Guangzhou Doctors Became Famous in Malaysia

Ten years ago, Xiaoxuan (alias), a Malaysian child, was diagnosed with brain cancer. Her parents took her all around to seek medical treatment. As they believed that Chinese doctor should have excellent medical skills since China has a large population, they took the flight to Guangzhou and Xiaoxuan underwent operation at Guangzhou Fuda Cancer Hospital. After two-year treatment, Xiaoxuan's disease was cured and she did not need to come back to Guangzhou for follow-up treatment. In the following ten years, Xiaoxuan and her parents have been making overseas phone calls on special occasions to express their appreciation to doctors at FUDA. On December 7, 2015 when the “Role Model of the Times” award winner and chief president of Fuda Hospital was invited to deliver a lecture in Malaysia, Xiaoxuan's family came along the way to the lecture venue. The child with brain cancer ten years ago has grown up and becomes a graceful young lady. Nineteen-year-old Xiaoxuna bowed her thanks to medical workers of FUDA at the venue to express her appreciation to Guangzhou doctors for saving her life.

Ten years ago, the 9-year-old Malaysian child with brain tumor sought treatment and was cured in Guangzhou.

Ten years ago, Xiaoxuan was seeking treatment in Guangzhou.

In 2004, 8-year-old Malaysian girl Xiaoxuan was diagnosed with brain glioma at a local hospital. As tumor was located at a special site in brain, only two third of tumor was removed at the local hospital in the end of 2005. “Brain glioma has a special character. It has an ill-defined margin like crabs and cannot be completely removed through operation. Patients often die of cerebral failure within months or years due to repeated operation.” After operation, Xiaoxuan's symptoms such as vomiting and headache hadn't been alleviated. Local doctors suggested Xiaoxuan's parents to seek for new treatment.

“At the very first start, we had wanted to go to Singapore for treatment. But later we learned that Guangzhou Fuda Cancer Hospital has a local immunotherapy for tumor bed that can prevent tumor recurrence. As we believed Chinese doctors must have excellent medical skills since China has a large population, we took a flight to Guangzhou with Xiaoxuan.” Xiaoxuan's father recalled.

“There was a 3-4cm large tumor in the third ventricle of cerebrum of Xiaoxuan. The tumor mass blocked the flow of cerebrospinal fluid and caused hydrocephaly. However, another major brain operation is more than what a 9-year-old child could take.” Xu Kecheng, the chief president of Guangzhou Fuda Cancer Hospital told the reporter. After case analysis, Prof. Wu at FUDA decided to give Xiaoxuan the following treatment. Firstly, residual tumor was removed as much as possible during the craniotomy. Then one side of a thin catheter was embedded in the third ventricle of cerebrum and the other side was embedded in abdominal cavity through subcutaneous tunnel of neck and chest to introduce cerebrospinal fluid into abdominal cavity. Then a medicine capsule was embedded in the tumor bed with the open end of the capsule at the basal part of the tumor and the close end under the head skin. After operation, immune preparations are injected into the capsule on a regular basis.

After the operation, Xiaoxuan came to FUDA every other month to receive immune preparation injection. After nearly two years' treatment and follow-up visit, Xiaoxuan's disease was cured and she did not need to come back to Guangzhou any more.

According to medical workers at FUDA, Xiaoxuan was very staunch though she was just a little girl when she underwent treatment. Each time after the injection, she would have fever up to 40℃. She managed to get through with it without crying. As Xiaoxuan's family had been to FUDA for many times, they mingled well with medical workers at FUDA like family members. Xiaoxuan's father said, “To speak of what we have went through is easy, but it was really difficult to have it done. Medical workers at FUDA have done a lot to take care of us.” He recalled, “I remember there was one time in winter that medical workers at FUDA invited us to have hot spring right after we arrived at FUDA”. As he had been going through the customs and going from and to hospital for many times with Xiaoxuan, in addition he was dark-skinned, medical workers cordially called him “Uncle Pirate”.

Ten years later, the recovered patient came along the way to bow her thanks when Guangzhou doctor delivered a lecture in Malaysia.

