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2016年6月5日星期日

Headline news: three academicians wrote prefaces for Xu Kecheng’s new book Living With Cancer


Living With Cancer, recently published by Guangzhou Publishing House, is the third popular science book on cancer treatment written by Xu Kecheng, Chief President of Guangzhou Fuda Cancer Hospital, after his Special Story in 2003 and Nothing But The Truth in 2010.

His understanding of cancer, based on his occupation as a doctor as well as his experience as a cancer survivor, has enabled him to blaze a new trail for cancer diagnosis and treatment and has pointed the way for cancer treatment. As there is no treatment available to cure cancer, Xu Kecheng and his medical team have combined local treatment with systemic treatment, aiming to control tumor progression, improve patient’s quality of life and prolong their lifespan. By doing so, they hope to enable patients to live with cancer and change cancer into a controllable chronic disease.

Living With Cancer is about
The insightful thinking of a sophisticated medical expert
The scrupulous work of a wise doctor with universal love
The true feeling of a strong cancer survivor

What is cancer? Cancer is not caused by foreign body invasion. Cancer cells are bad cells mutated from normal cells. There are numerous cells in human body. The DNA on cell nucleus carries several genes, each of which contains numerous base pair. Normal cells are replicating all the time, so is the DNA in cell nucleus. Gene mutation will occur when replication error, substitution and loss happens to a base group. Cancer cell is thus formed as mutation accumulates continuously. In this sense, each and every one of us is living with cancer. Hence, cancer is not horrible as it is the heritage of human evolution.

How to deal with the cancer cells transformed from normal cells? The cancer cells are to be eliminated but not to be annihilated completely. At present, the commonly used treatments (surgery, chemotherapy and radiotherapy) cannot cure cancer completely. Instead, to reach a harmony coexistence is the important theme to be pursued. It is an ideal and objective that can be attained through hard work to reach a peaceful coexistence between cancer cells and human body and convert cancer into a controllable chronic disease by controlling cancer cells with a single or combined treatment.
In his book Living With Cancer, Prof. Xu Kecheng has analyzed the truth and the secret of cancer by sharing his experience and practice in cancer treatment. There are successful and unsuccessful cases. Prof. Xu tells the story in a vivid way, and illustrates his point of view and assumptions in a simple language. Patient can get enlightenment and healthy people can also acquire knowledge by reading the book.

As a renowned expert in digestive disease with many works, Prof. Xu has been focusing on comprehensive treatment for cancer. As the first few ones in China to have introduced Cryosurgery and former president of International Society of Cryosurgery, he has combined cryosurgery (and the recently introduced NanoKnife) with other minimally invasive treatments such as vascular intervention for progressive tumor treatment. He has made a fruitful step in exploring long-time survival of cancer patients.
Prof. Xu is also a cancer survivor. It is with his unique life experience that he is able to have a better understanding of what are the best, most effective and most economic treatments for cancer patients. He is treating patients with reason as well as emotion, with which he has saved and even cured many patients who were once claimed to be hopeless. Many people are grateful for what he has done for them. He was also awarded Norman Bethune Medal, the highest award in the health system of China and the Role Model of the Times, the highest honor in China.
Living With Cancer is the crystallization of the author’s strenuous effort. Every word is carefully assessed and even the typing work is done by the author himself. It’s said that many of the articles were written at one stretch when the author was waiting at the terminal building or taking a flight. This book is complimenting with Nothing But The Truth compiled by the author in 2010, by reading which readers can have a profound understanding of the author’s philosophy of behavior and doctrine of practicing medicine.
Cancer has become a common disease. Everyone, like it or not, cannot avoid cancer for good. The new book of Prof. Xu Kecheng will make you realize that cancer is the new normality of our life. As long as we maintain a positive attitude, hold the correct idea, adopt innovative strategies, and accept appropriate method, we can coexist with cancer peacefully.   

Note: In January, 2016, academician Wu Mengchao of Chinese Academy of Science, academician Wang Zhenyi and academician Tang Zhaoyou of Chinese Academy of Engineering wrote preface for the book respectively.

Chief President Xu Kecheng noted that he will give all the sales of the book to Fuda Boai Foundation under Guangdong Branch Red Cross Society of China.

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Academician Wu Mengchao wrote a preface for Living With Cancer






Professor Wu Mengchao, academician of Chinese Academy of Science and laureate of the 2005 State Preeminent Science and Technology Award, is praised as the father of hepatobiliary surgery in China.

The past century has witnessed the significant progress made in research on cancer in the medical field. Surgery, radiotherapy and chemotherapy have developed greatly in terms of technology, curative effect and precision. The molecular biology, especially the deepened research in human genomics and proteomics, has created favorable conditions for individualized treatment and precision treatment.

However, cancer treatment remains to be a hard nut to crack in the medical field. Over the past ten years and more, the decreased mortality rate of certain types of cancer should attribute to early detection and early treatment rather than certain types of drugs. Chemotherapy couldn’t bring any actual benefits to most patients with progressive cancer; gene-based or receptor-based target therapy will also become futile in the end.

