R0 Resection for Colorectal Cancer with Multiple Peritoneal Metastases: 16 Chemotherapy Cycles and 2 Surgeries Give My Mom a New Lease on Life | Patient Story
For two years, I’ve lied to my mom three times, hoping to secure a sliver of hope for her. Some deceptions are love in disguise; some obsessions are reflections of despair. Our journey has been unsteady, but I have no regrets.
I’ve long wanted to write about patient stories. I always thought I’d wait until we achieved a small milestone in the fight against cancer, until I could hold onto a tangible hope, before putting those days into words. But fate seems to keep playing jokes on us, and that longed-for "perfect moment to write" always feels just out of reach.
Now, I no longer obsess over so-called achievements on this cancer journey. Those moments of gritted-teeth perseverance, the panic of rushing between hospitals, and the faint glimmers of light hidden in despair are themselves worthy of being recorded.
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Author丨Tiantian
Editor丨Chanchan
Reviewer丨Guangguang
「 I. Diagnosed with Colorectal Cancer via Checkup, Post-op Staged as 2A 」
The afternoon in mid-November 2023 was no different from any of the other three hundred afternoons that year. Sunlight streamed through the hospital windows, casting dappled shadows on the floor. Holding my parents' checkup reports, I was still wondering what to cook for dinner.
Mom had recently mentioned that her stools were becoming thinner. I initially dismissed it as age-related indigestion and bought her some digestive aids. When she said she felt better, I didn't think much of it. But out of caution, I scheduled colonoscopies and gastroscopies for them. After all, at their age, it's always better to be safe.
I naively thought this would just be another routine checkup, ending with the doctor's usual "everything looks normal," allowing us to continue our quiet life. That was until the colonoscopy report slowly printed out. The two bold black characters "肠CA" (Colorectal Cancer) stared back at me, glaring and harsh.
I forced myself to stay calm, followed by a breathless series of tests: CT scans, MRIs, pathological biopsies... Fortunately, distant metastasis was initially ruled out. The tumor was located at the rectosigmoid junction, and the doctor recommended laparoscopic surgery as soon as possible.
There was no time to break down or grieve. I quickly signed consent forms, paid the bills, arranged hospital admission, and hired a caregiver. When everything was settled and the night grew quiet, I hid in the hospital stairwell and finally broke down in tears.
The surgery went smoothly, and Mom recovered faster than expected. The final pathology report showed pT3N0MX, which the doctor classified as Stage 2A. During that time, I was fortunate to join the "Panda Group." Seeing many Stage 2A patients in the group achieve excellent treatment outcomes finally allowed my heart to settle a little.
However, when it was time to remove the drainage tube before discharge, a tiny tube took three intermittent days to be fully pulled out. At the time, I just thought we were unlucky. Little did I know, it was a metaphor from fate: "Our cancer journey was never going to be smooth sailing."
「 II. Anastomotic Recurrence Post-Surgery, Multiple Peritoneal Metastases 」
Although Mom's pathology was Stage 2A, there were two high-risk factors: perineural invasion and lymphovascular invasion. Following the doctor's advice, we completed 4 cycles of chemotherapy using the XELOX regimen (Oxaliplatin + Capecitabine) post-surgery.
I diligently studied how to manage chemotherapy side effects in the Panda Group, preparing antiemetics, white blood cell boosters, and mouth ulcer gels in advance. Mom was exceptionally strong. She gritted her teeth through nausea, vomiting, and numbness in her hands and feet, never once complaining.
The 4 cycles of chemotherapy concluded smoothly. Imaging and tumor marker results were highly encouraging. Seeing the color return to Mom's face, I firmly believed that spring was finally coming.
In mid-June 2024, it was time for a follow-up. The tumor marker CEA was 5.2, within the normal range, and all imaging appeared normal. Yet, a lingering unease stayed with me. Like someone possessed, I kept taking Mom to the hospital for repeated CEA tests. Watching the numbers climb from 5.2 to 6.3, 7.8, 9.1... my heart sank. I've never been greedy; since her diagnosis, I only hoped she could rest peacefully for a year or two. I never expected fate's second blow to come so fast and so hard.
I refused to leave anything to chance. I immediately arranged more precise imaging and repeatedly asked doctors to review the scans. Finally, a suspicious nodule a few millimeters in size was found at the anastomosis, and the biopsy confirmed "adenocarcinoma". When the report came out, I felt strangely calm. I immediately consulted Director Han from the Panda Group, who recommended a specialist in Beijing. I borrowed the pathology slides the same day and bought a train ticket to Beijing for the next morning.