 Ten years later, Xiaoxuan and her “lifesaver” gathered in Malaysia

Ten years ago, Xiaoxuan's parents took her to Guangzhou for treatment as the last resort. Ten years later, Xiaoxuan's family came along the way to the lecture venue in order to express their thanks to the “lifesaver” when they learned that Xu Kecheng was invited to deliver a lecture in Malaysia.

Xiaoxuan grew taller. She has a pair of big dark and sparkle eyes on her round face. The dimple on both cheeks makes her even more beautiful. It is hard to associate the graceful young girl with the child with brain cancer ten year ago.

“Ah, is it really you, Xiaoxuan?”“Nice meeting you, president Xu. It is me.” Xu Kecheng could not believe that the girl who was standing right in front of him is the girl with brain cancer ten years ago. “She embraced me tightly with tears in her eyes. I could feel a small bulging on her left head skin through her black hair.” Xu Kecheng said the bulging was the medicine capsule embedded by Prof. Wu ten years ago. It was really amazing that such an inexpensive but effective medicine capsule has saved the lives of hundreds of brain cancer patients.

It is learned that now 19-year-old Xioaxuan is a preparatory student of Methodist Pilley Institute, Sibu, Malaysia. “My classmates just couldn't tell that I'm a brain cancer survivor. They just wouldn't believe it when I shared my story with them. I told them it was doctors in Guangzhou who have cured my brain cancer.” She has never forgotten those who have treated her and taken care of her at FUDA. She asked about the recent situations of doctor Wu, her surgeon, Doctor Liu Zhengping, Doctor Wang Feng, the nurse Xiaoxia. She said, “I really appreciate what they have done for me”. She said now her best hope is to have a healthy body. She also hoped she can get the opportunity to go back to Guangzhou and visit medical workers at FUDA again. Xu Kecheng said, “It is my sincere hope that you will apply for Medical School of Jinan University in Guangzhou and become a doctor in the future.”

Dr Xu Kecheng wanted to find a way for advanced-stage cancer patients to live with the disease rather than die from it.

Dr Zhou Xulong analyses a patient's tumour cells before an intervention [Simina Mistreanu/Al Jazeera]

Beijing, China - As she waited to see her oncologist, Raluca Pietroiu felt nervous but hopeful.

For four years, the 34-year-old Romanian marketing executive had been fighting breast cancer. She knew she was a fighter - she'd grown up watching Jackie Chan movies and had fought hard for her professional success. But in the battle for her life, she was starting to feel like she might be losing.

At first, treatments made her cancer disappear, but after two years it returned. Now it was spreading to her bones. Doctors told her that they were running out of options. But Pietroiu had a new reason to hope: She'd heard about a hospital in China that was treating advanced-stage cancer patients like her with immunotherapy and other new procedures.

Immunotherapy, a treatment that uses the body's own immune system to attack cancer cells, has proven highly effective in certain cancers, such as melanoma. But forms of immunotherapy are still labelled experimental in many places, including the United States and Western Europe, and the treatment isn't available in Romania.

Pietroiu knew her doctor would be sceptical. After all, she'd already pursued treatments in Austria, France and Turkey. But this time, it was different.

Her stage 4 cancer was unresponsive to chemotherapy and radiation. She thought she was playing her last card in the game against death.

"If it's immunotherapy and you can afford it, by all means, go ahead," her doctor told her.

Hope and science 

According to the hospital's website, it uses a combination of immunotherapy, minimally invasive treatments and traditional Chinese medicine to make advanced-stage cancer patients comfortable and to possibly extend their lives.

And while the hospital's model has attracted awards from the Chinese government and praise from other doctors in the region, some Western health professionals have questioned the treatment's grounding in science, as well as the hospital's lack of randomised clinical trials.

The treatments cost in the range of tens of thousands of dollars. But about a dozen patients and family members interviewed expressed gratitude at what they perceived as a second chance at life or, at least, an opportunity to extend it by a matter of months or years.

"I think you should never take hope away from the patient," said Gurli Gregersen, a Fuda patient who has been living with stage-4 pancreatic cancer for eight years. Doctors in Denmark initially told her she had just a few months left to live.