In his book Cancer: The Heritage of Evolution, the world-renowned hematologist Mel Greaves illustrated from the perspective of Darwin’s theory of evolution that cancer involves both the very ancient heritage of evolution and the recent evolution. He proposed that cancer “can be said to be an innate component of nature in a sense” and “the proximate cause or direct cause of cancer is genetic variation or mutation, which is the result under the rule of occasionality...It is restricted by and at the same time driven by evolution and it is also the inevitable product of evolution”. The insightful views of the author have reminded the medical field to treat cancer with innovative thinking and also revealed that there might be underlying causes for the repeated failure of current treatments.

Having engaged in the research of diagnosis and treatment of cancer for several decades, Professor Xu Kecheng has accumulated rich practical experience. The local ablation (Cryosurgery, NanoKnife), vascular intervention and combined immunotherapy for cancer that he have proposed and carried out have enabled some progressive cancer patients to live with cancer and to be almost free of cancer, which are valuable exploration and practice.
The object of medical research is human life. The medical system that is formed under long-term theoretical exploration and clinical trials is very practical. The findings of animal experiment are not applicable to all patients. Different patients might also show heterogeneity even if they are suffering from the same disease. Ancient Greek philosopher Hippocrates once said, “It makes sense when people say medicine is an art. As a clinician, he/she should first have a caring heart to patient and then made careful observation and analysis of patient’s condition so as to make an accurate diagnosis and implement treatment accordingly. If a clinician doesn’t regard patients as their teachers and relatives, he/she will never become an eminent doctor and bring any actual benefits to patients no matter how much theoretical knowledge he/she has acquired.”

As a first-line practitioner of clinical work, Prof. Xu has been holding a loving heart towards patients and forward thinking towards medicine. He showed even greater perseverance, devotion and spirit of innovation after he underwent operation for liver cancer, which has set a good example for all the counterparts in the medical community. Prof. Xu wrote many essays on cases he attends to by combining the latest concept for cancer treatment and published the essays on several media, which has touched many patients and people who care about cancer. Today, all the essays are compiled into a book with the title of “Living with cancer”, which is really admirable and of great significance.

“Living with cancer” should be regarded as a new concept for cancer treatment and important strategy guiding clinical treatment. As a long-time friend and counterpart of Prof. XU, I would like to congratulate him on the publication of the book and recommend this book to the general public reader.

Wu Mengchao Academician of Chinese Academy of Science       

Academician Wang Zhenyi wrote a preface for Living With Cancer

Academician Wang Zhenyi (R) and Prof. Xu Kecheng

Wang Zhenyi is now an academician of the Chinese Academy of Engineering, foreign academician of French Academy, tenured professor of Ruijin Hospital Affiliated to SJTU. He is also the laureate of the 2011 State Preeminent Science and Technology Award and the first inventor of the induction of differentiation therapy for cancer.

Prof. Xu Kecheng hope that I could write a commentary on his new book Living With Cancer, I’m very pleased to do so as I’m very delighted to have witnessed the accomplishment he has made in clinical practice. I’m convinced that I’m obliged to introduce his experience, way of thinking and innovative method in cancer treatment to clinicians so that more cancer patients can receive benefits from that. I have met with many cancer patients who have gained long time survival after being treated by Prof. Xu Kecheng and his medical team. Among them, there is a 28-year-old ovarian cancer patient. The patient was having advanced ovarian cancer with multiple metastases in the abdominal cavity and large amount of ascites. She miraculously survived after undergoing comprehensive treatments with operation as the main treatment. 
It’s said that she only received 4 times of moderate treatments after operation. As of now, she has had 5-year-disease-free-survival. I can hardly believe that she almost had her cancer cured, which, I think, might be the so-called living with cancer.

Around 8 years ago, I met with Prof. Xu again after haven’t seen each other for over 20 years. During that meeting, we talked freely about the concept and assumptions for cancer treatment. I suggested him to investigate some patients who have lost survival hope in 1990 but received a nonspecific immunotherapy. We were amazed to find that 28 out of 38 patients have survived for 5 years after receiving the immunotherapy. The surprising finding has given me a profound inspiration. That is we might need to change a way of thinking in cancer treatment.

What is cancer? Ever since pathologist Rudolf Virchow founded cytopathology of cancer in 1855, cancer medicine has never made such significant progress like today. At present, a widely-recognized point-of-view among most pathologists is that cancer cells are originally normal cells. There are 40 trillion to 60 trillion cells and 35,000 genes in human body. Each gene has thousands of base pairs. When DNA is attacked by cancerogenic substance, genes tend to have mutations and have these mutations accumulated. Moreover, gene mispairing during gene replication will also cause gene mutations. The mutations are happening all the time along with our aging process, regeneration, healing and reproduction and then develop to the process of carcinogenesis. Hence, it can be said that we cannot get clear rid of cancer from a certain perspective. That is to say living with cancer is a normal state in a life entity like human being under many circumstance.