At that time, Mom was like a scared, helpless child, tugging at my sleeve and softly asking, "Can we not go to Beijing?" Looking at her wrinkled face, I felt deeply guilty but could only coax her: "The surgery here would be too traumatic. Beijing has a safer, localized treatment. We'll be back home soon after." Though reluctant, she followed me to Peking University Cancer Hospital.
This was the first time I lied to her. The words "localized treatment" lightly masked the reality we faced: recurrence, metastasis, and an entire treatment plan that might need to be completely overhauled.
In August 2024, the slide consultation and imaging at Peking University Cancer Hospital quickly confirmed a local lesion at the anastomosis. Surgery was scheduled, bringing Mom some relief. Until the afternoon the pre-op PET-CT report was pushed to my phone. We were eating at a small restaurant near the hospital when the notification arrived. Just a few lines: Tumor recurrence at the anastomosis, multiple peritoneal metastases.
I can barely remember how I finished that meal. The sky outside fittingly began to rain, the drizzle tapping against the window and chilling the last warmth in my heart.
I asked Director Jiang from the Imaging Department of the Cancer Hospital, Chinese Academy of Medical Sciences (East Cancer Hospital), to re-read the scans. It was ultimately confirmed: it wasn't just anastomotic recurrence; the peritoneum had indeed metastasized.
「 III. Tumor Progression Unstoppable by 11 Chemotherapy Cycles 」
In the context of cancer caregivers, the words "peritoneal metastasis" are roughly equivalent to "the sky falling." Hiding outside the hospital, leaning against a cold wall, I felt a bone-deep despair for the first time. I thought we had prepared for the worst, but fate always manages to deal a worse hand.
After half a day of despair, I wiped my tears, returned to the ward, and discussed switching to medical oncology treatment with Mom. She innocently asked, "A fellow patient just said he came for surgery, but the tumor couldn't even be found on the scans anymore. Is that true?"
Holding back tears, I nodded: "Yes, it's true." This was the second time I lied to her. Or perhaps, to myself. I needed her to believe there was still hope, to cooperate with the upcoming chemotherapy.
The medical oncology regimen was set as Irinotecan combined with Capecitabine and Bevacizumab. We returned to our local hospital to prepare for chemo, but it coincided with Mom's birthday. I postponed the treatment to the day after. Watching her close her eyes and silently make a wish, I thought her only wish must be to recover soon and stop being a burden to the family.
[Birthday before restarting chemotherapy for peritoneal metastasis]
Mom's side effects from Irinotecan came on fast and fierce. Hair loss, intestinal cramps, and severe diarrhea—she experienced them all. Every time the medication entered her veins, she would start dry heaving, breaking into cold sweats, curling up on the bed, trembling with pain.
Yet, she was incredibly strong. Through such unbearable side effects, she never made a sound. Whenever I asked if it hurt, she would always shake her head, force a smile, and say, "It doesn't hurt, I'm fine."
After four cycles, imaging evaluation showed SD (Stable Disease). Having learned so much in the peritoneal metastasis group, my initial desperate urge for surgery gradually settled. I knew that whether cytoreductive surgery truly benefits a patient depends not just on achieving macroscopic complete resection, but also on post-op recovery and the ability to seamlessly continue systemic therapy.
I coaxed Mom: "The tumor has shrunk a lot. If we persist a few more times, it might disappear completely." I know this cancer journey is incredibly hard. All I can give her is a sliver of hope, a little courage to keep walking.
Eleven times. Exactly eleven times. She was like a programmed machine, showing up in the chemo room on schedule. Until after the 11th cycle, imaging evaluation showed: the tumor had actually grown. This was like a bucket of ice water, instantly extinguishing all hope. Mom's persistence and efforts seemed to have been in vain.
Mom broke down. She demanded to stop the medication. My father, soft-hearted, agreed, "Let's stop it." For that month, no one in the house mentioned the word "hospital." Mom watered the balcony flowers every morning, as if nothing had happened.
At that crossroads, I understood better than anyone. Mom had endured 11 rounds of Irinotecan toxicity without a single break. The progression of the presacral tumor caused severe rectal tenesmus, making it impossible for her to sit or stand comfortably. Wanting to stop was completely normal.
But how were we supposed to move forward?
