Diagnosed at 32 with BRAF V600E Colorectal Cancer and Liver/Lung Metastases: A Girl's 101 Chemotherapy Sessions and Five-Year Rebirth | Patient Story

Author | Zhong Lala & Summer
Editor | Xianning
Reviewer | Guangguang

Part I: From "Tuberculosis" to Metastatic Adenocarcinoma: A Fatal Misjudgment by Fate

Looking back at the twists and turns of the past five years, I can now step back with a smile, recounting it as calmly as if it were someone else's story.

It all started with an unremarkable cough in November 2019. Initially just an occasional daytime tickle, it escalated by the 2020 Spring Festival into severe, sleep-disrupting wheezing that woke me up at dawn. I dismissed it as pharyngitis, and with a new job keeping me constantly busy, I just wanted to catch up on sleep whenever I could, never giving it a second thought.

As the cough worsened, I got a chest CT at my hometown hospital to return to Shenzhen sooner. The doctor initially suspected tuberculosis but reconsidered when he saw my rosy complexion and strong voice. Looking back, it was heartwarming that he personally gave me Professor Wang's phone number from the Hunan Chest Hospital, a gesture that truly surprised me at the time.

With a "nothing to lose" mindset, I reached out to Professor Wang.

I was admitted to the Chest Hospital on March 10, 2020. Twenty-one days of IV drips completely fulfilled my "KPI" for never having had an IV in my first 32 years. After all, aside from a rabies vaccine after a dog bite as a child and a shot for a seafood allergy in Shenzhen, I had never endured such treatment.

It was during the pandemic, and with fears of TB transmission, the ward was filled 24/7 with the smell of disinfectant and the stifling heat from masks. Beds were so crowded that cots filled the aisles. I was still teaching online classes and, not wanting to delay my students, set up a small desk in the ward. Interestingly, whenever I started a class, the noisy aisle would instantly quiet down as fellow patients cooperated silently. It still warms my heart to remember that.

After exhaustive TB screenings and nebulizer treatments, the cough persisted. I even started gasping for air while walking on flat ground with a wardmate. No TB was found, but my health deteriorated daily. Finally, the doctor arranged a bronchoscopy and a lung biopsy. The pathology report revealed metastatic adenocarcinoma. When the results came out, I hid in the restroom and shed a few tears, but I didn't even have the strength to cry properly, gasping like a fish out of water.

My mind went blank. I felt that the days I had finally worked so hard to look forward to were suddenly choked by fate and pushed into bottomless water, no matter how hard I struggled to reach the surface.

Fortunately, when my best friend heard the results, she didn't hesitate: "Medicine is so advanced now. If it's lung cancer, we'll go to Shanghai Pulmonary Hospital. If it's something else, we'll head to Fudan University Shanghai Cancer Center. We won't waste any time!"

Without a second thought, I bought a ticket to Shanghai that very day, completed my discharge procedures, and headed straight to the high-speed rail station. Back then, I had no idea that this long journey alongside cancer had only just begun.

Part II: The Survival Path of Late-Stage Colorectal Cancer: Chemotherapy, Surgery, and Rebirth

From Changsha to Shanghai, I essentially started a "check-in" tour of renowned hospitals in the city. Looking back, listening to my friend and coming to Shanghai was the best decision of my life—I took almost no detours in my treatment journey.

Recommended by Professor Chang at Fudan Cancer Center, I booked an appointment with Professor Li. That week, supported by my friend and sister, I shuttled between Fudan Cancer Center and Zhongshan Hospital. I had to wake up at 4 or 5 AM for early buses and drag my leaden legs back to my lodging by 5 or 6 PM. I later learned I already had a 20% right-sided pneumothorax and was short of breath just walking. Lacking experience, no one thought to rent a wheelchair. Relying on sheer stubbornness, I walked through every single test.

A PET-CT at Zhongshan Hospital finally located the primary lesion: metastatic colorectal cancer. A painless colonoscopy followed immediately. On the table, the doctor sensed something was wrong and told my family to register for an expedited special clinic for pathology. The final result hit hard: sigmoid colon cancer with multiple liver and lung metastases. Lesions in both lungs were scattered like stars, the liver had multiple spots, and mediastinal lymph node metastasis was severe. It was definitively late-stage.