Based on the above understanding, we need to rethink the current cancer treatment. Cancer cells, transformed from normal cells, are at a twisted state of normal self. There are cancer cells as well as normal cells and tissues (such as hematopoietic cell and tissues) in cancer patients, which means that cancer cells are coexisting with cancer cells and normal cells. Therefore, simple cancer killing method kills not only cancer cells but also normal cells and sometimes kills more normal cells than normal cells. That’s the reason why some patients die of excessive chemotherapy. Research results have shown that the reason why the constantly reproduced cancer cells are not forming cancer tissues is because human body has the mechanism of confronting, eliminating and transforming the non-self cells. The induced differentiation therapy for APL by all-transretinoic acid has reached a high curative effect, which is a good example of transforming malignant cells into good ones. According to our current understanding, immunotherapy, innate and artificially-activated immunological mechanism in particular, might be an important method to control the development of cancer.  

The articles in the book Living With Cancer tell about stories that Prof. Xu has come across in his clinical practice. There are success made, failures encountered, experience accumulated and lessons drawn. He never claimed he has cured cancer. As a doctor, he is happy for the successful treatment done to patients and anxious for the undesired treatment effect on patients. American doctor E. L. Trudeau once said, “To cure sometimes, to relieve often, to comfort always.” Prof. Xu and his medical team combined local treatments (such as cryosurgery, radiotherapy, vascular intervention) and systemic treatment (such as nutrition support, selective chemotherapy and traditional Chinese medicine), aiming to control the progression of cancer, improve patients’ quality of life and prolong their survival time. The combination of treatments has brought actual benefits to patients and some patients have received quite formidable curative effect. WHO claimed that cancer is a type of chronic disease, the meaning of which is to live with cancer. The treatment strategy advocated by Prof. Xu is a useful innovation to practice the concept of living with cancer. 

Some people said that there are four realms for person, natural realm, material realm, moral realm and cosmic realm. During each of our meetings, he could always put forward some prospective questions from the perspective of moral realm and cosmic realm, about which we have a lot in common. I also realized that the reason why Prof. Xu has treated so many patients is not only by virtue of excellent skill but also humanitarian factors. As a saying goes, doctor should have a parental heart. To love others and love patients are always the basis for a doctor to practice medicine.

I have read the popular science books Nothing But The Truth and Follow Me to Fight Against Cancer written by Prof. Xu and I’m greatly touched and enlightened after reading the books. I also find the book Living With Cancer, very interesting. I believe that the publication of the book will not only bring benefits to patients but also bring inspirations to professionals in cancer diagnosis and treatments. I would like to congratulate him on the publication of the book and warmly recommend this book to the general public readers.

Wang Zhenyi academician of Chinese Academy of Engineering    

Academician Tang Zhaoyou wrote a preface for Living With Cancer

Academician Tang Zhaoyou (R) and Prof. Xu Kecheng

Tang Zhaoyou is currently academician of Chinese Academy of Engineering, professor of surgery and chairman of Liver Cancer Institute of Fudan University. He has made a major contribution to the establishment of the concept and theory of Subclinical Hepatocellular Carcinoma. He is the laureate of gold medal of “early treatment, early recovery” of American National Cancer Institute.

As a long-time friend of Prof. Xu Kecheng, I readily agreed to write a preface for his new book Living With Cancer at his invitation. It’s not because I’m fully qualified to write the preface but because we hold similar views on certain concepts. Therefore, I would like to call for people to make a reflection on the strategy of anti-cancer battle by writing a preface for the book. I have read some of the articles and find the book quite interesting and full of philosophical implications. I personally believed that it is not only a popular science book but also a refined book to upgrade the strategy for anti-cancer battle.

In 2011, I compiled To Employ Both Elimination and Transformation—A New Perspective for Cancer from an Academician and the second edition went to publication in 2015. The preface of the book started like this, “Over the past century of anti-cancer battle, we hold cancer elimination as the main objective and have made a considerable headway in this regard. However, we still have a long way to go to conquer cancer. Though early detection and early treatment have greatly improved the curative effect, it’s very difficult to make further improvement. It seems that elimination alone is not enough and transformation should also be considered to enable patient to live with cancer. The transformation also involves the improvement of patients’ immunity to fight against cancer.”

After reading several articles of the book, I learned that the reason behind the successful treatments is a combined use of ablation methods and other comprehensive treatments, which has both eliminated the tumor and improved patient’s immunity to fight against cancer.

Last year, I delivered a speech titled “To develop medicine with Chinese characteristics” at the annual meeting of oncology of Chinese Medical Association. I believe that to develop medicine with Chinese characteristic is the history mission brought by Chinese rise. To fulfill the objective, Chinese elements are needed. Chinese elements should accord with China’s national conditions and Chinese thinking modes while Chinese thinking modes should make full use of traditional Chinese culture. In the book Living With Cancer, Prof. Xu quoted from The Inner Canon of Huangdi that “Moderate treatment should be applied to treat disease or else, the fundamentals might be injured.” The ancient wisdom also deserves our reflection on the current strategy of elimination in the anti-cancer battle.

