“My father died when I was very young when he was 36 and I was 1 when he died of stomach cancer. He left me no beautiful prose poems/ Didn’t take me to the open-air movie at night/ didn’t ask the neighbor to lend me money to buy biscuits/ didn’t fix the pedals of my mother’s sewing machine/ but he left me the cancer gene…” – “My Father Has No Prose Poems” 》
On April 9, 2020, in the inpatient department of Zhongnan Hospital in Wuhan, Cheng Yi, a 27-year-old patient with advanced bowel cancer, was lying on a clean hospital bed. She had just undergone an abdominal surgery Operation. The effect of the anesthetic slowly receded, and the world in front of him became brighter.
Another escape, Cheng Yixiang.
Three days ago, acute intestinal obstruction caused unbearable pain in her abdomen. Cheng Yi was rushed to the hospital by her family, and she walked from the hospital gate to the emergency room in three steps. To lie down on the side of the road to rest. Looking back now, it seemed like it happened to another person, and Cheng Yi sympathetically stared at himself who was rolling on the ground in pain.
(Cheng Yi in the hospital bed suddenly felt a little abdominal pain)
The body on the hospital bed gradually regained consciousness. Cheng Yi reached out and touched the scar on his abdomen. The first one from the left is the laparoscopic resection after the cancer was diagnosed in July last year, followed by the laparotomy when the cancer recurred in November. Now next to them, there is another one across the center of the abdomen. , nearly 12 cm long wound.
Further to the right abdomen, Cheng Yi touched something. It was a hole three centimeters in diameter through which the intestines were drawn into the belly, called a “stoma”. For the next period of time, her excrement will flow uncontrollably out of the body through the stoma and the small bag it is attached to.
The girl who was riddled with holes on the hospital bed did not make Cheng Yi feel too sad. Instead, from July 2019 to April 2020, after a series of serious illnesses, surgeries, relapses, serious illnesses again, surgeries, she felt an unprecedented power. “Fighting cancer, this is probably the best thing I’ve ever done in my life.” she thought triumphantly. So after the third escape, 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 died when I was very young / He was 36 and I was 1 and died of stomach cancer / I never called him ‘Dad’ / I don’t even know what he looks like / He’s just a name in my memory / He didn’t leave me beautiful prose poems / He didn’t take me to see a movie in the open air at night / He didn’t ask the neighbor to lend me money to buy it Biscuit eats / Didn’t fix sewing machine pedals for mom / But he left me cancer genes…”
(Cheng Yi’s home)
In the albums of the Cheng family, there is very little father. In the only family photo, Cheng Yi is still a few months old baby. His father was obviously thin at that time. Sister and brother, sitting beside mother and Cheng Yi, left precious images together at the door of the house. Less than a year after that, my father died of a recurrence of stomach cancer.
(Cheng Yi is one of the few photos taken with his father, in the photo is Cheng Yi being held by his mother)
In addition to her father, Cheng Yi has 6 relatives who have developed cancer successively. Her grandmother, aunt, cousin and a nephew all have bowel cancer; Cheng Yi’s cousin has breast cancer ; another aunt, who was also diagnosed with bowel cancer five years ago.
But it wasn’t until the family’s bad luck came to Cheng Yi that she passed the genetic test.Solved the cancer mystery that has been afflicting loved ones – Lynch Syndrome, a genetic disorder hidden in the genes, caused by mutations in MMR-encoding genes, which are normally responsible for correcting DNA Errors in the replication process, but after the mutation occurs, the abnormal cells are not corrected in time and continue to divide, and the accumulated errors lead to a significant increase in the risk of patients suffering from colorectal cancer, endometrial cancer, ovarian cancer and other cancers.
The median age of onset of Lynch syndrome is 40 years old. Cheng Yi, 26 years old, could not escape his fate and became the youngest cancer patient in his family.
April 18, 2020
《I have an immature idea, can you take a look? 》
“Yu Huanshui’s life was reversed, but I didn’t. Whatever fate gave me, whether good or bad, I had to accept them one by one.”
In the beginning, it was just a slight distending pain, which appeared in Cheng Yi’s left lower abdomen for a second or two and then disappeared. It was in March 2019. After this situation lasted for two weeks, she went to the hospital for a B-ultrasound. There were no abnormalities in both kidneys, ureters and uterus. No one has noticed yet, but the mutant cells are dividing frantically in the gut, which cannot be penetrated by B-mode ultrasound.
From April to May, Cheng Yi’s gastrointestinal discomfort continued to worsen, with multiple diarrhea a day, and abdominal pain, which was mild and short at the beginning, became frequent and intense. She bought the medicine to regulate the intestinal tract, but it didn’t work. She went to the hospital for a CT scan, but she still couldn’t see the lesions.