"You shouldn't be unrealistic, but it's very important that you keep up the spirit that you can do it, and you can fight it. They are very skilled when it comes to giving you a realistic view, but they also support you to be happy for your life and to endure everything you can to live with it."

Pietroiu put it more bluntly: "You go there because you still have hope."

"Here [in Romania], they close the door in your face, and they tell you, 'There's nothing more we can do,' or 'Why don't you continue with the same therapy?'. The treatment protocols are fixed. And in Vienna, even though they treat you very nicely, and they take your money gracefully, they do the same things," she said.

The doctors don't promise to cure very advanced cancer, explained Abdalla Gurashi, who is from Sudan and at the hospital with an Egyptian friend who has stage-4 stomach cancer. "There's no cure. There's only maintaining."

Immunotherapies

The discussion around care for the terminally ill is growing more urgent as cancer affects more of us, and in many places, that involves debates around the best practices for palliative and hospice care.

But at the other end of the spectrum of care, new immunotherapies and targeted therapies are yielding results.

While the concept of immunotherapy isn't new, the breakthrough over the past several years has been the development of medicines that are more tolerable and produce better responses, particularly in melanoma patients, explained Leonard Lichtenfeld, the deputy chief medical officer for the American Cancer Society.

"What we're seeing is that with a disease like melanoma, where we had nothing much to offer, we now have 35 to 40 percent of the patients with the most advanced disease responding in a meaningful way to immunotherapy," Lichtenfeld said. "And some of those patients are now going on several years with the positive responses. We don't even know how long those responses are going to last."

Scientists are also seeing results for immunotherapy applied to other types of cancer, such as lung, head, neck, colon and kidney cancer, Lichtenfeld said. They are studying combinations of immunotherapy, as well as immunotherapy combined with targeted drugs, which focus on a particular genetic change.

Not losing hope 

At Fuda, Pietroiu received immunotherapy as well as an injection with strontium-89, a radioactive substance used to reduce pain in patients with metastatic bone cancer. She didn't have any serious side-effects and after three weeks, returned home, full of hope.

Her years battling cancer had been some of the most important of her life. When she was in remission, she met Bogdan. They clicked instantly. She told him she was a cancer survivor. A few weeks later, in the spring of 2013, Pietroiu learned during one of her regular checkups that the cancer had reappeared in her spine. Bogdan joined her on some of her visits to hospitals abroad, and every time they tried to make a trip of it.

After the immunotherapy, she felt better, but tests showed that her liver had been invaded by thousands of tiny metastatic cancer cells. She returned to Fuda with Bogdan in May, two months after her first visit. This time the doctors took several days to suggest a treatment - transarterial chemoembolisation to her liver. 

Pietroiu wrote an article for her friends and for people who had started supporting her with donations.

"It won't be an overnight miracle," she wrote. "It's not a one-time intervention, after which I can go back home, and it's over. The road ahead is longer. I will continue to come here once every two or three months, upon these wonderful doctors' recommendations, to stabilise my situation if the results are good. If not, I will look for something else, but I won't stop."

Xu Kecheng talks to PhD students who work as researchers in Fuda Cancer Hospital's laboratories [Simina Mistreanu/Al Jazeera]

Weapons and knives against cancer' 

Care for the terminally ill is changing, and being debated, across the globe. In the case of cancer, doctors at first treat to cure, but they also treat for comfort. 

"It's very much part of our tradition in cancer care to treat patients with chemotherapy or other cancer treatments to improve their comfort, although we won't provide a cure," said Lichtenfeld. "If we were only treating for cure, for many patients we would stop at surgery." 

For patients and their families, it's often hard to decide when to stop so-called "active treatments" - those which are meant to cure.

Erik Fromme, a palliative care doctor who specialises in cancer at Oregon Health and Science University in the US, said he discusses with his patients their understanding of their disease, their priorities, their fears, their hopes, and helps them make the decision that will best suit them. 

"I think people continue to do treatments as long as the benefits outweigh the burdens as they understand it," Fromme explained. "But there are people who find benefit to just being in treatment, whether the treatment is working or not."

People want another shot at life, and they will travel the world to get it. Part of it has to do with the tendency to describe cancer as a "fight". This comes naturally, Fromme said, when the "weapons" we use against it resemble poison and knives.