Several months ago when I was making the rounds of wards, I put forward my own understanding of the definition of cancer, “Cancer is the internal turmoil caused by long-term internal-external unbalance. It is a systemic chronic disease mainly characterized by alternations of heredity character of local cells.” My view of internal turmoil coincides with that of Prof. Xu. Different from infectious disease that is caused by pathogen invasion, cancer is developed because human body is out of order and cancer cells are evolved from normal cells. The treatment for infectious disease is to eliminate invaders while cancer treatment focuses not only on eliminating the major insurgent but also on surrender the residual enemies.

The treatment strategies and therapeutic measures proposed by Prof. Xu are of great importance in practicing the concept of living with cancer. I wish the publication of the book a complete success!

Tang Zhaoyou academician of Chinese Academy of Engineering   

2016年5月9日星期一

Big news: The medical team of Fuda Cancer Hospital removed a giant abdominal tumor weighing up to 6.1kg for a female patient

On April 20, 2016, the medical team of Guangzhou Fuda Cancer Hospital created a miracle of life once again. After eight hours’ hard work, the medical team at Fuda Cancer Hospital completed a complicated operation-they removed the giant abdominal liomyoma for a young female. The largest mass removed, weighing over 6kg, is bigger than two footballs.



The medical team of Fuda Cancer Hospital Haizhu Branch successfully removed a giant abdominal tumor for a female patient


A women with giant abdomen walked into the office of President Xu Kecheng

In the morning of March 25, 2016, a “heavily pregnant” woman, accompanied by her family members, walked into the office of Xu Kecheng, Chief President of Fuda Cancer Hospital. The patient surnamed Lin, 29 years old, is from Lianjiang, Guangdong. She told President Xu that she was not pregnant; instead there was a big tumor in her abdomen. She could feel that the tumor was still growing and she was having breathing difficulty. She entreated Fuda Cancer Hospital to help her.

After studied Ms. Lin’s examination result, Prof. Xu Kecheng was shocked as the abdominal tumor was so big that it has occupied her whole abdominal cavity. The organs in abdominal cavity were heavily compressed. The patient was having breathing difficulty, urination difficulty, hydronephrosis, injured renal function and edema in the lower limbs. Due to long-term consumption of tumor, she was emaciated and pale but her eyes revealed her desire for life.

“President Xu, doctors at the local hospital and several major hospitals in Guangzhou said I cannot get operated. Please help me. I’ve got to stay alive because I have two kids to look after...”

Looking at the patient with a giant abdominal tumor reminds President Xu Kecheng of these patients with giant abdominal tumor who have been successfully treated at FUDA. They are Peng Ximei, Bingbing, etc. He decided to challenge the impossible once again and try all out to help her.

At noon on the same day, Ms. Lin was sent to Fuda Cancer Hospital Haizhu Branch and was admitted for postoperative recurrence of abdominal liomyoma.

The nightmare started three years ago

Ms. Lin is from Heliao town, Lianjiang City, Guangdong Province. In December 2013, Ms. Lin, 26 years old, felt abdominal distention accompanied by dull pain. She did ultrasound and CT scan at the affiliated hospital of Hainan Medical University and was found to have an enormous space-occupying lesion in the abdomen, which was suspected to be benign tumor. Then she underwent tumorectomy. The pathological result showed (abdominal wall) gastrointestinal mesenchymal tumor, likely to be liomyoma. After the operation, she had paroxysmal left lower abdominal pain occasionally, but she did not pay any attention to it. In October 2015, she was found to have mass in the previous tumor bed during her re-examination. Tumor recurrence was detected and the tumor was growing rapidly.

Ms. Lin was very afraid. She was even dreading to imagine what the consequences would be if the tumor continued to grow. The nightmare had been hanging over her and her family members.

“Maybe I consult with some major hospitals in Guangzhou.” it suddenly occurred to her.

However, things did not go well as they thought. They consulted several major hospitals in Guangzhou, but doctors all said that the tumor was too big to be resected.

She saw a glimmer of hope after being admitted by FUDA

As the tumor grew bigger, she started to have such symptoms as constipation and dysuria. Her husband proposed, “We may go to Beijing and have a try. There will always be a way out.” When Ms. Lin was hesitating the next step forward, what her mother-in-law said caught her attention “Several days ago, I watched a TV program. It tells about how a hospital successfully treated a girl who have giant abdominal tumor. I remember the hospital is called Fuda Cancer Hospital. “Should we have a try in that hospital?” Ms. Lin agreed to her mother-in-law’s proposal and come to Guangzhou Fuda Cancer Hospital with her family. On March 25, Ms. Lin was admitted into Fuda Cancer Hospital Haizhu Branch.

