A Remarkable Turnaround in Advanced Colorectal Cancer with Peritoneal Metastasis: Achieving Pathological Complete Response After Uterus and Ovary Removal | Patient Story

I met Sister Yajuan and her mother at Changzheng Hospital. When I first saw her mother, she had just undergone surgery and was receiving HIPEC, yet she still smiled and chatted with us. Hearing about her cancer journey, I was deeply moved by her profound optimism. It was more powerful than any encouragement, leaving a lasting impression of her strength and gentleness.

Sister Yajuan’s family shows us through their actions that peritoneal metastasis is not the end, and late-stage cancer is not a dead end. Her mother’s optimism is her foundation, while her family’s companionship and perseverance are the strength that carries her forward.

This patient story is dedicated to all group members navigating peritoneal metastasis: please do not give up hope. Like her mother, maintaining optimism and adhering to standardized treatment can lead to better outcomes.

To every member of the peritoneal metastasis group,
— Tiantian

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Author | Yajuan & Dun'er

Editor | Dun'er

Reviewer | Guangguang

The following is Sister Yajuan’s firsthand account of accompanying her mother through cancer treatment:

「 Part 1: From Chronic Hemorrhoids and Constipation to a Rectal Cancer Diagnosis 」

My mother used to be quite heavy, weighing up to 130 jin (65 kg) at her peak. However, in 2024, she suddenly lost a significant amount of weight, dropping to just over 80 jin (40 kg).

In our hometown in Jiangxi, spicy food is a staple, and many villagers suffer from hemorrhoids, including my mother. In May 2024, on a neighbor’s recommendation, she had hemorrhoid surgery at a local town hospital. Shortly after, she began experiencing abnormal bowel movements.

She often woke up in the middle of the night needing to use the bathroom but couldn’t pass stool. When she mentioned this to neighbors back home, they told her it was normal to have such symptoms a year after hemorrhoid surgery. Believing it was just a postoperative side effect, she didn’t even tell us about a single episode of rectal bleeding.

My mother always believed that as long as she had a good appetite and could still work, her health was fine. However, during a gathering with friends, I mentioned her symptoms. One friend warned me that alternating constipation and diarrhea should be taken seriously.

After returning home, my brother and I discussed it and decided that, no matter what, we had to take her to the hospital for a check-up.

On March 10, 2025, my mother was diagnosed with rectal cancer. Surprisingly, the doctor who reviewed her colonoscopy and pathology reports was quite optimistic. He noted that the tumor was located relatively high from the anus and was Stage II, which he considered a routine surgery for any top-tier hospital.

At the time, our family knew very little about rectal cancer. We had only heard that “once it’s cut out, you’re fine.” Combined with my busy work schedule, I didn’t have the energy to research deeply and simply trusted the doctor’s judgment.

A classmate of my brother suggested getting a PET-CT scan for further evaluation. However, the local hospital lacked the equipment, and given the doctor’s confidence, we quickly scheduled the surgery.

Looking back, the preoperative CT report mentioned “slightly enlarged lymph nodes visible in the retroperitoneum.” Unfortunately, the local doctor missed it, and due to our lack of medical knowledge, we failed to notice this crucial detail.

「 Part 2: The “Incomplete Resection” and a Failed Surgery 」

On March 15, what we thought would be a smooth surgery was unexpectedly interrupted after just one hour. My brother called me, saying that during laparoscopic exploration, the surgeon found: “Multiple millet-like nodules were observed on the upper part of the rectal mass above the peritoneal reflection, involving the vagina and upper cervix, as well as the left broad ligament and right uterine adnexa.”

The doctor immediately presented two options: either continue with the resection, but it might not be complete, or create a stoma. My mind went blank. I didn’t know what to do. I hadn’t even heard the term “stoma” before, let alone understood its purpose.

In a panic, I reached out to several relatives and friends who had colorectal cancer, but none had encountered this situation.

Half an hour later, my husband helped us make a decision: do not proceed with any further resection, and go directly to Shanghai.

