2023-10-18 08:15:05
[Ming Pao News]Cancer strikes, do we still have a choice? Middle school classmate “Da Lao Rong” and his friend Anson have been diagnosed with cancer one after another recently. Da Lao Rong (Editor’s note: He has had high cholesterol for more than 20 years, and a physical examination revealed that 50% of the coronary arteries were blocked and there was a shadow on the right lung) was diagnosed with early stage lung cancer. Anson was diagnosed with advanced cholangiocarcinoma due to swollen feet. (Editor’s note: The examination results showed that the patient had a tumor of about 7 cm in the abdomen. The tumor pressed on the main vein, blocking blood circulation and causing swollen feet.) The two people’s choices for cancer treatment , effectiveness, side effects, etc., there are different considerations, as well as arrangements other than treatment, which cannot be ignored.
Right lung shadow examination revealed early stage lung cancer and recovered after surgery
“Big Brother Rong” is one of my best middle school classmates, and he is also the “big brother” of our self-proclaimed “Metal Five”. It is natural for Ah Wing to be called the “Big Brother” because he is not only good at reading and has excellent interpersonal relationships, but he is also a natural leader; he is responsible, decisive and has strong expressive skills. Therefore, everyone calls him “big brother” obediently. After graduation, I don’t know when, but old friends started calling him “Lao Shirong”, probably because of Ah Wing’s outstanding achievements in the workplace. He is the vice president of the company and the “old man” of all employees, so he has changed from “big boss” to “old man”. Ah Wing has a lot of things to do. Today he is either flying to the United States or heading to the mainland. Tomorrow he will either go to South America or South Africa. As he said, “It is difficult to even eat in Hong Kong!” Moreover, he has been diagnosed with high cholesterol since he was 43 years old. . Although the doctor advised him to control his diet and eat lightly, it was not easy for Ah Rong. Not to mention quitting, I couldn’t even find time for a follow-up consultation. He said that he was riding a tiger and it was difficult to get off. How could he control cholesterol on the back of a tiger?
Weigh the pros and cons – When considering treatment options for cancer, it is best to understand the pros and cons of various treatments and do your homework before talking to your doctor. (sdecoret,imtmphoto@iStockphoto)
After 20 years of high cholesterol, 50% of coronary arteries are blocked
However, things are often not what you expect. Just when you thought the world couldn’t stop, suddenly a major epidemic, including flight bans, quarantines, and restrictions on gatherings, came one after another. A call to stop completely changed Ah Rong’s mind, and he realized that the person he was riding on might not be a tiger. Therefore, after jumping off, the first thing to do is a thorough physical examination.
The results of the physical examination will be available soon. Except for excessive cholesterol, all indicators are generally normal. However, the doctor still said: “Although you don’t have angina, your cholesterol has been high for more than 20 years, and you are a high-risk patient for coronary heart disease! Why don’t you do a coronary angiography?” So Ah Wing did the examination. The report found that calcification occurred in the coronary arteries and about 50% of the blood vessels were blocked. Although Tong Bo Tsai’s surgery was not necessary, an “unsettling” shadow was found in his right lung.
This report is truly disturbing. So Ah Rong came to me. After reading the report, I tried to explain: “This computer scan is mainly a cardiac coronary angiography. If you want to know the actual condition of the lung tissue, you need to do a computer scan of the lungs to obtain further information on the lungs and surrounding lymph. If the report found If the patient is abnormal and is suspected to be a tumor, further examination, such as a whole-body positron emission tomography scan, may be required to determine whether the tumor is malignant or has spread before a treatment decision can be made.”
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Cancer cells have not spread and stage one lung cancer is expected to be cured
Although Ah Wing was shocked, he was still willing to undergo further examinations. After all, his mother and aunt both died of lung cancer. The cancer of the two elders was already in the terminal stage when it was discovered. The cancer cells had spread and surgery was not possible. To be honest, when I read Arong’s subsequent inspection report, I felt really uneasy. At the moment, I couldn’t tell whether it was good news or bad news. The bad thing is: the tumor in the middle lobe of the right lung is malignant, and lung cancer is diagnosed; the good thing is: the cancer cells are limited to one lobe and have not spread; the peripheral lymph nodes have not been affected. It is a stage one lung cancer and usually only requires surgery. It is possible to recover without chemotherapy or electrotherapy.
Although cancer is scary because it is always a serious disease, it is still treatable with current medical treatments. Common cancers such as breast cancer, thyroid cancer, colorectal cancer, etc., if it is in the early stage, the tumor can be removed through surgery. The patient does not even need follow-up treatment such as electrotherapy and chemotherapy, and the cancer can be eliminated from now on. Therefore, the first principle is to remove the tumor as soon as possible. So I advised: “While the tumor is still small, the relevant part should be removed as soon as possible. Ah Wing, let me recommend a surgeon to you, okay?” Unexpectedly, he flatly refused.
Prescribe the right medicine to the case – everyone’s physical condition is different. The more expensive the medicine for cancer treatment, the better. Suitability is the most important thing. (Talaj@iStockphoto)
Minimally invasive tumor removal reduces pain
“Ah Fu, no need! I don’t want to do surgery. Cut off the lung lobes, how can I breathe! I would rather let nature take its course and not force it.” Ah Wing and his wife left the clinic. I feel even more uneasy. Later, I met Ah Wing’s wife Yingying, who was also my classmate and the “school beauty” of our middle school. She was one of the most gentle and virtuous women I had ever met.
I explained my worries to Yingying one by one: “If you delay the operation, it will be even more troublesome if it spreads! My aunt and uncle couldn’t do the surgery at that time, but it is different now. Ah Wing can be cured with the surgery. Not all cancers are terminal diseases. With medical treatment !” I introduced two doctors to them. A thoracic and pulmonary physician explained to Arong the necessity of surgery and the impact on postoperative function. Another cardiothoracic and pulmonary surgeon studies surgical practices and assesses postoperative risks.