It was around this time that Professor Li became my anchor in the fight against cancer. Initially, in my desperation, I had booked a gastroenterology surgery appointment, but she steered me back on track, coordinating further tests and genetic screening. Before the results were out, she started me on my first cycle of FOLFIRI chemotherapy (irinotecan + leucovorin + fluorouracil). A follow-up contrast-enhanced abdominal MRI showed the lesions hadn't grown and had even shrunk by a millimeter. Even if the doctor said it might be measurement error, it was enough to give me the courage to keep living.

The day the genetic report came out, Professor Li looked at me and her first words weighed heavily on my heart: "You're so young, how did you end up with a BRAF V600E mutation?" Hunched over, my voice trembled: "Is it... really that severe?"

She didn't answer directly but instead reassured me: "We'll start with the first-line regimen. If that doesn't work, there's a second line, and there's a new drug in Hong Kong." Back then, I didn't understand first-line or second-line treatments, nor how aggressive this mutation was, but from her words, I distinctly grasped the word "hope."

The treatment plan was quickly adjusted. From the 2nd to the 12th cycle, I endured 11 rounds of FOLFOXIRI + Bevacizumab (fluorouracil + oxaliplatin + irinotecan + bevacizumab). The chemo drugs acted like ruthless harvesters, thinning my waist-length straight hair. Looking at my bald head in the mirror, I inexplicably thought of Qiu Qianchi from Jin Yong's novels. As difficult as it was, I shared her unyielding resilience.

Knowing chemo would cause hair loss, I booked a photo shoot for four sets of portraits right after diagnosis, including wedding dresses and traditional Chinese bridal wear. Winning the "terminal illness lottery" at my prime before marriage or kids, I decided to marry myself. Enduring severe coughing pains during the shoot, I had my friend cut my hair afterward, formally bidding farewell to my past self.

Sadly, over a year later when I went to select the photos, the studio was unreachable. The pictures and negatives were lost, leaving only a few photos my sister took on her phone. I panicked at first, as they were precious mementos I risked my health to create. But I eventually made peace with it: everyone struggled to survive during the pandemic. As long as the studio owner was safe, losing the photos was fine. The courage I showed during the shoot was far more precious than any film.

After the third chemo cycle, my shortness of breath and cough surprisingly eased significantly.

A comprehensive evaluation after the fourth cycle clearly stated "tumor regression" on the report.

The side effects of the early cycles hit fast and hard: hair fell out in clumps, mouth ulcers made drinking water feel like swallowing razor blades, and my gums constantly bled. The worst was during the irinotecan infusion. Abdominal cramps came in waves, with sharp pains piercing every few seconds. I pushed through the infusion, only to face severe vomiting and diarrhea. Cold sweat soaked my inner and outer clothes. I could only squat by the toilet, unable to stand. That was my first time truly understanding what "worse than death" meant.

That pain terrified me, breaking my usual "eat even if you vomit" habit. I was afraid to touch food. Professor Li personally came to my bedside to encourage me: "Just eat. With our doctors and nurses here, what's there to fear?" That single sentence restored my courage. I picked up my bowl again—eating for an hour, vomiting within two minutes, wiping my mouth, catching my breath, and continuing to eat.

During the maintenance phase with capecitabine and bevacizumab, I started experiencing rectal bleeding. Professor Li immediately helped me contact a surgeon. I left for the hospital at 5 AM to queue for registration. After reviewing my report, Professor Xu smiled and gave me a thumbs-up: "Young lady, you're doing great!" Even more unexpectedly, she came to my bedside to explain the treatment plan: "We will preserve your ovaries. You're young and haven't had children. Even with only a 1% chance, we'll preserve them."

In mid-December 2020, I lay on the operating table. As I was wheeled into the OR, seeing sunlight streaming through the glass window, I suddenly felt certain: I would definitely get through this. The anesthesiologist's words, "The person you should thank most is yourself," are still etched in my mind.

To prevent intestinal adhesions post-surgery, I endured incision pain daily, shuffling to the end of the corridor and only turning back when my toes touched the wall. Books were placed on my nightstand and by the toilet. Waking up in pain at midnight, I would read a few pages, slowly transforming my fear of death into inner peace.