Looking back, I am deeply grateful to him. At the time, I didn’t fully understand what “incomplete resection” meant. A fleeting thought crossed my mind: maybe we should just continue since she’s already on the operating table. I later learned what it truly means, and I realized how critical the first surgery really is.

Once my mother’s surgical wound had slightly healed, my brother brought her to Shanghai to stay with me. We visited several hospitals. At Zhongshan Hospital, after reviewing her medical records from our hometown, the doctor told us that the multiple millet-like nodules were very serious, and there was also suspected liver metastasis. He explained that the cancer cells had likely spread throughout her body and advised us to first get genetic testing done, then transfer to the medical oncology department once the results were out.

Hearing this, I couldn’t stop crying. I felt completely panicked and helpless. I had always assumed my mother only had early-stage rectal cancer that could be cured with surgery. I never imagined it would be this severe. In that hospital, which I used to know so well, I walked around in circles three times, completely unable to find the exit.

「 Part 3: “The Most Advanced Stage”: Confirmed Peritoneal Metastasis 」

After the first surgery failed, I searched online using my mother’s medical records and discovered the “Panda Group” on Zhihu. I joined this supportive community. Initially, I joined the gastrointestinal tumor group, which contained extensive foundational disease knowledge. After carefully studying it, I realized my mother’s condition was likely pelvic peritoneal seeding metastasis, which is much more severe than typical colorectal cancer.

I later joined several other groups, including those for ovarian metastasis, peritoneal metastasis, and a specialized pelvic floor team, hoping to find a glimmer of hope to save my mother from fellow patients’ experiences.

On the recommendation of group members, I booked an appointment with a specialist at Zhongshan Hospital. During the 14-day wait, I relied on the professional materials compiled by the Panda Group to educate myself about rectal cancer. I read Director Han’s article multiple times, which gradually calmed my panic. Since my mother was experiencing a partial bowel obstruction, I followed the group’s dietary guidelines, bought lactulose and enteral nutrition powder, and did my best to alleviate her discomfort.

When we finally saw the doctor, his words dealt another heavy blow: “This type of peritoneal metastasis is the most advanced stage. Surgery is out of the question. We can only start with palliative treatment.” Hearing this directly was hard to bear. When I returned to my mother, I couldn’t bring myself to tell her the truth. I simply said, “If the doctor hasn’t sent us home, it means your condition can be treated. Just follow the treatment plan with confidence.”

My mother’s genetic test results came back as KRAS G13D, pMMR, and MSS. I took the results to several AI platforms for verification, but the outlook wasn’t promising. Fortunately, Teacher Xiaobu from the group consistently helped me. He patiently reviewed every report, analyzed the genetic results, guided me step-by-step, and his recommendations closely aligned with the doctors’ plans.

Initially, the doctor recommended the XELOX regimen. After my mother was admitted, it was changed to FOLFOX. As soon as Teacher Xiaobu saw the “CPS=70” score on her immunohistochemistry report, he immediately suggested adding immunotherapy.

During the third chemotherapy cycle, the doctor indeed incorporated immunotherapy. The doctor originally recommended an imported drug, but it was too expensive for our family’s budget. Teacher Xiaobu recommended a cost-effective domestic alternative, tislelizumab.

「 Part 4: Chemotherapy Combined with Immunotherapy: The “Halved” CEA 」

During chemotherapy, my mother’s CEA levels dropped remarkably well, falling from an initial 136 to below 5. However, imaging scans showed the tumor hadn’t shrunk. The report noted unclear boundaries between the uterus and rectum, indicating stable disease (SD).

Every time we consulted the doctor, the response was the same: “It can’t be completely resected, and forcing surgery is meaningless.” We had no choice but to continue chemotherapy.

Throughout the treatment, my mother’s own resilience and cooperation provided us with immense support. Following the doctor’s advice for bowel obstruction patients to stay active, she insisted on taking slow walks after every meal without fail. To boost her immunity, she spent at least an hour outdoors in the sun daily.