Face up to the difficulty

Ms. Lin completed relevant examination upon admission. The findings of CT scan are as follows: postoperative recurrence of abdominal liomyoma is considered; adjacent intestines, bladder and uterus are compressed and adhered; the inferior pole of left kidney is compressed; bilateral ureters are compressed and narrowed. The abdominal aorta and bilateral illiac arteries and veins are compressed; small nodular lesions are noted in the inferior lobe of right lung; hydronephrosis is noted in bilateral pelvises and the superior segment of ureter and the left side is more significant, which are considered to be caused by the compression of the middle-lower segment of both lower ureters; the left kidney is enlarged; the left kidney function is damaged; varicosity is noted in the space between the inferior margin of spleen and the abdominal mass; varicosity is noted in pelvic cavity...ECG test showed sinus bradycardia.

As the tumor showed rapid progression, Ms. Lin had difficult defecation. Patient’s symptoms together with the erect abdominal plain radiograph showed the possibility of incomplete intestinal obstruction.

The Vice President Li Haibo, Chief Physician Wang Jiannan, Visiting Doctor Zhou Zhanchun, Visiting Doctor Leng Yin, Resident Doctor Lin Qiongmei, Resident Doctor Li Chunli made an in-depth study on Ms. Lin’s condition and held preoperative discussion.


Prof. Wang Jiannan noted that the operation carries four major risks:

1. The surgical incision will be very hard to heal since the tumor is too big and needs to be fully exposed during the operation;

2. There isn’t a clear demarcation between the tumor and adjacent organs and tissues. The adjacent blood vessels, kidney, ureters, intestines, uterus, and bilateral adnexa might be easily injured; hence, revascularization, colostomy, pyelostomy might be done during the operation;

3. The postoperative recurrence rate is high and repeated operation may need to be done due to incomplete resection of tumor;

4. The risk of intraoperation massive haemorrhage is high; hence, abundant blood product should be prepared. The chance of having extensive intestinal adhesion is high; hence, anti-adhesion treatment needs to be done before closing the abdominal cavity.

Dr. Li Haibo noted that the giant abdominal tumor is compressing important visceral organs such as heart, blood vessels, kidneys and intestines, causing functional disturbance. Patient will die of multiple organ failure if the operation cannot be done. Other treatments, such as radiotherapy, chemotherapy, mini-invasive ablation are of no help to the patient. Only surgical resection of tumor can save the patient’s life. Fortunately, the tumor is only compressing not invading the important organs in the abdominal cavity. Impaired renal function is caused by urination difficulty that is caused by tumor compression. The impaired renal function can be reversed if the compression is relieved. He mentioned that considering that the patient can tolerate major operation as she was at her prime and the level of tumor malignancy was not high, the patient had the opportunity to have the tumor resected and enjoy a long-term surviving. Though the operation carries great risk, the reward was worth the risk as long as adequate preoperative operation was made.

The anesthetist Fang Gang believed that the reward of the operation was worth its risk. The consequence would be fatal if operation was not done at an early date.

After three rounds of discussion, the medical team of Fuda Cancer Hospital decided to do the following procedures for the patient: bilateral ureter stenting+exploratory laparotomy+abdominal tumor resection+colostomy. The operation was scheduled to take place on April 20.

The giant tumor is removed

After the attending doctor explained to Ms. Lin and her family member the operation plan and the possible risks entailed, Ms. Lin said, “I don’t have any way out. I want to have a try regardless.”

At 8:00a.m., of April 20, Ms. Lin was wheeled into the operation room. The operation room was in tension. The surgeons were Prof. Wang Jiannan and Vice President Li Haibo; the assistants were Zhou Zhanchun and Leng Yin.  Anesthesiologist Fang Gang was in charge of intraoperative management.

As expected, the giant tumor was found to have occupied the abdominal cavity and it’s impossible to have a full view of the tumor after the abdominal wall was cut open. A slight move would cause bleeding as the tumor was rich in blood vessels. Shortly after the operation began, the amount of bleeding reached about 1,000ml. The operation was a big test of perseverance and courage to the surgeons. The surgeons, bold but cautious, exposed the tumor while stopping bleeding. The anesthesiologist and the surgeons acted in close coordination. The anesthesiologist kept the surgeons informed of the patient’s vital signs and gave timely blood transfusion and fluid infusion to patients, which have bought more time for surgeons.

The operation was ongoing: to separate abdominal wall adhesion, to separate angiosynizesis, to separate ureter adhesion, to separate bladder adhesion, to separate intestinal adhesion, to remove part of the invaded intestine, to do intestinal anastomosis, to do hemostasis by ligation, in the end, to do colostomy. Unconsciously, eight hours passed, with the concerted effort of all medical staff, the tumor was finally removed.

The largest mass removed weighs up to 6.135kg


It took a dozen of operation staffs eight hours to complete the operation. The amount of bleeding, blood transfusion, blood plasma, platelet, albumin were 6,300ml, 5,000mg, 3,000ml, 1 mechanical production unit, 90g respectively. A total of over 10,000ml infusion and transfusion were made. The largest mass removed weighed up to 6.1kg. These startling figures represent the return of a life.

When Prof. Wang Jiannan walked out of the operation room, he took a deep breath and said to the patient’s family, “The operation is very successful. The patient has had stable vital signs throughout the operation. Please rest assured.”