「 IV. Resuming Chemotherapy Shows Clear Results, Regaining Surgical Opportunity 」
I began frantically searching for answers. Consulting surgeons, they said there was a surgical opportunity and recommended it. Consulting medical oncologists, they said surgical benefit was limited and recommended systemic therapy. Visiting radiation oncology, they suggested radiotherapy to relieve presacral discomfort. Conflicting opinions from different departments wove together like an airtight net, leaving me barely able to breathe.
This is the daily reality for peritoneal metastasis patients: no standard answers, no foolproof plans. Every choice is a gamble, and the stakes are Mom's life.
During that period, both Mom's tumor markers and imaging results were progressing. On August 1, 2025, following medical oncology advice, I adjusted the regimen to Oxaliplatin + TAS-102 + Bevacizumab. Fortunately, after three cycles, tumor markers dropped significantly. Seeing a turning point, I decisively stopped Bevacizumab after the fourth cycle and began actively preparing for surgery.
Considering Mom's lesions were in the mid-lower abdomen and presacral area, I wanted to remove them all at once. In the peritoneal group, many patients recommended Shanghai Changzheng Hospital. I organized Mom's medical records and imaging and sent them to Dr. Liu at Changzheng Hospital. He carefully and thoroughly analyzed the surgical risks and benefits for me. His explanation was clear, professional, and warm, neither exaggerating the outcomes nor avoiding potential risks.
After hearing his analysis, I hesitated no longer. I made up my mind to take Mom to "fight" for this surgery. Compared to my previous hesitation, I was unusually firm this time. I knew clearly that Mom was already on third-line drugs, and future surgical opportunities would only narrow. This might be our last chance.
But when I tried to mention surgery to Mom, she cried and protested, refusing outright, saying, "I've had enough, I don't want to suffer anymore." My father also worried she wouldn't survive the post-op recovery. My mind was already made up: I had to take her to Shanghai. Even if a laparoscopic exploration found it unresectable, I would accept it.
Both Mom and I are stubborn, but on this long, brutal cancer journey, she ultimately couldn't out-stubborn me. I continued to "coax and deceive" her, saying we were just going to Shanghai for imaging follow-ups and expert evaluation, not for surgery. Though deeply reluctant, she eventually followed me to Changzheng Hospital after my persistent persuasion.
At Changzheng Hospital, I also booked an appointment with Director Zhang from the Colorectal Surgery Department and specifically brought my father along. I wanted him to hear why I was so insistent on surgery. After listening to Director Zhang's surgical plan and expectations, my father relented: "You decide on the surgery. I'll support you."
「 V. R0 Resection Achieved, "Sepsis" Leads to ICU 」
On October 9, 2025, Mom received her final pre-op chemotherapy: Oxaliplatin + TAS-102. The surgery was scheduled for October 29. Pre-op checks proceeded methodically. I had mentally prepared for everything: open laparotomy, incomplete resection, rapid recurrence, obstruction, intra- and post-op complications... I weighed every risk I could imagine in my mind. The multiple lesions still visible on the PET-CT made me waver, but Director Han finally gave me peace of mind. Since we had come this far, we might as well go all out.
The surgery went exceptionally well. Intraoperatively, 3 lesions on the greater omentum, 1 presacral lesion, 1 anastomotic lesion, 2 small bowel lesions, and 1 abdominal wall lesion were removed, achieving an R0 resection.
On the second day post-op, when Dr. Jia changed Mom's dressing, I saw the long incision stretching from her chest to her lower abdomen through the curtain. Though mentally prepared, I couldn't help but shed tears of heartache.
Especially after two sessions of HIPEC (Hyperthermic Intraperitoneal Chemotherapy), Mom couldn't help but softly murmur about the painful bloating. I repeatedly asked myself in my heart: Was it really worth putting Mom through so much suffering and hardship?
Before I could answer that question, a crisis struck.
Haunted by the shadow of the difficult tube removal from her first surgery, Mom insisted on having all drainage tubes removed before going home. Due to work, I returned home first, leaving my father in Shanghai to accompany her post-op recovery.
One month post-op, Mom was preparing for discharge. I planned to pick her up after finishing work. That evening, my father called: "Your mom has a fever of 41°C."
I rushed to Shanghai overnight. Mom had a persistent high fever and was delirious in the first half of the night. Her temperature barely dropped in the second half, and her blood pressure recovered by morning. I thought things would gradually improve.