She was extremely careful with her diet, boiling or steaming almost all ingredients. Even during chemotherapy, she refused to use cooking wine to remove the fishy smell from seafood, aiming to avoid any seasoning that might irritate her intestines. She also consistently took probiotics recommended by group members, carefully tracking her body’s responses, and striving to optimize every detail.

Yet, seeing my mother grow weaker with each chemotherapy cycle, losing her appetite, and struggling to walk, I felt heartbroken. Watching a loved one suffer while feeling powerless is a pain, anxiety, and frustration that every caregiver in a similar situation understands.

「 Part 5: An Unexpected “Reassurance”: Good Tumor Response Makes Surgery Possible 」

The turning point came on August 23. Patient groups were sharing information about Director Han’s offline Q&A session in Shanghai. I wanted to attend but hesitated. I’m naturally introverted and anxious about meeting strangers.

However, my mother’s treatment had hit a bottleneck. Even with a one-in-ten-thousand chance, I couldn’t give up, so I registered. To my surprise, as soon as I joined the event group, the volunteers were incredibly warm. They provided detailed directions, a checklist of required documents, and arrival times, which greatly eased my anxiety.

I was initially nervous, but this offline event completely changed my perspective. The organizers had carefully arranged the venue, and everyone was so welcoming, treating us like family.

Director Han patiently reviewed all the documents, addressed all my questions, and most importantly, told me that my mother’s tumor had a “good response profile,” making surgery a viable option.

I asked him what “good tumor response” meant. He explained that tumors that respond well to chemotherapy and are highly sensitive to treatment are considered to have a “good response profile.”

He also asked if we had the laparoscopic exploration video from the initial surgery and suggested bringing it to the Shanghai doctors for reference. He then explained the PCI (Peritoneal Cancer Index) score, noting that my mother’s score might not be very high, meaning it wasn’t the most severe case. There was still a chance for surgery, and he strongly advised us to operate before November, during the optimal window when chemotherapy effects peak.

I remember walking out of that session in tears. This time, they weren’t tears of helplessness, but of gratitude. First, because there was a turning point in my mother’s illness, giving us a glimmer of hope—a true beacon for desperate families. Second, Director Han’s patient demeanor instantly lifted the heavy burden I had been carrying.

「 Part 6: Transferring to Changzheng Hospital and Achieving Victory on the “Long March Against Cancer” 」

Back at Zhongshan Hospital, after evaluating my mother’s condition, the doctor informed us that the tumor’s location wasn’t ideal. The final surgical plan was a posterior pelvic exenteration, with a Miles procedure as a backup. If optimal resection or sphincter preservation wasn’t possible during surgery, a permanent stoma would be necessary. However, week after week passed without a hospitalization notice. Bed availability at Zhongshan was extremely tight, and waiting longer would mean missing the optimal surgical window.

Just as I was growing frantic, a group member named Yanhuo recommended Changzheng Hospital. She told me that Director Zhang there is highly authoritative in total and pelvic resections.

By chance, I managed to book an appointment with Director Zhang. After reviewing my mother’s PET-CT report, he said, “This is localized peritoneal metastasis. We can operate on it.” Just like that, we quickly transferred to Changzheng Hospital and successfully scheduled the surgery before the window closed.

On October 28 at 7:30 AM, my mother was wheeled out of the ward. She didn’t return until 5:30 PM. The surgery lasted over seven hours.

My mother’s uterus, ovaries, and rectum were all removed. When the surgeon came out, he told us that they didn’t find the widespread metastasis previously suspected. The chemotherapy had been so effective that the tumors had significantly regressed. They didn’t even need to create a temporary stoma. The outcome far exceeded our expectations.

My mother recovered well after surgery. Knowing the operation was a success, she was in high spirits. She strictly followed the doctor’s dietary advice, gradually transitioning from liquid to residue-free, and then to a normal diet. She also proactively continued walking and doing exercises, never staying idle when she could move.