When Dr. Li Haibo showed the removed mass to the patient’s family members, they were full of surprise, happiness and appreciation. They never thought that there was such a big mass in the patient’s abdomen. They are so amazed that the tumor that was deemed to be unresectable by the nationally renowned hospitals is removed at Fuda Cancer Hospital. They are so happy that the patient’s life gets extended. They are even more grateful for the respect that the medical team of Fuda Cancer Hospital has shown to life.

At 10p.m., five hours after the operation, Ms. Lin, who was still on respirator has been wide awake from operation in the ICU. Her vital signs were stable and intraperitoneal drainage was becoming less. After completing relevant examinations, Li Haibo, the Vice President of FUDA, removed her tracheal intubation, which means that her life was out of danger. He said, “We are greatly relieved to see that she has pulled through the difficult situation and is having stable vital signs now. What we have done have been very rewarding. ”



Xu Kecheng, the Chief President of FUDA, visiting Ms. Lin

2016年4月8日星期五

The New Technology Could Bring Benefits to Cancer Patients if the Tumor is Identified

Ms. Gurli, a 68-year-old Danish anti-cancer celebrity

“To know others having cancer is one thing, but to know yourself having cancer is another thing. My world was almost collapsed when I got to know my diagnosis.” Ms. Gurli, a retired Danish teacher said when she was sharing her experience of “living with cancer”. It~s hard to tell that she has been a 68-year-old cancer patient from her energetic demeanor. In 2008, her Danish doctor claimed that “she only had three to four months to live whatever treatments she would receive”. What it is that has made her such an active and humorous person 8 years later.

In the morning of March 16, 2016, Guangzhou Fuda Cancer Hospital held a special experience sharing meeting, on which the cancer patient Ms. Gurli, the 100th patient who has underwent NanoKnife illustrated to the attendants the success of NanoKnife with her own experience. It is known that conventional resection operation would inflict great physical trauma to cancer patient; it makes cancer patients even more painful to undergo radiotherapy and chemotherapy. Moreover, resection operation would often inflict irreversible damage to normal tissues, blood vessels and nerve system in particular. The physical trauma and damage would adversely affect postoperative recovery and the living quality of patient. Hence, in the face of treatment, cancer patients have more fears to the operative wound and the trauma that might be caused by resection operation. Fortunately, we are pleased to see the application of a latest treatment modality for cancer that is NanoKnife. According to Prof. Niu, Executive President of Guangzhou Fuda Cancer Hospital, during the procedure of NanoKnife, 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. Apoptotic tumor cells will be consumed by immune cells as their antigens are exposed. The zone where tumor was located will be replaced by normal cells and resume normal function gradually. In short, NanoKnife is a mini-invasive, harmless or low harm, precise and effective method for tumor inactivation. The most distinctive feature of NanoKnife is that it can preserve the normal tissues and structures in the targeted area in a non-invasive way so as to create favorable conditions for the blood vessels, nerve tissues in the ablated area to restore their normal function. Ms. Gurli underwent NanoKnife for the multiple neuroendocrine neoplasms in liver on March 8, 2016. She was full of spirit and energy and was able to walk and talk like a normal person when we met her at the experience sharing meeting. Such a fast postoperative recovery can never be seen in traditional resection operation.

Dr. Lu Mingying, the Rank Prize winner and Chinese scientist shared with the attendants her successful treatment experience

Another special patient also presented at the experience sharing meeting. She is Dr. Lu Mingying, the Rank Prize winner and Chinese scientist. She learned of NanoKnife on the internet. She noted, “I searched on the internet with NanoKnife as the keyword and found Guangzhou Fuda Cancer Hospital in the end. I made several phone calls to FUDA and learned that FUDA has completed over 70 cases of NanoKnife at that time. I believe that NanoKnife has been well developed at FUDA and I made the decision to FUDA to receive NanoKnife.” Prof. Niu said, “She could not walk due to intense abdominal pain and abdominal distension upon admission.” Dr. Lu Mingying underwent NanoKnife at FUDA on February 2, 2016. She had her symptoms alleviated significantly and was able to walk on February 6. It is reported that NanoKnife is applicable to liver cancer, lung cancer, kidney cancer, prostate cancer and other solid cancers. It has distinctive advantage in treating tumors that is close to hepatic hilus, gallbladder bile duct, pancreas, and ureter. Moreover, over half cases of NanoKnife in China are completed at Fuda Cancer Hospital.


Xu Kecheng, Chief President of Guangzhou Fuda Cancer Hospital noted that over the past ten years, Fuda Cancer Hospital has been committing to treat advanced cancer--a difficult medical problem in the world with “3C+P” treatment model dominated by cryosurgical ablation (CSA), cancer microvascular intervention (CMI) and combined immunotherapy for cancer (CIC) with an aim of prolonging patients~ life and improving their quality of life. FUDA has been leading the world in terms of the number of cases and types of cancer that CSA has treated; FUDA has also made breakthrough achievements in treating central lung cancer, great hepatic carcinoma, and pancreatic cancer with CSA, which has won several awards for FUDA at home and abroad. In June, 2015, FUDA introduced NanoKnife equipment from America and carried out the first NanoKnife on pancreatic cancer in mainland China on July 2, 2015. As of now, FUDA has completed 100 cases of NanoKnife, the number of which ranks the first in China.


