I am a gynecological oncologist and spend most of my time wrestling with cancer.
In hospitals, many cancer patients often ask, why do I get this disease?
Most of the time I don't get an answer, but sometimes there are exceptions, such as an ovarian tumor that is written into the "gene" when it occurs.
In the first half of 2019, I received the first medical call from Ms. He through the online medical platform, revealing despair and helplessness.
At that time, she had just been diagnosed with ovarian cancer, and she had a puncture at the local hospital, and the results were very bad, and the doctor diagnosed it as a highly malignant serous ovarian cancer, and there was a swollen clavicle lymph node.
After carefully inquiring about her family history, I found that the case was unusual, and the women in her family seemed to be "cursed" by fate.
Ms. He's mum was diagnosed with ovarian cancer at the age of 58 and died after more than a year of treatment. Shortly before that, her aunt was diagnosed with breast cancer.
In her generation, her sister was diagnosed with breast cancer two years earlier, and she was the fourth woman in her mother's family to develop cancer.
According to Ms. He's recollection, a year before her mother was diagnosed, she went to the hospital for examination because of symptoms such as weight loss and gradual enlargement of her stomach, and once diagnosed, she was diagnosed with stage III of ovarian cancer.
Although surgery was performed quickly, the painful surgery and three rounds of chemotherapy after the operation failed to stop the disease and relapsed at the end of the year.
Although her mother has been gone for 8 years, Ms. He will always think of the last journey of her life.
For more than a year of battling the disease, her quality of life was very poor, and every day was very torturous.
What is even more heart-wrenching is that not long after her mother left, Ms. He's sister was diagnosed with breast cancer.
"My sister was 40 years old." Ms. He remembers that after she got her sister's puncture pathology report, she sat alone in the car and cried loudly.
Now, she also has the same disease as her mother, Ms. He said that she can't understand, how cancer specifically caught their family "bullying"?
The four female members of the family are concentrated in these two cancers, and the age of onset is relatively early, and Ms. He pessimistically believes that this is "fate's arrangement".
She fell into despair after her diagnosis:
"If I had suffered like my mother did back then, I'd rather die."
After listening to Ms. He's narration on the phone, I told her not to give up hope, things have not yet reached the point of exhaustion.
Based on the clues she provided, I analyzed that the family's condition was likely to be hereditary breast-ovarian cancer syndrome, which required genetic testing to verify.
Although her condition has progressed to the advanced stage of ovarian cancer, the treatment now is very different from when her mother fell ill 8 years ago.
In addition to surgical chemotherapy, there are new drugs such as specific targeted drugs, especially patients with familial BRCA gene mutations, which are likely to benefit from them.
I suggested she come to Beijing for treatment.
Ms. He soon came to Beijing, and we planned her treatment into three stages:
Surgery followed by chemotherapy and maintenance with targeted drugs.
In March 2019, Ms. He performed tumor cytoreduction with satisfactory results:
Most of the pelvic tumors have been removed, and some residual lymph nodes with metastatic cancer cells can be left to postoperative chemotherapy.
The genetic test results came out after the operation, which verified my previous conjecture that Ms. He was indeed a mutant gene carrier of the BRCA1 gene, and other test results were also in line with "hereditary breast cancer-ovarian cancer syndrome".
Seeing this result, my heart is actually a little complicated.
If Ms. He's mother, aunt and sister could have done this test earlier, perhaps the cancer could be treated preventively, and perhaps the story of their family could be rewritten.
Immediately after that, we gave Ms. He chemotherapy.
After 6 courses of "paclitaxel + carboplatin" chemotherapy regimen, her tumor marker (CA125) index was successfully reduced from 218 to about 3, and the metastatic lymph nodes on the collarbone were also greatly reduced.
The next phase of maintenance therapy is critical, with survival rates consistently low in patients with advanced ovarian cancer in the absence of targeted drugs.
The specific targeted drug for ovarian cancer taken by Ms. He is called Olapally, when she first took it, Olapalli had not yet entered medical insurance, and Ms. He would spend more than 40,000 yuan per month just to take medicine;
But fortunately, now that the drug has been included in medical insurance, the cost of taking drugs every month has dropped to about 4,000 yuan, and the burden on families has also been reduced a lot.
Today, Ms. He has been operating for 2 and a half years and her condition has been stable.
Her physical strength is also getting better and better, walking ten thousand steps a day is no problem, and she told me four words when she returned to the clinic:
"Very content."