After surgery, she underwent three sessions of HIPEC. The pathology report confirmed a pathological complete response (pCR). She is currently on maintenance immunotherapy with tislelizumab. Her weight has gradually increased from 80 jin to 90 jin, her energy levels improve daily, and color has returned to her face.

「 Part 7: A Long “Roll Call” of Gratitude 」

Throughout this journey, I am deeply grateful to the Panda Group. It has been like a guiding light, illuminating our confusing path through cancer and helping us avoid many detours.

Special thanks to Teacher Xiaobu, Brother Tai, Yanhuo, Sister Qiuyu, and Tiantian from the Panda Group.

Teacher Xiaobu: I learned about him through the Panda Group’s educational materials, which explained that millet-like nodules often indicate pelvic peritoneal seeding. After joining the ovarian group, he analyzed every test result for me and advised which specialists to consult next. For a panicked family member facing a late-stage cancer diagnosis, this guidance was truly invaluable.

Brother Tai: Initially, I thought metastasis meant there was no hope. The doctor even said my mother had “at most a year left.” In my despair, I came across Brother Tai’s story. He shared that despite widespread metastasis, standardized treatment allowed him to live for five years, enjoying food and travel. His example was incredibly inspiring. It showed me that following medical advice and adhering to standardized treatment can make extended survival a reality, not a myth.

Yanhuo: I met Sister Yanhuo in the ovarian group. She played an indispensable role in pushing me to seek surgical options. “Sister, your mother’s chemotherapy response is excellent. It’s time to consult a surgeon.” “Changzheng Hospital is the best for pelvic surgery. Go ask.” She even shared Dr. Liu Yilei’s WeChat with me and patiently answered all my questions.

Sister Qiuyu: The organizer of Director Han’s August 23 offline Q&A and the December 20 Shanghai annual meeting. Both events felt like family gatherings. At the annual meeting, seeing so many patients and families chatting warmly for the first time was an experience I had never witnessed before.

Tiantian: I met her in the inpatient ward at Changzheng Hospital. On the day of my mother’s surgery, she struck up a conversation with me, and we discovered we were in the same group. True to her name, she is a positive, active, and enthusiastic volunteer. Our conversations felt so natural. She encouraged me, “Sister, you should write a patient story to give others hope.”

Additionally, I must give special thanks to my husband. In my darkest, most helpless moments, he comforted me, saying, “No matter what happens, I support you, and we will face it together.” Those words gave me immense strength, making me realize I was no longer alone but had a true partner in this fight. He has since lived up to his promise—taking full responsibility for our two children’s daily care and education, and providing unwavering financial support without ever shirking his duties because he is a “son-in-law.” He may not be tall, but his profound sense of responsibility makes him stand incredibly tall in my heart.

「 Part 8: Written from the Heart ❤️ 」

Finally, I want to remind everyone: many elderly people tend to endure pain silently, avoiding hospital visits due to fear of medical costs, which delays diagnosis and misses the optimal early treatment window. Two of my colleagues’ parents went to the hospital immediately when their bowel habits changed irregularly. Both were diagnosed at an early stage, and their conditions were effectively controlled.

Since her diagnosis, my mother has never been defeated by the disease. Whenever we suggest something beneficial for her condition, she follows it unconditionally. She has never doubted that she will recover. This certainty has been my anchor. Before she came to Shanghai, I was so worried I couldn’t sleep. But once she arrived, seeing her always look on the bright side and cooperate fully with treatment, I finally found peace of mind.

It has only been three months since my mother’s surgery, and the future remains uncertain. Yet, I decided to share this experience to tell every patient and caregiver on this journey: Do not give up searching for possibilities, and leave no regrets. As family members, doing our absolute best is enough.

May our story bring you a little strength and confidence. On the road against cancer, you are not alone.

To protect patient privacy, names used in this article are pseudonyms. Images featuring the patient have been used with explicit authorization and may not be reproduced without permission.