The flip side of that interpretation is that stopping treatment is likened to being defeated.

The Discussion of New Idea for Cancer Treatment

2016 the 5^th International (Guangzhou) Forum for Cancer Treatment (IFCT),  was convened at Jinan University Affiliated Fuda Cancer Hospital on July 2. It was organized by International Society of Cryosurgery and Asian Society of Cryosurgery and was undertaken by Jinan University School of Medicine Affiliated Fuda Cancer Hospital, and First Affiliated Hospital of Shenzhen University. Over 200 medical experts from China, the US, the UK, Austria, Israel, Romania, Malaysia and Thailand gathered together to have in-depth discussion on the application of cryosurgery, Irreversible Electroporation (also called NanoKnife) and stem cell in the field of cancer treatment. 

Xu Kecheng, chairman of the current session of forum and chief president of Jinan University School of Medicine Affiliated Fuda Cancer Hospital, noted that Surgical resection, chemotherapy and radiotherapy are the three conventional treatments for cancer. Over the past forty years and more, scientists have come to a deeper understanding of cancer. At the same time, the research of genetics and protrinology has prompted the development of targeted drugs for cancer cells. However, there remains huge challenges in the field of cancer treatment. We are still using the conventional technologies to treat most common cancers with few breakthroughs made.

The development of imaging technology has prompted the rise of interventional oncology, which marks a remarkable advance in cancer treatment. Modern cryoablation which is represented by argon-helium cryosurgery was emerged in the late period of last century. Irreversible Electroporation, came out in recent years, have gained rapid development. Both of the ablation methods have brought hope of life for patients who cannot tolerate surgery or who have unresectable tumors. At the forum, several experts shared their experience in performing cryoablation and IRE.

Prof. Nikolai N. Korpan, honorary president of the International Society of Cryosurgery and president of the Austrian Society of Cryosurgery delivered a presentation titled A Novel BioCryoImmunological Concept in Science and Medicine: Discovery, Hypothesis & Evolution, which reviewed the development and the promising prospect of cryosurgery for cancer.

Prof. Huang Kaiwen, director and chief executive of Minimally Invasive Interventional Treatment Center for Cancer, Medical School Affiliated Hospital, Taiwan University, made a presentation titled US Guided IRE for Cancer Treatment. Prof. Xiao Yueyong from Radiology Department, General Hospital of People’s Liberation made a presentation titled Basic Research and Clinical Application of Irreversible Electroporation Ablation in Cancer Treatment. 

During the session of the forum, an IRE operation was also broadcast live. The surgeon was Prof. Niu Lizhi, executive president of Jinan University School of Medicine Affiliated Fuda Cancer Hospital. The patient, a 55-year old Hong Kong SAR resident, had repeated fever since early 2016 and was diagnosed with pancreatic cancer. Moreover, the patient was also found to have right thyroid nodules. On July 2^nd, 2016, Prof. Niu Lizhi performed IRE on pancreatic tumor and right thyroid nodules. The procedure went smoothly and intraoperative bleeding was 2ml. 

Prof. Niu Lizhi noted irreversible electroporation (IRE) is a novel mini-invasive technology for tumor ablation. Its rationale goes like as follows: during the procedure, high electric-field and ultrashort pulses are given to destroy lipid bilayer structure of cancer cell membrane and form numerous irreversible nano-sized pores in the cell membrane. Cell membrane permeability will be changed to allow molecules of different sizes free access to cells, which will lead to cell death. It has been approved by America FDA and European Union for clinical application respectively in April and December 2012. In June, 2015, it was approved by Chinese FDA for clinical application. At present, over 6,000 cases of IRE treatments have performed for patients with tumor in parenchymal organs, including pancreas, liver, prostate, etc. It is especially advantageous in treating unresectable liver cancer and pancreatic cancer and tumors that are close to big blood vessels, hepatic hilar region, bile duct, and ureter.

At this forum, the participants reached an consensus that cancer treatment should be getting minimally invasive and based on fundamental experiment study. Only by applying the latest research result can breakthrough be made in cancer treatment. 