When fellow patients or their families first meet me, they usually ask if I'm married or have kids. I tell them: "In 2020 at Fudan Cancer Center, Professor Xu helped me deliver a 'tumor baby' via laparotomy!"

Post-surgery, I returned to Professor Li's clinic to continue maintenance chemotherapy with capecitabine plus bevacizumab, or bevacizumab alone. Unfortunately, capecitabine triggered hand-foot syndrome, so it was later replaced with fluorouracil, still combined with bevacizumab.

In September 2023, my lung nodules showed signs of growth. Professor Li recommended ablation therapy, referred me to Professor Wang, and coordinated the details. Three lesions were successfully treated in one session.

That October, during the National Day holiday, after experiencing high fever and chest pain post-ablation, I spontaneously decided to visit Hunan with my family. We explored Furong Town, Hongshilin, and Tianmen Mountain. At Tianmen Mountain, I hiked down from the highest peak, completing both the east and west routes without resting on the 999 steps. I walked 30,000 steps in a single day, which even I found incredible.

However, follow-up scans after ablation still showed growing lung nodules. The doctor added irinotecan to the fluorouracil and bevacizumab regimen, which I underwent 14 times. Once scans showed the disease stabilizing, irinotecan was stopped. I continued with fluorouracil and bevacizumab at the same dose, extending the chemo cycle from 14 to 21 days.

This maintenance therapy lasted nearly a year until some lung nodules grew again, briefly causing panic. The treatment was promptly adjusted to oxaliplatin + fluorouracil + bevacizumab.

To date, I have completed 6 cycles of this regimen. Good news came at the 4th follow-up: some lung nodules shrank, and the CA19-9 marker began to drop.

Part III: The Light in My Life: Those Who Warmed Me

In these "5 years and 7 months" of fighting cancer, I often reflect on what I "have" rather than what I've "lost," filling my heart with gratitude. Stumbling through life, I always tried to show more kindness to the world. I never expected that kindness to be returned with such overwhelming gentleness. Over these five years, I have never fought alone.

Let's start with family. My mother never went to school and struggles with Mandarin. Bringing her to live with me wasn't just for home-cooked meals; it was mostly to show her the outside world while I still could.

At 76, I "forced" her to learn pinyin, memorizing one a day and filling a page. Now, her handwriting is neater than mine. She also learned to check blood sugar, measure blood pressure, and properly take medication for hypertension, hyperlipidemia, and hyperglycemia. When I lost my appetite after chemo, she'd bring a bowl of millet porridge, encouraging me: "One more bite, and you'll recover faster." My third sister literally "left her husband and kids behind" to accompany me in Shanghai, running between hospitals for tests. At night, she'd secretly place her finger under my nose to check if I was still breathing. Thinking of it now still brings tears to my eyes.

Then there's my incredible best friend. Knowing her since I was 15, our 23-year bond is priceless. During my hardest times, she took me into her Shanghai home for over three years. Beyond free rent and utilities, she helped me contact doctors, cared for my mother, and meticulously organized all my medical arrangements.

Some friends I hadn't contacted in years, upon hearing my situation, immediately transferred money without a word, saying only, "Don't worry about money, just focus on treatment." Others regularly mailed me free-range chicken and fresh fish, pre-portioned and shipped via cold chain, fearing I might lack nutrition.

The medical staff were my ultimate safety net. In January 2024, when doctors planned a three-drug FOLFIRI + Bevacizumab regimen, I was deeply terrified, fearing I couldn't handle it. Professor Chang decisively said, "You can do it!" That certainty instantly gave me strength.

Over the years, starting from my second year, I've written an annual thank-you letter to Professors Li and Chang, meticulously recording their kindness to me and other patients. I also want to thank Professor Xu's team and Dr. Zheng from his former team. I'm alive to see Professors Chang and Zheng advance from regular specialist clinics to special needs experts. It feels as though, over these years, we have been "moving forward" together.

Fellow patients in the hospital also became my family. The older sister I met during my first admission, enduring her own chemo pain, still helped me fetch meals. Family members in the ward eagerly took out my bedside trash bags and brought freshly cooked porridge to my nightstand at 5 AM. A gentleman would always cook my groceries if I bought them. In the Fudan Cancer inpatient ward, I essentially ate "community meals." From security guards to cleaning staff, everyone treated me like family.

