"My father left when I was very young, when he was 36 and I was 1, and he died of stomach cancer. He didn't leave me beautiful prose poems / Didn't take me to the open-air movies at night / Didn't ask a neighbor to lend me money to buy me cookies to eat / Didn't fix the pedals for my mother's sewing machine / But he left me with cancer genes..." – "My Father Has No Prose Poems"
On April 9, 2020, cheng yi, a 27-year-old patient with advanced bowel cancer, was lying on a clean bed in the inpatient department of Wuhan Zhongnan Hospital, and she had just undergone an open abdominal surgery. The effect of the anesthetic slowly faded, and the world in front of him brightened.
Another death escape, Cheng Yi thought.
Three days ago, the acute intestinal obstruction made her abdominal pain unbearable, Cheng Yi was rushed to the hospital by her family, crawled from the hospital gate to the emergency room with a rolling belt, and walked three steps to lie on the side of the road to rest. Looking back now, it seemed to have happened to another person, and Cheng Yi stared sympathetically at himself who was rolling on the ground in pain.
(Cheng Yi on the hospital bed suddenly felt a little abdominal pain)
The body on the hospital bed also gradually regained consciousness, and Cheng Yi reached out and touched the scar on his abdomen. The first of the several cases on the left is a laparoscopic resection operation after the cancer was detected in July last year, followed by an open surgery in November when the cancer recurred, and now next to them, there is a wound nearly 12 cm long that runs through the center of the abdomen.
Touching his right abdomen again, Cheng Yi touched something. It was a hole three centimeters in diameter, and the intestines were drawn to the belly, called the "stoma." For the next period of time, her excrement will flow uncontrollably through the stoma and the small pouch attached to it.
The battered girl in the hospital bed did not make Cheng Yi feel too sad. On the contrary, from July 2019 to April 2020, after a series of serious illnesses, surgeries, relapses, serious illnesses again, surgeries, she felt an unprecedented strength. "Fighting cancer, this is probably the most awesome thing I've ever done in my life." She thought triumphantly. So after escaping from death for the third time, Cheng Yi decided to write down his anti-cancer experience.
This story should start with her father...
April 20, 2020
"My Father Has No Prose Poems"
"My father left when I was very young / He was 36, I was 1, died of stomach cancer / I never called him 'Daddy' / I don't even know what he looked like / He was just a title in my memory / He didn't leave me beautiful prose poems / Didn't take me to the open-air movie at night / Didn't ask a neighbor to lend me money to buy cookies to eat / Didn't fix the pedals for my mom's sewing machine / But he left me with cancer genes ..."
(Cheng Yijia)
In the photo album of the Cheng family, there is rarely a father's figure, the only family portrait, Cheng Yi is still a baby of several months, the father was obviously emaciated at that time, he hugged his sister and brother, sat next to his mother and Cheng Yi, and left precious images at the door of the house together. Less than a year after that, my father died of a recurrence of stomach cancer.
(Cheng Yi is one of the few photos with his father, and it is Cheng Yi who is held by his mother in the photo)
In addition to her father, Cheng Yi has 6 relatives who have suffered from cancer, her grandmother and aunt, cousin and a nephew all have bowel cancer; Cheng Yi's cousin has breast cancer; another aunt was also diagnosed with bowel cancer five years ago.
But it wasn't until the family's doom came to Cheng Yi that she cracked the cancer mystery that has been torturing her loved ones through genetic testing - Lynch Syndrome, a genetic disease hidden in the gene, which is caused by mutations in the MMR coding gene, which are normally responsible for correcting the errors in the DNA replication process, but after the mutation occurs, the abnormal cells fail to be corrected in time and continue to divide. The accumulated errors lead to a significant increase in the risk of developing colorectal, endometrial, ovarian and other cancers.
The median age of Lynch syndrome is 40 years old, and Cheng Yi, who is 26 years old, eventually cannot escape fate and becomes the youngest cancer patient in the family.