The 5th International (Guangzhou) Forum on Cancer Treatment (IFCT) ( Second part) --- Cancer Treatment New Idea Reported

More than 200 experts at home and abroad come together to investigate the new idea of tumor treatment in Guangzhou.

Professor, Director of the center for sleep, school of medicine, university of California, Los Angeles, USA, FRISCA LEE YAN-GO and More than 200 experts at home and abroad come together to investigate the new idea of tumor treatment and others from UK, JAPAN and other counties and regions in Guangzhou at July 2^nd . Most  of experts think that new tumor immune therapies will become a new field to defeat the cancer.

The day of opening 2016 5^th International(Guangzhou)Forum on Cancer Treatment, which undertake by Jinan University School of Medicine, International Society of Cryosurgery and other institution, communicated the field of application for Nanokife to treat the tumor and stem cell.

With the influence of aging population, environment pollution, high pressure lead to the rate of cancer incident higher and higher, most of cancer patients were found with mid-advanced cancer when they did their first examination. Face the huge challenge in cancer treatment, how to improve the good quality survival of cancer patients become the most important issue in medical profession today.

The most attracting extension attention is the tumor immune therapy in the meeting , which is a way to use self-immune system therapy to treat cancer and other diseases, mainly include cellular immune treatment technology, the immune molecular targeted drugs , immune engineering technology and etc...

Surgery, chemotherapy and radiotherapy are traditional treatments, but these three treatments just can make effect for 20%-30% of caner patients. Xu Kecheng(Chief president of Fuda Cancer Hospital , Jinan University School of Medicine, Guangzhou,China) said, represented by cryoablation of argon-helium technology and Nanoknife ablation technology as the immune therapies can
 bring the hope to the cancer patients.

Nanokife tumor treatment is a new technology which become a new mode in recent years, that can motivate the anti-tumor immunoreaction. For showing the function of  Nanokife ablation technology, a cancer patient who is 55 year-old has a pancreatic cancer accepted the surgery on the spot communicated by video to the meeting.With the guidance of ultrasound and CT, the patients cancer accepted the pancreatic tumor Nanokife ablation treatment, there is intraoperative bleeding only 2 ml, and the operation is smooth.

LAURAROSS-PAUL, Former associate professor who is from Art Emeritus, Portland State University in US, Suffer the breast cancer 13 years ago, she did a speech: A New Protocol for Cryoablation in Breast Cancer Treatment: What Women Want And Need, which call for doing the cryosurgery treatment for breast cancer patients at an early date.

Moreover, International Society of Stem Cell Regenerative Medicine was established at the same day. Shenzhen second people’s hospital, the director of the center for stem cell Zhao Zhenlin revealed that the society will establish international stem cell function library and engineering technology center, establish the foundation, provide funding for the potential young scholars of stell cell research, promote the development of stem cell research projects at home and abroad.

The 5th International (Guangzhou) Forum on Cancer Treatment (IFCI) （First Part)

The 5th International (Guangzhou) Forum on Cancer Treatment (IFCT) in conjunction with Founding Conference of International Society of Stem Cell Regenerative Medicine, which was held in Guangzhou Fuda Cancer Hospital on July 2^nd , 2016.

It is my first time to attend the Congress which was held in Guangzhou Fuda Cancer Hospital. When i stepped into the hall, there are many experts and medias from different countries to attend the opening ceremony , which make me so excited and amazed about that. 

During the opening ceremony the professor Xu Kecheng did a welcome speech, what most impressive for me is that:

The past two hundred years have witnessed the development of modern cancer treatment. In particular, the recent years and more have seen the deeper understanding of cancer among the public. Moreover, the researches on genetics and protrinology have prompted the development of large number of targeted medicines for cancer. However, there remain huge challenges in the field of cancer treatment. We are still using the conventional technologies to treat most common cancers making few breakthroughs.

The development of imaging technology has prompted the rise of interventional oncology, which marks a remarkable advance in cance treatment. Modern cryoablation which is represented by argon-helium cryosurgery was emerged in the late period of last century. Irreversible Electroporation, came out in recent years, have gained rapid development. Both of the ablation methods have brought hope of life for cancer patients who cannot tolerate surgery or who have unresectable tumors. As an unique therapy, immunotherapy has made itself into new territory for cancer treatment. 

