After a Late-Stage Gastric Cancer Diagnosis, She Regained Time Through "Clinical Trials" | Patient Story

In January 2024, Lan noticed a small bump on her collarbone. She asked colleagues and her husband to take a look. Comparing both sides, they found it was indeed different. "This side is protruding, while the other is flat, and it feels hard to the touch." Having lived in Quanzhou for 26 years, Lan had long grown accustomed to the steady, orderly rhythm of a shoe factory assembly line. At age 51, gastric cancer quietly struck, briefly interrupting her routine life.

—————

Author丨Maling Shu & Xiao Han

Editor丨Xian Ning

Reviewer丨Guang Guang & Xiao Han

「 I. The Bump on the Collarbone 」

Traveling 200 kilometers northeast from her hometown of Jian'ou to Quanzhou, Lan and her husband had settled there 26 years ago.

Returning to Jian'ou for the Spring Festival was one of the few times a year she connected with her hometown. In early 2024, noticing the bump on her collarbone, Lan felt uneasy. The day after arriving in Jian'ou near the end of the year, she went straight to a local hospital for an ultrasound.

The experienced doctor looked at the results with a grave expression but did not reveal the full truth to Lan. "The doctor said the lesion was likely in the stomach or intestines, and the situation wasn't good. He advised me to be hospitalized immediately," she recalled.

Jian'ou is a small city with only one major hospital. Lan didn't seek a second opinion elsewhere and was admitted right away. After a series of tests, her family tacitly agreed to hide the diagnosis from her, deliberately excluding her from conversations with the doctor. Initially, the doctor only spoke with her husband. Pressed by Lan's questions, he finally told her, "Your intestines are fine, but there's a large ulcer in your stomach."

Though Lan couldn't decipher the anxiety behind her family's glances, she sensed something was wrong. When the doctor suggested surgery after the New Year, she made her own decision.

"Jian'ou is a small town with limited medical resources. Based on my experience with three C-sections, I knew bigger cities had more reliable technology. I told my husband that if I needed surgery, we should go to either Fuzhou or Quanzhou."

「 II. TV Drama Plots Unfold in Real Life 」

On the eighth day of the Lunar New Year, all pathology results were finally confirmed: late-stage gastric cancer with multiple intra-abdominal metastases and a metastatic lymph node in the collarbone. Both her maternal and paternal families knew the truth. Her cousin, a doctor at the local hospital, immediately explained the severity to the family. Only Lan was kept in the dark.

Before the festival ended, Lan was admitted to Fujian Provincial Hospital. Without waiting for all final tests, the doctor recommended a port-a-cath. Lan grew even more confused. "The test results weren't even out yet. Why are you asking me to get a port?"

Lan didn't know that in the doctor's eyes, she was already a late-stage patient, and every decision was a matter of life and death. Later, her cousin reached out to various contacts and finally connected with Director Lin at Fujian Cancer Hospital. It was around this time that Lan finally learned her diagnosis from her husband.

"You might not be able to imagine it, but I had only ever heard the word 'cancer' in TV dramas. None of my relatives or friends had it," Lan said with a hint of helplessness. Her husband told her that without treatment, she might only have six months left. With treatment, if she fought hard, she might have one or two years.

Her family firmly supported her decision to undergo treatment. Lan reasoned that with modern medicine, there was still hope. Her children were still too young to fend for themselves.

After reviewing Lan's test results and inquiring about her family's financial situation, Director Lin suggested she enroll in a clinical trial.

At the time, Lan's family finances were tight. After traveling between hospitals for initial consultations, they had already spent tens of thousands of RMB, with only her husband earning an income. "Sister, let's join the trial," her cousin advised. "It will ease the financial burden."

The trial recommended by Professor Lin, ZWI-ZW25-301, is a Phase III study targeting HER2-positive late-stage gastroesophageal adenocarcinoma. It uses zenocutuzumab combined with chemotherapy and immunotherapy (tislelizumab). This offered access to cutting-edge treatment while significantly reducing financial strain. For Lan, it was a highly worthwhile path forward in a difficult situation.

[ In Lan's test report, the HER2 indicator was 3+, a key criterion for trial eligibility ]

「 III. Good Fortune in Desperation 」

Looking back on her treatment, Lan recalls that chemotherapy brought only mild side effects. Allergies to oxaliplatin and a drop in platelets were just brief episodes. Otherwise, she felt no different from a healthy person.

Only once did she experience severe vomiting after drinking milk, which led to vomiting blood and severe damage to her gastric mucosa. Her family rushed her to the emergency room. "Actually, I only stayed in the hospital for one night. They gave me symptomatic treatment, and I went home the next day," Lan said. "Maybe my physical foundation is strong. I didn't feel particularly uncomfortable during treatment."

Later, Lan developed a loss of appetite and frequent diarrhea. The doctor adjusted the dose of capecitabine in her regimen, reducing it from three pills twice daily to two. The discomfort gradually eased.

"Since getting sick, I haven't had any pain or itching, and I've never even had stomach pain," she noted. As treatment progressed, her side effects grew lighter. Mild peeling and numbness in her hands and feet became the only traces. Her complexion, once darkened by chemotherapy, gradually regained its color, and her energy improved.

The doctor clearly remembers what she was like at the start of treatment. "For the first six months, every time she came for treatment, her husband and brother had to accompany her to help with daily care," he recalled. Back then, Lan still carried the frailty of her initial admission and her family's careful protection. But as treatment cycles progressed, the caregivers gradually stepped back. Eventually, Lan came to the hospital alone.

