Jellyfish network November 17 news (correspondent Li Chengxiu Cui Fangrong Li Lingfeng) radiotherapy, chemotherapy, hair loss, side reactions serious... When it comes to the treatment plan for tumors, many people have these terms in their minds. In this regard, Chen Jian, director of the Department of Oncology of Yantai Yuhuangding Hospital, said that with the advent of the era of precision medicine, the diagnosis and treatment of tumor diseases can be more in-depth understanding of tumors through genetic testing, immune checkpoint assessment, etc., to clarify its pathogenesis, and to formulate individualized treatment plans for patients in a targeted manner, so as to better improve the quality of life of patients and prolong the survival of patients.
Director Chen Jian, who has been engaged in clinical work for 25 years and has rich clinical experience in the field of diagnosis and comprehensive treatment of various malignant tumors, has opened a door of hope for cancer patients in the era of precision medicine.
One life, one home
The healer's benevolent heart holds up the hope of life
Precision medicine is to make the most accurate diagnosis of each patient's condition, formulate the best plan for the right medicine, pursue the best efficacy, and really and maximize the consideration of the patient. Chen Jian summed it up simply in one sentence: different "cancers" with different treatment plans.
Three years ago, a 66-year-old patient with advanced breast cancer came to Director Chen Jian's clinic. She said that since she was diagnosed with the disease in 2014, she has been mentally prepared.
"I'm not afraid of death, but there's a mentally handicapped child in the family who needs to be cared for." Doctor, you save me, if I go first, what can the child do? My home is over. Looking at the strong desire to survive in the patient's eyes, Chen Jian couldn't bear to refuse.
Chen Jian (fourth from left) in the rounds
But this patient is already terminal cancer, and has been ill for many years, can her body still withstand the pain caused by chemotherapy? Clinically, for some frail and older patients, it is easy to identify patients who cannot withstand the side effects of chemotherapy and abandon treatment. It is for these reasons that the patient has been repeatedly denied admission in the outer hospital.
"If I am also refused treatment here, then she will have to wait in pain until her life is gone." A home, there is no more. At this time, Chen Jian, who is facing the patient, only thinks about how to complete the patient's wish through a more detailed treatment plan.
In the specific treatment process, he developed an individualized treatment plan for this patient through weakened chemotherapy regimen combined with targeted drug therapy based on the implementation of the principle of precision medicine. In the blink of an eye, three years have passed, and this patient can not only take care of himself, but also take care of his daughter three times a day. Every time he went to See Director Chen for regular review, the old man had to thank the doctor who extended her life cycle.
One program, one chance
"From scratch" to create surgical conditions
Through multidisciplinary consultation, the development of a full-process and accurate treatment plan for cancer patients is also one of the precision medicine contents advocated by Director Chen Jian.
Mr. Zhang, 61, is a patient with liver metastases from bowel cancer. Because his disease area is adjacent to the bladder and there is already a state of adhesion, considering the patient's age, the advice given by the outer hospital is to go home to recuperate, do conservative treatment, and not operate.
"But at that time, there were three metastases on the liver of this patient, and if surgery was not done, there would be only a six-month survival cycle at most." Chen Jian recalled the scene when he received the patient six years ago, and still could not refuse the desire for life in the eyes of the patient and his family, he still accepted the patient. After the patient was admitted to the hospital, Chen Jian convened doctors from different departments to participate in multidisciplinary consultation: together with imaging and pathologists to clarify the diagnosis and clinical analysis, and then combined with doctors in gastrointestinal surgery, radiotherapy and other disciplines to discuss the specific situation of the patient, and formulate the most reasonable translational treatment plan. After a period of treatment, the patient's lesions are controlled and reduced, giving the surgeon the opportunity to operate.
The great healer saves the life and the wounded. Until now, this patient only needs to use regular and safe medication, and his life is no different from ordinary people.