When i heard about that, there was same feeling deep down my heart, i just heard and watch many of cancer patients who benefit from the new cancer treatment, and make them cured or have a long-term survival.

During the meeting, the experts from all over the world to do their keynote speeches and share their new researches of cancer treatments, and what they are talking about is going to a new higher stage of cancer treatment. The subject include:

Section 1: New Thoughts and Strategies on Cancer Treatment.

1. Pancreatic Cancer Research: Gaps and Opportunities.----- Los Angeles, US.

2. Importance of Regulation and Ethics Committee for Cellular Therapy.------ Tokyo, Japan.

3. Testosterone Enhances of the differentiation Efficiency of Insulin-producing Cells from Human Induced Pluripotent Stem Cells.------ Guangzhou, China.

4. Combining ERBB4 with TP53 and RAS Sugnaling Predicts Clinical Outcome in Subtypes of Gastric Cancer.------ Beijing, China.

5.  Sleep Disturbances in Cancer Patients. ------- University of California Los Angeles, USA.

Discussion

Specially Invited Speeches: Voice of Patients

1. Treatment Experience in China. ----- UK

2. New protocol got Cryoablation in Breast Cancer Treatment: what women want and need.------- Oregon, USA

3. Treatment Experience with IRE in Fuda. ------- Philippine

Section 2: Cryoablation Therapy for Cancer

1. The Repetitive Freeze-thaw in Vivo and in Vitro Subculture Method, RFTIVIVSCM to Treat Cancer Patients, and some Evidences from the Mesenchymal Cells Derived from Adipocytes to Support Cancer Therapy.------- Tokyo, Janpan

2. Newly Developed Cryosurgical System Using Thermosiphon: A Fundamental Study and An Animal Experiment.------- Nagoya, Japan

3. A Novel BioCryolmmunological Concept in Science and Medicine: Discovery, Hypothesis & Evolution.------- Vienna, Austria.

4. Survival Analysis of 8000 Cases of Cancer Treated by Percutaneous Cryosurgery.------ Guangzhou China.

5. Application of Catheter Radiofrequency Ablation Combined Stenting in Malignant Bilignant Obstruction------ Guangzhou China.

6. Experience with Skin Cancer Ablation By Intralesional Cryosurgery As well As Executing A live Demonstration. ----- Haifa, Israel

Discussion

Liquid Nitrogen Based Cryoablation. ----- Caesarea, Israel.

Section 3: Irreversible Electroporation Therapy in Cancer Treatment.

1. Ultrasound Guided IRE for Cancer Treatment.------- Taiwai, China

2. Basic Research and Clinical Application of Irreversible Electroporation Ablation in Cancer Treatment.---------- Beijing, China.

3. Experience in Complication of IRE in Cancer Treatment.---------- Guangzhou, China.

4. Interventional Oncology: The Current Status and Future Direction.----------- Leeds, UK.

5. Minimally Invasive Laparoscopic Surgery for Cancer.--------- Kuala Lumpur, Malaysia.

Section 4: Immunotherapy in Cancer Treatment

1. Clinical Application of Stem Cell Transplantation in Pancreatic Surgery.-------- Oxford, UK.

2. Therapeutic Efficacy of Cancer Stem Cell Vaccines in the Adjuvant Setting.------- Michigan, USA.

3. Review to Immune Therapy in Oncology.---------- Beijing, China.

4. Immnotherapy in Lung Cancer in 2016.-------- New York, USA

5. Opinions and Exploration in Multidisciplinary and Personalized Treatment for Cancer.-------- Beijing, China.

6. Clinical Progress of Mesenchymal Stem Cell Therapy in Infertility.--------- Shenzhen, China.

7. Stem Cell Therapy In the Treatment of Cancers.--------- Bangkok, Thailand.

After Listening the content from this international Forum,i know for fighting the various cancer and disease around us, the doctors and experts always try to improve their clinical medical technologies and skills, and try their every effort to save every life from sickness. We can not decide and control the environment we live with, and don’t know when the disease may happen to us, but we need to believe whatever bad disease we meet, the human always can find new breakthrough to overcome the troubles.