To the medical staff, she even became a unique sight in the ward: after getting her IV, she would dance square dances in the hallway. Between infusions, she would visit other rooms, chat with patients, and bring a lively, everyday warmth to her hospital stay.

Throughout the process, Lan followed the doctor's arrangements and focused on her treatment. After four cycles, the doctor clearly told her the results were excellent, even exceeding everyone's expectations.

What surprised the medical team even more was how completely her tumors had shrunk. "The regression was so remarkable that we even discussed whether she might be a candidate for curative surgery," the doctor said. To make a careful decision, Director Lin's team organized a multidisciplinary team (MDT) consultation for Lan. The conclusion was: perform a PET-CT first. If the lesions were still active, they would aim for complete surgical removal. If inactive, it would mean the current regimen had controlled the tumor well, sparing her from unnecessary surgery.

The PET-CT showed no active lesions. This meant Lan could avoid the trauma of open surgery; the medication had firmly held the tumor in check. Without surgery, Lan achieved living with the tumor.

Every 21 days, Lan would check in at the hospital. Her life's main focus shifted from "fighting death" to "managing the disease."

「 IV. The Return of a "Normal Person" 」

More than two years since her diagnosis, Lan has not experienced the withering and despair often depicted in TV dramas. Instead, her story reflects a quiet resilience.

From initially needing two people to take turns caring for her, to now traveling alone between Jian'ou and the hospital, the change in Lan is visible even to the medical staff. The patient who once needed care has gradually become someone who cares for others' emotions.

After falling ill, Lan stopped working, but her life didn't stall. Friends often invite her out. Villagers know she has late-stage cancer, but she doesn't mind them talking about it. "When people ask why I'm not working, I just tell them I'm sick," she says.

Regarding diet, Lan follows the doctor's advice to "eat a bit of everything." She doesn't strictly avoid foods, limits fried items, and eats what she can to maintain nutrition. She cooks, does laundry, and manages all household chores, keeping everything in order. In her spare time, she does aerobic exercises following videos on her phone to moderately strengthen her body. Once during a hospital stay, a nurse even mistook her for a caregiver for the patient in the next bed. "She said my condition was so good that I didn't look like a patient at all," Lan recalls.

「 V. "Living with the Tumor" Becomes the New Normal 」

"At first, I just wanted to try this medication. I never expected it to work so well," Lan says. Getting sick was unfortunate, but meeting good doctors and finding the right treatment made her feel lucky. "I originally thought I was very unlucky, but after joining the trial, things suddenly turned around. It gave me hope to live, and I feel quite fortunate."

Through medication, family support, and her own mindset, Lan regained control of her life. Her attitude subtly shifted as treatment progressed, and she learned to coexist with uncertainty. Among the patients she has met, some are anxious, while others give up. She maintains the simplest mindset: "Treat your physical condition with a normal attitude. Don't constantly dwell on having cancer. Look at it from a broader perspective. Even healthy people don't know whether an accident or tomorrow will come first."

This might sound like a resigned compromise, but in Lan's world, it is the most powerful way to live. It is neither about conquering nor surrendering, but about striving to be someone who doesn't look like a patient.

"Living with the tumor" embodies its truest meaning in Lan, reflecting a wisdom of making peace with life. It is not about coexisting with the tumor, but about coexisting with life, accepting the uncertainties that may come, and cherishing every day worth living within them.

(Special thanks to Dr. Su Liyu for her assistance with this article.)

Commentary from Ms. Lan's Attending Physician, Director Lin Rongbo of Fujian Cancer Hospital:

The case of Ms. Lan, a patient with HER2-positive late-stage gastric cancer, offers valuable insights for both the public and clinicians.

First, regular check-ups are a crucial defense for the early detection and intervention of gastrointestinal tumors. China is a high-incidence country for gastric cancer. Clinicians and the public must remain highly vigilant about non-specific symptoms. It is recommended that individuals over 40, especially those at high risk (family history, H. pylori infection, chronic stomach disease, etc.), undergo regular gastroscopy screenings. Many gastric cancer patients have subtle early symptoms, such as indigestion or slight weight loss, which are often ignored until the disease progresses to a late stage. Therefore, everyone must prioritize regular health screenings.

Second, precision treatment for gastric cancer has made remarkable progress in recent years, continuously improving patient survival benefits. For HER2-positive patients, the median survival with chemotherapy alone was previously around 11 months. However, data presented at this year's ASCO-GI conference showed that the regimen of zenocutuzumab combined with tislelizumab and chemotherapy extended the median overall survival to 26.4 months, more than doubling it. More importantly, 2026 ASCO data indicates that the 2-year progression-free survival (PFS) rate for this regimen reaches 38.2%. This not only signifies extended survival but also suggests that some patients may achieve long-term progression-free survival or even clinical cure. Others may reach curative goals through combined local treatments (such as ablation, radiotherapy, or surgery). This marks a major shift in the treatment model and goals for late-stage gastric cancer—for some patients, it is gradually transitioning from "incurable" to "curable."

Third, participating in clinical research is by no means being a "guinea pig," but rather an important pathway to access advanced treatments. Clinical trials undergo rigorous scientific design and ethical review, and their treatment protocols are often superior to the standard of care at the time. Ms. Lan is a typical example of benefiting from this. She accessed cutting-edge therapy before the drug was officially marketed and achieved remarkable efficacy.

To protect patient privacy, the names used in this article are pseudonyms.

Images featuring the patient's portrait in this article have been authorized by the patient. Unauthorized use is prohibited.