On the same day, Guangzhou Fuda Cancer Hospital and BGI Group signed a strategic alliance agreement. FUDA-BGI strategic alliance allows experts on both sides to carry out concrete discussion on the cooperation vision and feasibility of the building and application of tumor sample data base, tumor detection at molecular level and the screening and early warning of high risk group by combining cancer high incidence scene and high-throughput sequencing.

2016年3月20日星期日

Xu Kecheng’s Ward Round Essays: Four Cases of Pancreatic Cancer

On 26th February, 2016, it’s Friday. I made rounds of the wards and visited 14 patients including four pancreatic cancer patients which made me impressed.



The first case is a female of 58 years old with pancreatic tail ductal adenocarcinoma. She was admitted to FUDA for the first time on November last year. At that time, she suffered from severe pain on lower back. The CA 19-9 in the blood was 8000u/ml. The size of the tumor was 3*4 cm with peripancreatic lymph nodes metastasis. After having ultrasound screen and irreversible electroporation (nanoknife therapy) ablation guided by CT, the pain was relieved. Patient went back to hospital for re-examination this time, and the general condition was good. The patient complained of ambiguous pain on left abdomen, which was relieved by taking non-steriodal pain-killing drugs. And the CA19-9 dropped to 600u/ml. Then, the patient was having peripancreatic lymph nodes absolute alcohol injection guided by ultrasound screen. She was also having NK immunotherapy at the same time.  

The second case is a male of 65 years old. His waist has been painful for a month. Neck of pancreas occupying lesion is 3-5 cm with peripancreatic lymph nodes swelling. The biopsy showed adenocarcinoma. In January this year, under the guidance combined with ultrasound and CT scan, the lump of tail of pancreas and peripancreatic lymph nodes were ablated by percutaneous nanoknife (irreversible electroporation ) surgery. After surgery, abdominal pain was relieved quickly. He went back to FUDA for re-examination a week ago with mild pain on his abdomen. The MR re-examination showed that activity of original lump in the pancreas was cut by 90%. Under the guidance of ultrasound scan, he had local alcohol injection and NK cells injection for taking immunotherapy.


The third case is a male of 61 years old who comes from Hong Kong. The lump in the head of pancreas was 3cm, which suppressed common bile duct and caused obstructive jaundice. Serum bilirubin concentration was 65mmol/L. The tumor was ablated by nanoknife (irreversible electroporation) with the guidance of ultrasound and CT. After surgery, patient could walk and get ready to come back Hong Kong for having endoscopic common bile duct cathetering.  


The fourth case is female of 62 years old. She accepted surgery at a hospital of a big city which included resection of stomach, duodenum, common bile duct and the head of pancreas. And he had chemotherapy. On 15th February, 2016, he was admitted to our hospital. The CT examination showed that there were multiple metastases in liver and enlarged lymph nodes in the head and neck of pancreas. HepaSpherin microspheres intervention was injected percutaneously to hepatic artery. Recently he had percutaneous cryosurgical ablation on liver with the guidance of CT. At the same time, metastatic lymph nodes were injected with 125 iodine seeds. And he was ready to get NK cell immunotherapy. 

Recent years, the morbidity of pancreatic cancer has been increased obviously, which is the No.4 most common cancer of digestive system. Treating pancreatic cancer is still world’s challenge so far. As for the above four cases, the first three cases were accepting nanoknife (irreversible electroporation) therapy. When three cases were diagnosed as pancreatic cancer, there were metastases in peripancreatic lymph nodes and suppression in blood vessels, which was impossible to remove by surgery. As for unresectable pancreatic cancer, ablation plays an important role as alternative treatment nowadays. Cryosurgery and nanoknife are common ways to ablate tumors. In 2012, after nanoknife (irreversible electroporation) being allowed to apply in treating soft-tissue tumors in America, nanoknife for pancreatic cancer treatment attracts attention all around the world. It can ablate tumors in targeted area clearly without much harm to great vessels and intestinal wall. Nanoknife conducts nanoscale perforation to cells membrane by high voltage and short current pulse. It’s neither hot nor cold, which doesn’t cause obvious inflammation. As we know, inflammation is the main factor causing cancer’s development and metastases. Therefore, nanoknife makes fewer side effects on patients. Patients will recover sooner after surgery. 

According to the reports from ten great hospitals’ reports, nanoknife therapy for pancreatic cancer treatment has been applied in more than 3000 cases, and the therapeutic effects are good. Guangzhou Fuda Cancer Hospital has applied nanoknife therapy since last July, which was the first case of nanoknife application in the mainland of China. More than 50 cases of pancreatic cancer patients accepted nanoknife therapy. Initial follow-up shows that the ablation technique has a good therapeutic effect with slight complications.