The "Panda Group" family gave me countless touching moments. Thank you, Secretary Kang, for traveling from out of town with your two children to visit me in Shanghai. Thank you, Sister Kuang, for instantly sending a red envelope to cover the expensive tissue paper I complained about at the hospital convenience store. Thank you for Da Hai's exclusive gift, Brother Wen's sponsorship, Sister Xia Tian's Qianxi chestnuts, Teacher Ye Jian's professional and warm guidance, and thanks to Lunlun, Feifei, Yanyan, and Xixi. Thank you, Director Han, for creating the Panda Group...

Of course, the treatment journey comes with a price, but I always prefer to magnify joy and minimize pain. I like to brush off chemo discomfort and test anxiety with jokes. When I see fellow patients struggling with disease progression or side effects, I always want to share my experiences to give them a glimpse of hope. That's probably what matters most to me now.

Part IV: My Little Tips for Coexisting with Mr. Tumor

I've long figured out how to "coexist peacefully" with my tumor. Every time I get a test report, I thank each "part" of my body: Thank you, my tumor "baby," for accompanying me through over five stable years. Thank you, my liver and lungs, and thank you to all the good cells that fought so hard to protect me, making me who I am today.

These little tips might offer some reference for those on the same path:

1. How to Combat Negative Emotions?

First, build enough belief to survive. In this life, I want to live for myself once, and also for those who pulled me up when I first fell—so I can stand up for them when they face difficulties. I'm a rural kid who grew up in the mud. My elementary school math teacher always said, "Eat one more bowl of rice, and you'll recover faster." I've remembered that my whole life.

From the day of diagnosis, I trusted my doctors 100%. My sister and friend always said, "As long as a doctor accepts you, there's hope." I also firmly believe: as long as I can eat, I have the strength to live.

So, over these years, I've truly tried my best to eat well. Interestingly, I thought I'd waste away to skin and bones upon diagnosis, but I actually reached a record high weight. Before diagnosis in 2020, I weighed about 52 kg. By May 2021, my net weight reached 62.6 kg, gaining about 10 kg—an unexpected bonus.

Second, shift your mindset promptly when facing difficulties. Psychologist Ellis said people aren't troubled by events themselves, but by their views of those events.

After diagnosis, I learned to "shift my mindset." While waiting for colon surgery, I received a bouquet with white carnations. I was highly anxious, thinking white was unlucky. After contacting customer service, I learned they were just seasonal flowers. I used meditation to guide myself: flowers don't carry special meanings; I was overthinking. Gradually, I calmed down, and despite some twists, the surgery went smoothly.

Post-surgery, the anal fixation stitches pulled painfully, and I even needed my sister's help to use the toilet. I felt frustrated about relying on others, but then I shifted my perspective: everyone has vulnerable moments. I just experienced mine earlier. There's nothing to be ashamed of.

When hand-foot syndrome flared up, I couldn't help scratching and peeling my feet, later regretting it for delaying my walks. I learned to respond rationally: using mindfulness to ease discomfort, disinfecting, applying medication, and gently cleaning the skin. I told myself not to be anxious about current pain; just deal with it when it arises.

Even the night before an irinotecan infusion, I proactively shaved my newly grown hair to avoid feeling sad about hair loss the next morning. After shaving, I realized my head shape actually looked quite nice—another small, unexpected gain.

2. Practical Mind-Body Management Methods

First, create a positive environment for yourself. Let's see: making small daily changes to life can accumulate the motivation to live.

For the first two years, I loved subscribing to monthly flowers, receiving a bouquet weekly. Seeing fresh flowers instantly brightened my mood. Every time I passed a follow-up scan smoothly, I'd order a book I'd long wanted. The days waiting for delivery were filled with anticipation. Occasionally, I'd adjust my diet, changing flavors to change my mood.

I stuck smiley face stickers cut from delivery boxes on my rental door and desk, washed and dried. My clothes had smiley patterns, and my friend specially bought me smiley socks.