From scratch, to create an opportunity for patients to operate, improve the probability of long-term disease-free survival of patients, this is the goal set by Chen Jian for himself and his team. He said that in today's increasingly developed medicine, precision medicine has indeed reduced tumor treatment by taking many detours, allowing patients to prolong their lives and improve their quality of life.
A test that targets medications
Genetic testing makes tumor treatment more precise
The 52-year-old patient, Mr. Sun, suffered from lung cancer and had multiple metastases, and after chemotherapy in other hospitals, he found that his condition deteriorated and his hands and feet were dysfunctional, and he once wanted to give up treatment. With the encouragement of his family, he found Director Chen. Jian Chen conducted a comprehensive disease assessment of the patient and, based on the genetic test results, finally determined that the patient could be treated with targeted drugs through the ALK gold mutation.
If you want to do a good job, you must first use it, and genetic testing is a prerequisite for achieving precision treatment. "Genetic testing is like GPS navigation, which helps doctors develop the best treatment path and allows patients to obtain economical and rapid clinical results." In the interview, Director Chen said so. He uses a figurative metaphor to explain the importance of targeted drugs for tumor treatment. Targeted drugs, like missiles, will only destroy the cancer cells with the target, not the healthy cells. Therefore, it will not bring adverse reactions like chemotherapy. After entering the human body, this "biological missile" will select the corresponding carcinogenic site to bind, causing cancer cells to die and inhibit their growth.
Chen Jian (second from left) team discusses the patient's condition
According to reports, at present, there are more than twenty kinds of targeted drugs that have been listed in the world, and new target discoveries are constantly being made. Targeted drugs have significantly improved the cure rate of some tumors similar to bowel cancer, and also greatly prolonged the survival of some types of tumor patients. However, most targeted drug applications have one premise: genetic testing.
"Genetic testing allows targeted drugs to be used accurately and personalized therapies to be truly realized." Chen Jian said that taking lung cancer as an example, before this lung cancer patients were simply divided into small cell lung cancer and non-small cell lung cancer, using their own set of chemotherapy programs. But in fact, non-small cell lung cancer can also be divided into adenocarcinoma, squamous cell carcinoma, large cell carcinoma and other types. After the advent of targeted drugs, today's advanced patients with non-squamous cell carcinoma are subjected to genetic testing after they are pathologically taken at Yuhuangding Hospital. If genetic mutations such as EGFR and ALK are detected, it is possible that patients only need to take oral drugs every day to control them. In addition, genetic testing can also detect the "tolerance" of tumor patients to some drugs. If genetic testing is done in advance, it is possible to know how well the patient is to tolerate the drug, which is very critical for tumor patients. ”
A smile, a word of reassurance
He is called a kind "tumor killer" by patients.
Director Chen spoke with a smile in his eyes and an unpleasant and unhurried speed, so that patients and their families could hear clearly and treat diseases with peace of mind.
"Patients suffering from diseases struggle with pain and fear every day, and when their lives are dying, they need the encouragement of doctors the most." Chen Jian said that the heavy mood and low mood are the real state of many cancer patients. For such patients, they cannot simply take medication, they need psychological comfort. Because whether the mood is stable or not is directly related to the patient's enthusiasm for treatment and the degree of tumor recurrence and metastasis. In order to allow patients to come out of a low state, Director Chen often enlightens patients and chats with patients, and many of his tumor patients have evolved from a simple doctor-patient relationship to a friend in life because they need to deal with drugs for many years.
Chen Jian said that the early diagnosis rate of tumor patients is very low, and once it is found, it is the advanced stage of tumor. Especially in recent years, the incidence of malignant tumors has increased, and tumor patients tend to be younger. "Once you have a tumor and cancer, don't give up on yourself, because with the increasing development of the medical field, many tumors and cancers are possible to cure." Director Chen said that especially after Yuhuangding Hospital became the only clinical pharmacology base in Yanwei in 2010, cancer patients here can use some of the latest international and domestic anti-cancer drugs a year or even a few years in advance.