I remember that morning, the sunlight was exceptionally bright. Dr. Liu came to check on Mom, the sun casting a warm, bright glow on him. After understanding her condition, he returned shortly after, reminding me to contact him anytime if anything changed. In the afternoon, he specifically messaged to ask about her temperature and lab results. His dedication and responsibility filled me with gratitude. Actually, the thought of "sepsis" had crossed my mind, but seeing her temperature drop, I still held onto a sliver of hope, thinking we wouldn't be that unlucky.
That day, although Mom's fever broke, her mental state visibly deteriorated. She was extremely weak, lacking even the strength to speak. That night, her BNP (B-type natriuretic peptide, mainly used for heart failure diagnosis) levels skyrocketed above 1000, and doctors recommended transferring her to the ICU.
ICU. I had told myself countless times that if it ever came to intubation and resuscitation, I would let go. But when the moment actually arrived, I couldn't do it.
I watched as she was intubated, her hands and feet restrained to the bed, her lips covered in blister after blister. My heart was filled with self-blame and guilt. In that moment, I humbly thought: If this cancer journey could at least give us and our loved ones a chance to say a proper goodbye, that would already be a blessing. If I couldn't bring Mom home safely, this guilt would be like a thorn in my heart, impossible to remove for a lifetime.
Those days were exceptionally grueling. My father and I waited outside the ICU, unable to eat or sleep. Every time a doctor called our number, our hearts leapt to our throats.
But we were also incredibly lucky to have exceptionally responsible doctors. In those moments of despair when I felt I couldn't hold on, Dr. Liu repeatedly comforted me, "It'll be fine, don't worry too much," giving me peace of mind. No matter how busy or tired he was, he always kept Mom's condition in mind, visiting the ICU to check on her. Hard work pays off. With the doctors' full efforts and meticulous care, Mom's organ functions gradually recovered. She bravely survived this life-and-death crisis.
「 VI. Experience Sharing: Cautious Decision-Making & No Regrets 」
After surviving sepsis, Mom's constitution noticeably weakened, and she developed low-grade fevers at night. Thanks to Professor Zhang and Professor Su, we were transferred back to Changzheng Hospital for continued treatment.
During our hospitalization at Changzheng Hospital, I always felt at ease. Despite his busy schedule, Director Zhang would always make time to check on Mom. Knowing beds were tight, I suggested removing the urinary catheter to discharge early, but Dr. Peng firmly said, "Since you're here, don't rush. Stay until the treatment is complete." Whenever he had time, Dr. Liu would remind me to help Mom get out of bed and move around slowly, rather than lying down all day.
Once all of Mom's indicators met the discharge criteria, we finally went home. Sitting on the high-speed train, watching the scenery blur past the window, I felt as if the past two years had been a long, vivid dream.
Later, a group member asked me if I regretted choosing surgery. I don't. I have never regretted it. The surgeons gave it their all, and the outcome met expectations. I deeply admire and am grateful for surgeons who dare to perform complex surgeries like peritoneal and pelvic procedures. They are doctors with true dedication. The Colorectal Surgery Department at Changzheng Hospital is exactly such a dedicated, highly skilled team.
The only thing that still weighs on me is that work prevented me from properly accompanying Mom during her post-op recovery. If I had noticed the abnormalities earlier, perhaps she wouldn't have suffered so much. But life has no "what ifs."
Later, I came to terms with it. This cancer journey isn't one where effort guarantees results. The first surgery was non-standard, leading to disseminated metastasis. Mom herself was not highly sensitive to chemotherapy, so 11 cycles had limited effect. These "detours" were partly due to information gaps and partly dictated by her constitution. Even with a different person or a different timeline, they might not have been avoidable.
All I could do was make the best choice possible with the knowledge I had at each moment, and accept all its consequences—good or bad. Precisely because I walked these "detours," I want to share some firsthand experiences with others on the same path.
— Regarding surgical choices. Many peritoneal metastasis patients face conflicting advice from medical and surgical oncologists. My takeaway: integrate both professional judgments, and weigh the benefits and risks against your own situation. When I decided to "gamble" on surgery, the imaging PCI (Peritoneal Cancer Index) score was around 8, though the actual intraoperative finding was slightly higher. But my definition of this surgery was always simple: it was a "gamble." I was ready to accept either winning or losing.
At Changzheng Hospital, I met many group members preparing for surgery, repeatedly asking themselves, "Is this surgery the right choice?" I used to fall into that same internal struggle. But whether a choice is right or wrong, you can't redo it. So, please trust that any choice you make with all your heart at that moment is the right one.