April 18, 2020
"I have an immature idea, you see? 》
"Yu Huanshui's life has a reversal, but I don't. What fate has given me, whether good or bad, I have to accept them all. ”
At first, it was just a slight feeling of swelling and pain, which appeared in Cheng Yi's left lower abdomen for a second or two and then disappeared. It was in March 2019, and after two weeks of this condition, she went to the hospital to take a ultrasound B, and there were no abnormalities in both kidneys, ureters and uterus. No one has noticed that in the intestines that cannot be penetrated by B-type ultrasound, the mutated cells are dividing wildly.
From April to May, Cheng Yi's gastrointestinal discomfort continued to worsen, with multiple diarrheas a day, and abdominal pain changed from mild and short at the beginning to frequent and intense. She bought the medicine to regulate the intestines, ate it did not work, and went to the hospital to do CT, still did not see the lesion.
It is not surprising that the signals of bowel cancer do not alarm them, after all, this is a disease of old age, which occurs more often in people over 50 years old, and young people are less sick. But at the same time, it is also closely related to genes, and the genetic predisposition is obvious. Therefore, people with a family history of bowel cancer should have colonoscopic screening every three years after the age of 45 [1].
As her condition worsened, one day in mid-June, Cheng Yi had blood in her stool, and when she saw the blood overflowing from the urinal, she realized that something was wrong and quickly made an appointment for a coloncoscopy.
May 18, 2020
"I am 27 years old, fighting cancer for ten months, this is a precursor to my cancer"
"This month I have clearly felt the cancer baby growing wildly in my body. I was getting weaker and weaker, often dizzy, my face was as white as a piece of paper, I could only drink one bowl of porridge a day, and I was getting thinner and thinner, and the pain was accompanied by 24 hours and the pain was so painful that it was difficult to walk. The colonoscopy did not go well, and the lens did not pass at the position of the descending colon, because the tumor had blocked the intestine. Cut a little tissue for testing: descending colon adenocarcinoma. ”
The topic of the trend of younger cancer patients always attracts our attention. Cancer is habitually thought to be age-related: as we get older, the body accumulates more oncogene mutations, and the chances of developing cancer increase greatly. Cancer rejuvenation, on the other hand, is an anti-empirical phenomenon, and a new fear emerges—a super killer that has yet to be conquered by humanity, with its own greedy nature of infinite expansion, is about to occupy new territory.
Through the National Oncology Registry data, we can see more clearly that between 2000 and 2014, the incidence of cancer among people under the age of 40, both men and women, increased significantly, while young people living in cities, compared with rural areas, had a faster incidence of cancer. Like Cheng Yi, the number of cases of cancer before the age of 40 is increasing year by year [2].
According to Peng Jin, the attending physician of Cheng Yi and a doctor of abdominal tumor radiotherapy and chemotherapy in Wuhan Zhongnan Hospital, in addition to the trend of rejuvenation in patients who come to receive treatment, most young patients have a higher degree of tumor malignancy than elderly patients, progress faster, and respond poorly to treatment. This may be related to a genetic mutation that induces cancer.
Of course, the elderly cancer patients in the same ward as Cheng Yi do not think so. They always feel that young people's bodies can better fight cancer cells, and whenever Cheng Yi comes to the hospital for treatment, it always brings them a breath of vitality. The old people greeted her kindly, praised her good looks, optimistic attitude, and always cheered her up. And Cheng Yi is also happy to be their pistachio and does not tire of answering their questions about cancer.
(Cheng intends to eat with the patients in the ward)
Most patients do not know what they have experienced when they first started treatment.
May 6, 2020
"A Good Mindset is Reconciliation with the World"
"I was also devastated when I found a relapse in October. The doctor at the local hospital told me that day, 'You don't need surgery anymore, there are seeds of cancer cells in the whole abdominal cavity', and I didn't have any expression on my face after listening to this, but the tears fell down in large pieces. This period of time is the most desperate time, while enduring the torture of cancer, while thinking about how to say goodbye to the people around me, at that time I was crying every day, crying silently during the day, crying loudly in the quilt at night, often thinking: Obviously I do not belong to this world, why should I give me the necessity of existence. ”
After the first surgery, Cheng Yi thought that life would return to normal. But in October, the cancer in her body returned, and reality hit her to the bottom again. The relapse made her realize that no matter how brave she was to undergo surgery and chemotherapy, cancer was likely to make a comeback for the rest of her life. The high medical expenses have already overwhelmed this rural single-parent family, and Cheng Yi has the idea of giving up for the first time.