"The clinical pharmacology base is the state-approved clinical drug experimental base. When some drugs are tested before entering the clinic, patients can enroll and use them. Director Chen Jian explained. These emerging anti-cancer drugs have brought dawn to many patients and families. In addition to the fact that the efficacy is often better than that of "old drugs", the medication, treatment and even transportation to and from the hospital are all free for patients who are admitted to the group. Since joining the group in 2019, one of Director Chen's patients has been taking an anti-angiogenesis drug for free for three years, and the effect is very good, and the family's financial burden has also been greatly alleviated.
In addition, because the current hospitals are participating in phase II to IV clinical trial drugs, they have all undergone the evaluation of the pharmacokinetics of the phase I trial, and have a full understanding of their toxic side reactions and safety and accessibility. And because these clinical trials follow the most stringent procedures in the world, they invisibly standardize the tumor treatment of the department.
A persistence, a belief
Initiated the establishment of the Yantai Medical Association Precision Medicine Committee
Chen Jian often told the young doctors in the department that precision medicine is changing the face of tumor diagnosis and treatment, and for oncologists, they must not only take the initiative to seize the opportunity, but also meet the challenge with practical actions.
In order to benefit more patients, on October 30, 2021, the Precision Medicine Committee of Yantai Medical Association was officially established, and the initiator was Director Chen Jian. At the meeting, more than 70 members from different professions recommended by 28 hospitals in Yantai City gathered together to improve the level of precision medicine theory research in our city through academic exchanges related to precision medicine, continuing education in precision medicine, and various forms of practical seminars on different themes. In order to cultivate the professional and technical team of precision medicine, build a professional clinical research and technical exchange platform, and promote the development of precision medicine.
"Precision medicine is simply the application of modern molecular biology technology, molecular imaging technology, biological information technology, combined with the patient's own condition and living environment, to achieve accurate disease diagnosis, the development of personalized disease prevention and treatment programs, which is the frontier direction of medical science and technology development." Director Chen said that with the development of genomic technology and the concept of precision medicine, new health concepts and technical needs have been put in front of them, and young doctors must seize this opportunity to be independent in the field of cancer treatment they are good at.
The reporter learned in the interview that in the process of disease diagnosis and treatment of Yantai Yuhuangding Hospital, special attention is paid to accurate diagnosis and treatment. The hospital has set up a molecular diagnosis platform, molecular pathology platform, specialized disease database platform, a variety of minimally invasive surgical platforms, tomo radiotherapy systems, robotic surgery, etc., in terms of scientific research, the establishment of specialized laboratories, investment is very much, these are in order to be able to achieve accurate diagnosis, precision treatment, these coincide with the concept of precision medicine.
Expert Profiles
Jian Chen, Chief Physician, Master Supervisor, Doctoral Supervisor, Director of the Department of Oncology, Yantai Yuhuangding Hospital, Postdoctoral Fellow of Northwestern University, Visiting Scholar of Cardiff University, UK. He is also the vice chairman of the Precision Medicine Branch of the Shandong Medical Association, the vice chairman of the Lung Cancer Committee of the Shandong Medical Education Association, the vice chairman of the Tumor Precision Therapy Physician Branch of the Shandong Medical Doctor Association, the vice chairman of the Tumor Molecular Targeted Therapy Society of the Shandong Research Hospital Association, the vice chairman of the Clinical Cell Therapy Professional Committee of the Shandong Medical Doctor Association, and the vice chairman of the Stem Cell Technology and Clinical Application Research Committee of the Shandong Stem Cell Society. He has presided over 2 projects of the National Natural Science Foundation, 1 sub-project of the National 863 Project, 4 projects of key research and development in Shandong Province, 1 project of the Returned Study Abroad Fund of the Ministry of Education, and more than 40 SCI papers published by the first author and corresponding author.