The first three cases above accepted nanoknife therapy, which was correct. Of course, the long-term effects need to be further observed. The recent condition was steady and the pain was relieved obviously. The fourth case of pancreatic cancer patient accepted surgery at out-of-town hospital. It’s conventional treatment. Unfortunately, the lesion recurred with liver metastases. Why did it metastasize so quickly? Was it undiscovered before surgery, or was surgery promoting metastases?

In 2007, a report named “Reveal the Mystery about Treating Cancer Causing More Metastases” from America said, treating cancer by surgery, chemotherapy and radiation would probably lead to cancer cells metastases. Surgery can accelerate cancer. I don’t have direct evidence on this topic. Someone has compared the cancer metastases after cryosurgery and surgery in experimental animal mode. He found that cancer metastasis after having surgery was earlier and more severe. And he thought TGF-βincreased after surgery. It’s the factor that leaded to cancer cell proliferation. Cryosurgery and nanoknife therapy are local ablations. The damage of tissue is less, and died cancer cells after ablation release antigen, which stimulates immune cells to generate anti-cancer immunity. Then it reduce the incidence rate of cancer metastasis.   

It doesn’t deny surgery certainly. Surgery is still the main means of treating early-stage cancer with mastering indication. It’s hard to say whether the 4th case has surgical indication. The diagnosis of pancreatic cancer is often with metastases. Therefore, it should be especially cautious of evaluating patient’s condition and grasping surgical indication.

The February 26th ward-round was to solve the problem about subsequent treatment. The first three cases all accepted nanoknife therapy. It’s impossible to ablate all tumors. I am not advocating chemotherapy for its function of prolonging patient’s life is limited, especially to pancreatic cancer patient of middle and advanced stage.

Famous book Sun Tzu’s The Art of War once said that a cornered animal is a dangerous foe, which is full of philosophy. In other words, it means that not hotly pursuing an enemy who is caught in a hopeless situation. Fierce attacks make enemy to resist strongly, which leads to great cost inevitably. The right way is inducing it to capitulate and making it safe. Then, live peace with each other.

A great number of evidence shows that chemotherapy has opposite effect which not only kills no cancer cells, but makes cancer cells growing. No.4 case had chemotherapy after surgery. I can’t claim whether the opposite effect of chemotherapy promotes metastases.

I suggest the former patients taking immunotherapy mainly. At present, CIK-DC and NK cell immunotherapy are most practical among all immunotherapy adopted in our hospital.

Recently, I read a report of World J Gastrointest Pharmacol Ther.2016. It said that scholars from five units reported their result of applying DC cell-based vaccine in treating pancreatic cancer. They processed DC cell with streptococcus immunoadjuvent OK432 and made Vaccel vaccine. They found DC vaccine could promote Th1 at a favorable situation and generate IL-12 in the way they processed DC vaccine, which had a better effect on fighting against cancer. 255 inoperable pancreatic cancer patients injected the vaccine. It’s discovered that patients with positive DTH had longer survival time than patients with negative DTH. Then, the author added HLAI restrictive WT1-II and restrictive WT1-I into DC cell, which was proved to prolong survival time of pancreatic cancer patient. In Japan, OK432 is most common potentiator for boosting immunity in cancer treatment. There are medicines like OK432 at home. Such as highly agglutinative staphylococcin (HASL), it’s extracted from staphylococcin. It should be sublingual medicine for lots of sublingual lymph nodes absorbing and stimulating immunity directly. I suggest giving patient this medicine.

There is always one thing conquering another in nature. Snake is the enemy of rat; bat is the enemy of mosquito; and bird is the enemy of grasshopper. The same as in human body, to fight against cancer cells, we also can use the natural enemy of cancer cell. That is NK cell.

I read lots of literature, which demonstrated that in-vitro amplificatory and highly activated NK cell shows strong activity of fighting against cancer in vitro and vivo. Another clinical test shows that allograft NK cell is effective in treating lymphoma and progressive, recurrent and solid tumors. The author injected continually NK cell to the patients three times, and the highest number of NK cell was 3*107 (about 30 billion) per kilogram. Among 17 evaluable patients, eight patients’ condition (47.1%) tended to be steady. CD8+T cells which have killing effect on cancer cells increased and T cells correlated cytokines was up regulated. On the contrary, T cells, myeloid-derived suppressor cells and TGF-β(transforming growth factor-β) which have regulatory rather than inhibitory effect on cancer diseased. The author thought a great number of allograft NK cell injections not only were safe and available but also were important method to maintain organism’s effective immune response (Cancer Immunol Res.2016).
  
Therefore, as to the four cases of pancreatic cancer above, I suggest giving cells adoptive immunotherapy. At meanwhile, I suggest adopting traditional Chinese medicine to adjust intestine and stomach, which also helps improve immunity. A few days ago, I offered eight kinds of TCM including salvia miltiorrhizae, astragalus, dried wolfberry, dried hawthorn, dried tangerine and Mangnolia officinalis etc. to the four patients above. After taking these TCM, distending pain of upper abdomen was relieved and the eating was improved.