These little items constantly remind me: no matter the circumstances, remember to smile. After crying, wipe your tears and face things with a smile. You can't change facts, but you can change your attitude toward them.

Second, moving gives you confidence. Post-surgery, doctors advised moderate exercise, warning that a second surgery for intestinal adhesions would be worse. That scared me, making me realize for the first time that "fear" can also be a motivator.

In the first few days I could get out of bed, I walked to the end of the corridor and back even with tears falling. My sister pleaded out of pity, but I didn't ease up. Back at my lodging, even if I had to run to the bathroom every half hour, I persisted in walking around the restroom area. My little nephew accompanied me then. Though he couldn't read, he recognized the toilet icon and always spotted the location for me in advance, which was incredibly heartwarming.

Maintaining appropriate activity based on my physical condition, I developed a habit of tracking my daily steps.

3. Building an External Support System

First, store all kindness in your heart. Knowing how to be grateful is crucial. Recording every bit of goodness from those around you gives you the strength to pull yourself up when you fall. People ask me, with such an aggressive BRAF mutation, how did I survive five years? I think it's because the kindness from family, medical staff, friends, and fellow patients lit up my darkest days like stars. Even once, a taxi driver, upon hearing I was a patient, quietly waived the fare. All this kindness combined became my "life-extending talisman." I once thought I wouldn't live long, but now I understand that every day alive is a bonus. Turning bitter days sweet is the greatest victory.

Second, communicate well with your doctors. Manage your own disease course. Before each clinic visit, I list my questions one by one and ask Professor Li systematically. Unless the doctor specifically mentions something, I assume my condition is fine. I'm truly grateful for the patience of Professors Li and Chang, who worried about me in ways I couldn't see.

Today, I'm still persisting with treatment. Except for pauses around surgery and a COVID infection, I've barely interrupted my "magic water" (chemo drugs) for over five years. Counting it up, my chemotherapy plus targeted therapy has reached the 101st session.

Part V: Glimmers Become Torches: Heroes in Ordinary Life

Actually, I've faced death several times in my life: carbon monoxide poisoning as a child, fainting outside with a rice bowl in hand, waking up to my father frantically scraping my skin with a coin. Another CO poisoning after college graduation, I crawled out struggling, hearing neighbors playing cards and my phone hitting the floor, not knowing how long it took to wake up. A few years ago, while cycling home from work, a car suddenly swerved toward me. My bike was totaled on the spot. Thanks to the driver's quick steering, I survived.

Encountering a "highly aggressive subtype" of cancer at my prime is unfortunate. But having so many people walk alongside me is incredibly fortunate.

A teacher in the Panda Group said she first saw me at a KTV. The petite me gripped the microphone, belting out high notes with a flushed face. She said it wasn't singing; it was life wrestling with death. Every high note was a javelin thrown at fate, every note a counterattack against pain. She also said my singing redefined life—not measured by days survived, but by the intensity of existence; not passive acceptance, but active roaring.

I always want to share my story with fellow warriors on this path: even with highly aggressive mutations, long-term survival is possible. The most important thing is to build enough belief to live, carry hope, actively cooperate with treatment, and maintain an optimistic mindset. I firmly believe the current treatment plan is the best fit for me, and I'm doing my utmost to make every dose of medication work to its fullest potential.

The formerly quiet me has now become a "chatterbox" among fellow patients, always eager to chat. It's not that I love talking so much, but that I deeply cherish our time together. After talking enough outside, I actually prefer quiet solitude back at my lodging. I want to pass on all the kindness and encouragement I've received to those around me.

The editor said the most touching part of my story isn't sinking into pain, but blooming in hardship. Not complaining about unfair fate, only grateful for every encounter. The ordinary office worker from a Shenzhen skyscraper has now become a "5 years and 7 months" newcomer coexisting with a tumor. The past hardships of daily life have all transformed into the strength to fight the disease.

Life is vast, mountains and rivers flow. 101 chemotherapy sessions, over 2,000 days and nights of perseverance—love and hope forged my miracle of life. It is also this love that wove an oasis in my heart, withstanding the long passage of time. We are all heroes in our own ordinary lives.

May we all have a patch of sky, a pure land, and an oasis in our hearts, carrying us over the hills of life.

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

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