The understanding and support of family members are often the biggest pillar of support for patients. After calm analysis, Yingying and Ah Rong visited two doctors within a week. I would especially like to thank my colleague from the Department of Cardiothoracic and Pulmonary Surgery. His extremely detailed professional analysis and empathy greatly cleared Arong’s doubts. Minimally invasive surgery greatly reduces pain. Ah Wing can return home and rest 5 days after the surgery. He recovered quickly and in the past six months, he said he was healthier than before.
Later, I received a message from him: “The computer scan report came out after 6 months. I am grateful that everything is normal and has not spread. If I want to go deeper, I may be grateful for this disease, because after I stopped, I discovered that life can actually be possible. So happy, so leisurely. Thank you, Ah Fu.”
Related reading:[Top 10 Common Cancers]Early-stage lung cancer symptoms may be difficult to detect. Non-smoking patients are more likely to suffer from lung adenocarcinoma. Multiple treatment methods at different stages
There is no hope of radical cure for advanced cholangiocarcinoma. Make arrangements now.
Just when I was feeling comforted, another friend’s message came from my phone: “Edward, I’m sorry to bother you. After I got this news, I thought of you immediately. I hope you can give me some advice.” Oh, what’s up. It seems Anson has run into a problem. Anson has been retired for many years and has a very exciting life. He often jokes that he is a full-time person. She is a full-time volunteer and is busy with many voluntary tasks in the Catholic district and her alma mater every day.
Although it was already 11:30 pm, I thought she must not be able to sleep. So, I called her directly. Anson informed that due to persistent edema in both feet, he saw his family doctor and had a check-up. She uploaded the blood, magnetic resonance and positron scan test reports and asked me to read them and give her some opinions.
The risk of surgery for cancer cells spreading in tumors 7 cm inside the abdomen is high
The report was: The patient had a tumor of about 7 centimeters in his abdomen. The tumor presses against the main vein, blocking blood flow and causing swollen feet. The blood cancer cell index is 100 times higher than the normal index. Such a report really makes people feel calm instantly. It seems that cancer is inevitable and the condition is quite difficult to deal with. What tumors could arise in that location? Are any other organs affected? Can removing the tumor stop its spread? Are there any other ways to treat it? For a moment, it was hard to tell. Therefore, I advised Anson: “At this stage, the most important thing is to find a specialist and get more actual information about the condition before making a treatment decision.”
Within 3 days, the specialist made the following analysis: The patient suffered from cholangiocarcinoma, and the cancer cells had spread to the main vein and peripheral organs, including the liver and kidneys. If you want to remove the tumor through surgery, you need to remove a large part of the liver and right kidney, and reconnect the main vein to surrounding organs. This is a very large operation and the risk is quite high.
I believe that anyone who knows this will be frustrated and worried. Many cancers that grow in internal organs, such as the lungs, liver, gallbladder, pancreas, esophagus, stomach, ovary, prostate, etc., have symptoms that are discovered late and are already stage 3 or 4 cancers. Surgical removal alone may not be enough. Cure. Therefore, when considering treatment options, it is best to understand the pros and cons of various therapies, such as radiation therapy, chemotherapy, targeted drugs, immunotherapy, etc. Before communicating with the doctor, we must first do our homework, collect more relevant information, and understand the similarities, differences, pros and cons of various treatments. Only then can we know how to ask the doctor the “right” questions and clearly understand the side effects and costs of the treatments. .
Leong Man Fook – a specialist in geriatrics, has been engaged in geriatric medicine and gerontology research, actively participated in voluntary work, retired from the Hospital Authority, and still spares no effort to promote health education and medical services for the elderly.
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Get the “Lao Lai Three Treasures” now and travel with your family
Because drugs for the treatment of cancer vary in price and efficacy. Of course, the more expensive the drug, the better. Suitability is the most important. Because of genetic differences and different physical conditions, the effectiveness of cancer drugs in different patients is different. Therefore, you must fully weigh it according to your own ability to bear it, including physical, mental and financial burdens. When considering treatment, you should also consider how to reduce the pain caused by future symptoms. For example, although colorectal cancer has spread, if the patient has a life expectancy of 1 year or more, we should still consider tumor removal surgery, because this can avoid the pain of intestinal obstruction and continuous bleeding in the later period. Local radiotherapy can alleviate the symptoms of brain cancer and bone cancer, and drainage and drainage can relieve the discomfort of pulmonary fluid accumulation. Therefore, different forms of palliative care should be considered simultaneously.
Anson promised to discuss it with his son. After her husband died of pancreatic cancer two years ago, her only son Howard was her mother’s biggest support. A week later, I received a message from Anson: “Edward, thank you for your recommendation. I have made appointments with several specialists. Howard accompanied me every time, and we discussed it many times. Howard was worried about the risks of surgery. He said Now I only have swollen feet and no other discomfort. I can still walk and do volunteer work every day. However, after the surgery, I am expected to become disabled immediately, and I don’t know when I will be able to get up and take care of myself. Another The point is, surgery probably won’t cure my disease. So, we’re going to use medication. What do you think?”
I have to admire Anson’s will and psychological quality. Her calmness and positive attitude are commendable. Later, she sent me another message: “We are currently working hard to complete the “Three Treasures of Lao Lai”; the “Will” and “Advance Medical Directive” have been signed, and now only the “Enduring Power of Attorney” remains. Once that is done, I will go on a river cruise with my family. It was only after I came back that I started my medication journey. Don’t read it. “
May God protect my old friends. I wish you all the best.
Text: Liang Wanfu
Editor: Zhu Jianxun
Art: Xie Weihao
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