"Doctor, I had a liver cancer resection 32 years ago. I cut off half of the liver and want to find out how the rest of the liver is now." Liang Sheng (a pseudonym), a 69-year-old from Guangdong Sihui, walked into Sun Yat-sen Memorial Sun Yat-sen University Liu Chao, the vice president of the hospital and director of the pancreatic and biliary surgery department, was stunned by a word.
Liver cancer is known as the "cancer king", and the effect of advanced liver cancer is not good, especially more than 30 years ago, it is not easy for patients to survive such a long postoperatively, which is called a "miracle."
An all-media reporter of Guangzhou Daily learned from Sun Yat-sen Memorial Hospital on November 23 that the latest magnetic resonance (MR) review showed that the remaining half of Liang's liver was healthy as usual, and blood tests showed that the level of tumor markers was not abnormal.
And this follow-up visit unexpectedly led to a long-dusted doctor-patient story.
Liang Sheng's medical record 32 years ago.
Text/Guangzhou Daily All-Media Reporter Ren Shanshan Correspondents Lin Weiyin and Zhang Yang
He has kept the medical records from 32 years ago
"Upper abdominal pain for 3 years, alpha-fetoprotein (AFP) lasting more than 500ng, diffuse liver cirrhosis (moderate), primary liver cancer with cirrhosis, hypersplenism, splenomegaly..." The paper yellowed medical record Above, the condition written in neat pen writing, after 32 years, is still frightening to read.
For many years, Liang Sheng has carefully kept this medical record: it records in detail his unforgettable experience of fighting the "cancer monster" with the doctor and regaining his life.
"When I was young, my family's economic conditions were not good. My father was the pillar of the family, and he relied on farming to support the family. After learning that he was seriously ill, our family felt that the sky was going to collapse." Liang Sheng's second daughter Ling still remembers that period of panic.
Liang Sheng had three children. At that time, the eldest daughter was in junior high school, A Ling was in elementary school, and the younger son was only two or three years old.
During that time, Liang Sheng often felt pain in the liver area, but because of family poverty, he has been dragged out without treatment.
It wasn't until the skin all over his body turned yellow and wasted a lot that he realized that something was wrong.
Liu Chao took a group photo with the patient.
He adopted a new treatment plan after the operation
In July 1988, Liang Sheng arrived in Guangzhou and sought medical treatment from Professor Liu Chao's teacher and the late famous hepatobiliary surgery expert, Professor Qingjia Qu. By this time, he was in the middle stage of liver cancer.
He didn't know why he, who had always been strong, got liver cancer.
Professor Ou Qingjia told him that it was related to his suffering from hepatitis B for many years.
"Viral hepatitis is the main cause of liver cancer. Among them, the risk of hepatitis B virus infection is 15-20 times that of non-infected people." According to Professor Liu Chao, in my country, the proportion of hepatitis B-related liver cancer is extremely high, accounting for about total liver cancer. From 63.9% to 90%.
Many patients have no typical symptoms or signs in the early stage of onset. When they feel pain in the liver area and jaundice, most of them have reached the middle and late stages. In addition, many patients have liver cirrhosis and may lose the opportunity for surgery.
According to relevant statistics, out of every 100 liver cancer patients, only 20 to 30 people still have the opportunity to undergo surgery at the time of diagnosis.
Fortunately, Liang Sheng got the opportunity for surgery, which also means that his fate may be reversed.
On July 21, 1988, with the assistance of Professor Chen Jisheng, Professor Qingjia Ou carefully and completely removed the left liver lobe where the tumor was located, and ligated the splenic artery.
Seven days after the operation, Liang Sheng started chemotherapy with 5-fluorouracil (5-Fu), an anti-tumor drug.
At the insistence of Professor Qingjia Ou, Liang Sheng received hepatic artery infusion chemotherapy.
Making this decision is a risk of "failure" for a hepatobiliary surgery expert.
Hepatic arterial infusion chemotherapy is an interventional treatment method. In layman's terms, it is equivalent to "soaking" the tumor tissue with drugs nearby, thereby maximizing the elimination of the remaining tumor tissue.
At the end of the 1980s, this kind of treatment was a new thing in the field of tumor treatment.
Until the beginning of this century, the hepatobiliary surgery community had different opinions on whether to use hepatic artery infusion chemotherapy after liver cancer surgery.
Limited by the use of drugs at the time, this treatment was evaluated by many surgeons as "poorly effective and unnecessary to use".
However, Professor Ou Qingjia hoped to give his patients a go and do everything possible. He rejected all the arguments and arranged Liang Sheng for hepatic artery infusion chemotherapy.
The foresight of an old professor
Six months after the operation, Liang Sheng returned to the hospital for a review, and the tumor was suppressed.
In the following years, he followed the doctor's instructions, paying attention to health preservation and dietary restraint, and spent more than 30 years without incident.
Professor Qingjia Ou, who passed away in 2017, was one of the representatives of hepatobiliary surgery in South China.
He once asked the surgeon to answer eight questions before the operation: "What disease does the patient have? What is the relationship between the lesion and the surrounding area? Is there a comprehensive assessment of the functional state of the patient's vital organs? Will the operation exceed the patient's payment? Ability? Are the indications for surgery clear? Can surgery prolong the life of the patient and improve the quality of life of the patient? What is the probability of postoperative complications and the countermeasures? Is the doctor himself capable of performing the operation?" These eight questions are Ou Qingjia's summary of his clinical experience is widely circulated in the surgical field, and is referred to as the "Gu Ba Tiao" by younger doctors.
"Teacher District's medical career has always been patient-centered. He has a forward-looking vision for the treatment of liver cancer and believes that the surgeon’s lancet cannot be used alone." Liu Chao said that nowadays, with the development of new drugs, the liver The value of arterial infusion chemotherapy has been rediscovered by the medical community, and new progress has been made in the treatment.
In the early 1980s, Ou Qingjia went to Harvard University Medical School for advanced studies.
He is keenly aware that the treatment of liver disease cannot be done by surgery alone. After returning to China, he immediately prepared a laboratory to introduce immunotherapy into the treatment of liver tumors.
"As soon as I entered the teacher, I was arranged to study cells. I felt a bit wronged and puzzled." Professor Liu Chao recalled that after many years, with the development of tumor precision medicine, the disciples realized that Ou Qingjia's vision Beyond the times.