndrome history, total removal was the best choice to reduce recurrence risk.

Due to a sudden family matter, Mumu couldn't go to Guangzhou immediately, so her mother took her father to SYSUCC for admission. The whole family was immersed in the complex emotions of "finally facing the decisive battle."

However, on the eve of surgery, during rounds, the attending doctor asked, "Is he taking any medications recently?" Mumu’s mother instinctively replied, "He's been taking his stroke medication continuously, never stopped." The doctor's expression instantly changed: "How can we operate if he hasn't stopped the medication? There will be massive bleeding during surgery!" The surgery was urgently halted.

When Mumu received her mother's tearful call, her heart sank. "How could it be stopped just like that?" After clarifying the situation, Mumu followed the doctor's instructions: her father stopped anticoagulants for ten days, receiving daily low-molecular-weight heparin injections as "bridge therapy" to prevent thrombosis. "It was likely an oversight in preoperative communication; our information wasn't synchronized with the doctor. But dwelling on it is pointless now. The priority is solving the problem."

During this period, they temporarily stayed at a cousin's place in Guangzhou, traveling to the hospital daily for injections. Initially, her father was irritable, grumbling about the "hassle," but seeing his family tirelessly running errands for him—registering, fetching medicine—his anxiety and frustration gradually melted into warmth and guilt. "His mindset is actually quite good. He just complains a bit, sometimes even comforting us, saying 'It's fine, a few days' delay won't change anything,'" Mumu said.

After the medication pause, Mumu’s father was readmitted in March 2025. On surgery day, Mumu and her family waited anxiously outside the OR until the doctor emerged saying, "The surgery was very successful." The family's tense nerves finally relaxed. "Although the process was tortuous, the outcome is ultimately good," Mumu said. "Looking back, halting the surgery was terrifying but ultimately a 'close call' that avoided intraoperative massive bleeding. Post-surgery, my father feels great, had no complications, and was discharged smoothly."

[ Total Gastrectomy Record ]

Despite the twists and turns and the removal of his entire stomach, Mumu’s father’s natural "optimist" personality remains unchanged. Soon after surgery, eager to satisfy his appetite, he ignored the "at least six months of liquid diet" advice and started eating rice and other solid foods. "We bought enteral nutrition powder, but he refused it, saying it doesn't taste as good as rice," Mumu said helplessly. Now, he often experiences choking and reflux while eating, and was even hospitalized for indigestion, losing significant weight. Even so, he still can't quit spicy food. "Nothing major, just enjoy each day as it comes," has become his mantra, leaving his family both heartbroken and exasperated.

Currently, Mumu’s father has completed three cycles of postoperative immunotherapy. Although he developed a leg rash as a side effect, it is controlled with medication and doesn't hinder treatment. As planned, after three to five more cycles, if all tests show no significant abnormalities, he can conclude treatment.

Part V: The "Qi" in "Lynch" Stands for "Miracle"

Looking back on the long cancer journey, Mumu’s mind is filled with the figures who helped her through the darkest times, her heart overflowing with gratitude.

"I am deeply grateful to Prof. Qiu Haibo for his exceptional skills and rigorous attitude, insisting on re-evaluating the diagnosis and formulating a precise treatment plan. I also want to thank the Panda Group public welfare organization. Thanks to Director Han's reminder, I could participate in the Lynch syndrome genetic testing, uncovering our family's hereditary risk. On countless confused nights, fellow patients from all over the country selflessly shared their experiences and provided immediate emotional support. Especially living in a third-tier city with limited information, their advice saved me from detours and led me directly to Dr. Qiu Haibo, an expert in Lynch-related cancers. Their help has been a series of guiding lights, illuminating the right path as I accompanied my father over this mountain of cancer."

Her deepest gratitude, however, is reserved for her closest family. "Thank you to my mother, whose dedication is warm porridge and gentle sponge baths, the strongest backing for two generations fighting cancer. Thank you to my brother, whose silent companionship is a steadfast support through storms. And most importantly, thank you to my father. His trust gave me the courage to fight fate time and again, and finally allowed me to make up for the regrets of 2019, slowly lifting the heavy burden of guilt."

Today, Mumu is transitioning from a "light chaser" to a "guide." She frequently answers questions in the Panda Group, reminding patients with a family cancer history to "get genetic testing early and seek professional medical teams." The shadow of Lynch syndrome may never fully dissipate, but with vigilance and proactive management, "we can weave armor against the disease."

At the end of the interview, Mumu shared a "surprise" from her journey: Diagnosed with colon cancer in 2015, after open surgery and eight cycles of chemotherapy, Mumu was fortunate to conceive her second child. The little angel is now almost 7 years old! She hugs her grandfather's neck and says, "Grandpa, get well soon so you can take me to the park."

So you see, cancer may take our health, but it can never take our hope for life. As long as we don't give up, unexpected warmth and miracles always lie ahead.

[ Mumu's father after surgery ]

To protect patient privacy, names in this article are pseudonyms.
Images featuring patients are used with authorization and may not be used without permission.

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