— Regarding infection monitoring. White blood cell count, C-reactive protein, procalcitonin, and Interleukin-6 are the most critical indicators for infection. Mom's temperature suddenly spiked to 41°C. We promptly did blood cultures and upgraded antibiotics, buying crucial time for subsequent rescue.
Only after experiencing it do you truly understand that bacterial infection is far more dangerous and grueling than cancer itself. Cancer has a direction to follow, but when infection strikes, every second is a race against death, leaving no room to catch your breath.
— Regarding post-op recovery. Mom's overall recovery was relatively smooth. Bowel function returned quickly, she walked on the third day, and the wound healed well. However, during recovery, she experienced persistent vomiting for a while. Initially, I thought it was mild gastroparesis or poor gastric motility and didn't pay much attention. Later, I discovered the symptoms disappeared after stopping the amino acid nutritional solution. I share this detail for your reference.
「 VII. On the Cancer Journey, We Are Never Alone 」
After sharing these experiences, what I want to say most is countless "thank yous."
Thank you to my dad. Throughout Mom's two-year cancer journey, he never missed a single day. Though he occasionally disagreed with treatment decisions and even harbored resentment toward me, it never diminished my deep admiration for the man who shouldered most of the storm for Mom.
Thank you to Director Han, who guided me at every critical decision point. During Mom's most desperate moments in the ICU, it was Director Han who woke me up to the reality that treatment is never smooth sailing, and to focus on solving problems. I often share this quote in the peritoneal group to encourage fellow members lost in confusion.
Thank you to Sister Qiuyu, who helped and comforted me throughout my time in Shanghai. When Mom's platelets suddenly plummeted during chemo, she called immediately, "scolding" me for being careless while instantly helping me find and ship the medication.
Thank you to Sister Lun, who seems omnipotent in my eyes. On several late nights, she helped me review Mom's lab results, teaching me step-by-step how to handle them better. I used to admire how much she knew, but later I realized: no one is born knowing so much; it's simply the result of experiencing too much.
Thank you to Sister Yangyang, who silently helped me and brought countless moments of warmth. Love given returns as love; blessings sent return as blessings. I hope one day I can be as warm and bright as you, illuminating the path for more fellow travelers.
Thank you to Brother Ming. Whether during my usual emotional lows or Mom's most grueling days in the ICU, he constantly fed me "chicken soup for the soul." Those precisely delivered words of encouragement kept me moving forward.
Thank you to Brother B, who is like an encyclopedia. No matter what problem I faced, he would always analyze the core issue, help me clear my thoughts, and tell me exactly what steps to take next.
Thank you to Sister Manman, who steadfastly supported every choice I made on Mom's cancer journey.
Thank you to Chacha, who is not only beautiful but also incredibly helpful, always helping me sort out medication strategies based on Mom's changing conditions.
Thank you to Wanyun, who, during my most confused moments, went to various groups to "rally support" for me and shared Big G's articles to encourage me.
Thank you to Xiaoyu, Yiren, and Guzhi, who stayed up with me on those grueling nights, helping me analyze every lab indicator.
Thank you to An'an, Teacher Wu, Faye, Feifei, RIKI, and Tingting, who always provided crucial support at key turning points.
Thank you to that little boy who loves to cry and laugh. Even while rushing to catch a train, he never forgot to tell me to hold on, offering ideas and encouragement. You were like a little sun, illuminating our path...
Finally, a special thank you to my good friend from the Panda Group, Dr. Liu at Changzheng Hospital. Not only did he help me navigate countless hurdles, but whenever group members sent him medical records for advice, no matter how busy he was, he always patiently and professionally analyzed their conditions and pointed the way forward. He is like a beam of light, illuminating this arduous cancer journey.
This path is truly too hard, too exhausting. Fortunately, I met a group of shining, warm, and reliable companions along the way. Their companionship and help allowed me to stand up again in countless moments when I wanted to give up. I no longer obsess over a "cure," no longer demand a perfect ending, and have learned to allow everything to happen as it may. Now, Mom's tumor markers are still rising, but I have calmly accepted it. After all, in this mortal world, regrets are common.
When inviting group members to the peritoneal group, I often hear that heartbreaking phrase: "Peritoneal metastasis, the sky has fallen." But the sky has never fallen. As long as there is light, it is worth walking forward. As long as we hold onto hope and pursue standardized treatment, we can surely walk this difficult path more steadily and further. The road may indeed be incredibly hard, but we are never alone...
To protect patient privacy, names used in this article are pseudonyms.
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