The mother could not bear to lose her loved one again due to cancer, and always encouraged Cheng Yi to persevere. After the local hospital announced that it was impossible to operate, the mother took her daughter to Wuhan Zhongnan Hospital, 75 kilometers away, for medical treatment. Cheng Yi underwent a second open surgery there to remove the tumor that had grown to 7 centimeters.
After this operation, Cheng Yi performed the first immunohistochemical protein test, and the results showed that microsatellite high instability (MSI-H) and mismatch repair function defect (dMMR) appeared in the DNA of her tumor cells, which indicated that Cheng Yi applied the latest immunotherapy, and she entered the clinical research group and used unlisted PD-1 monoclonal antibody drugs for free treatment.
In 2017, the U.S. Food and Drug Administration approved PD-1 inhibitors for the treatment of cancer patients with MSI-H/dMMR, an immunosuppressive molecule that prevents autoimmune diseases by controlling T-cell leukocytes. But at the same time, it can also be used by cancer cells to block the attack of the immune system. In order to restart the T cells in the human body to kill cancer cells, scientists have developed new anti-cancer drugs that inhibit PD-1. This anti-tumor therapy, which is differentiated by biomarkers, also represents a milestone in precision medicine.
Lucky cared for the girl for the first time, and in January 2020, after the second injection, the pain in Cheng Yi's body miraculously disappeared.
Cheng Yi attending doctor Peng Jin believes that although the road to anti-cancer for young cancer patients is more arduous, as cancer treatment enters the era of precision medicine, we know more and more about the mutations of molecular biology hidden under the tumor, and more targeted special drugs will come into being.
April 20, 2020
"My Father Has No Prose Poems"
"Nevertheless / I am still very grateful to him / He gave me life / Let me in the past twenty years or so / Tasted the bittersweet and bittersweet of the world / Experienced the bitterness of the lack of fatherly love in childhood / Felt the care of a friend for me / Experienced the suffering of repeated torments of illness / Understood that life is alive / Health is important, family affection is greater than heaven"
With the gradual stabilization of his condition, Cheng Yi's physical strength recovered no different from that of ordinary people. Once every two weeks, she travels alone to Wuhan for PD-1 treatment. At the same time, she also began to share her story with cancer on the public account.
(Cheng Yi rode to the hospital alone)
She documents the physical signs before her diagnosis, her mental journey through three surgeries, Lynch syndrome and family ties, and memories of her parents; she is also happy to share practical skills in life, hospitalization processes during the epidemic, how unemployed patients pay health insurance, and so on.
In addition to these heart-wrenching words, Cheng Yi always has to paste a few funny pictures, make a surprise joke, and unload the psychological burden for the reader.
(Cheng Yi's public account self-introduction is: post-90s anti-cancer girls, Lynch syndrome)
Of course, she still has a lot of worries about the future and about her family. But on the Internet, she prefers to share things that make people laugh, those small hopes that are within reach.
Just like she was alone, sitting in a deserted hospital room singing Zheng Jun's "Cinderella", that smiling face seemed to have never experienced suffering.
Bibliography:
[1] http://wsjkw.sh.gov.cn/zl/20191230/e3d0a95fc75e4266b91ab4714fd5bfcf.html How can bowel cancer be detected early? Author: Fu Chuangang, Director of The Department of General Surgery and Director of the Department of Gastrointestinal and Anorectal Surgery, Oriental Hospital Affiliated to Tongji University
[2] https://www.doc88.com/p-9466471453967.html 2000-2014 Cancer incidence trend and age change in China's tumor registry areas
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