It’s not surprising that the signs of bowel cancer didn’t alert them, after all, it’s a geriatric disease that occurs more often in people over the age of 50 and is less common in younger people. But at the same time, it is also closely related to genes, and the genetic tendency is obvious. Therefore, people with a family history of bowel cancer should have colonoscopy screening every three years after the age of 45 [1].
As her condition worsened, one day in June, Cheng Yi had blood in her stool. When she saw the blood overflowing the urinal, she realized that something was wrong and quickly made an appointment for a colonoscopy.
May 18, 2020
“I am 27 years old and I have been fighting cancer for ten months. This is a precursor to my cancer”
“This month, I have clearly felt that the cancer baby is growing wildly in my body. I am getting more and more tired, often dizzy, my face is as white as a piece of paper, and I can only drink one bowl of porridge every day. People are getting thinner and thinner. The pain is accompanied by 24 hours and it is difficult to walk. The colonoscopy is not smooth, and the lens cannot pass through the position of the descending colon because the tumor has blocked the intestine. A little tissue is cut for medical examination. : adenocarcinoma of the descending colon.”
The topic of younger cancer patients is always on our radar. Cancer is traditionally thought to be age-related: as you get older, your body accumulates more oncogene mutations, which greatly increases your chances of developing cancer. The rejuvenation of cancer is an anti-experience phenomenon, and a new fear arises spontaneously – this super killer that human beings have not yet conquered, with its own infinitely expanding greedy nature, is about to occupy a new territory.
Through the National Cancer Registry data, we can see more clearly that between 2000 and 2014, there was a significant increase in the incidence of cancer in both men and women under the age of 40, while Young people living in cities are more likely to develop cancer than those in rural areas. Like Cheng Yi, the number of cancer cases before the age of 40 is increasing year by year [2].
According to the introduction of Cheng Yi’s attending physician, Peng Jin, an abdominal tumor radiochemotherapy physician in Wuhan Zhongnan Hospital, in addition to the trend of younger patients who come to receive treatment, most of the younger patients are younger than the older patients. Tumors with higher malignancy, faster progression, and poorer response to treatment. This may be related to genetic mutations that cause cancer.
Of course, the elderly cancer patients in the same ward as Cheng Yi don’t think so. They always feel that young people’s bodies are better able to fight cancer cells, and whenever Cheng Yi comes to the hospital for treatment, it always brings them a burst of anger. The old people warmly greeted her recent situation, praised her good complexion and optimistic attitude, and always cheered her on. Cheng Yi was also happy to be their pistachio and took the trouble to answer their questions about cancer.
(Cheng Yi is eating with the patients in the ward)
Most patients don’t know what Cheng Yi, who is “in good condition” in front of them, has experienced at the beginning of treatment.
May 6, 2020
“A Good Attitude Is Reconciliation with the World”
“I was also devastated when I discovered the recurrence in October. The doctor at the local hospital told me that day, ‘You don’t need surgery anymore, there are cancer cells in the entire abdominal cavity’, I listened to After saying this, there was no expression on his face, but big tears fell. This period was the most desperate time, while enduring the pain of cancer, while thinking about how to say goodbye to the people around him, at that time I cry every day, cry silently during the day, cry aloud in the quilt at night, and often think: I don’t belong in this world, why do I need to exist.”
After the first surgery, Cheng Yi thought life would return to normal. But in October, the cancer in her body returned, and reality knocked her down again. The recurrence made her realize that, no matter how brave she was to undergo surgery and chemotherapy, the cancer was likely to keep coming back for the rest of her life. The high medical expenses had already overwhelmed this rural single-parent family, and Cheng Yi had the idea of giving up for the first time.
Mother could not bear losing her close relative to cancer again, and always encouraged Cheng Yi to persevere. After the local hospital announced that the operation was impossible, the mother took her daughter to Wuhan Zhongnan Hospital, 75 kilometers away, to seek medical treatment. Cheng Yi underwent a second laparotomy there to remove the tumor that had grown to 7 centimeters.
After this operation, Cheng Yi performed immunohistochemical protein detection for the first time, and the results showed that there were microsatellite highly unstable (MSI-H) and mismatch repair in the DNA of his tumor cells Functional deficiency (dMMR), which indicates that Cheng Yi is suitable for the latest immunotherapy, she entered the clinical research group and used unmarketed PD-1 monoclonal antibodies 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. PD-1 is an immunosuppressive molecule that controls T-cell white blood cells to prevent autoimmune diseases. But at the same time, it is also used by cancer cells to block the attack of the immune system. In order to restart T cells in the human body to kill cancer cells, scientists have developed new anti-cancer drugs that inhibit PD-1. This biomarker-based anti-tumor therapy also represents a milestone in precision medicine.
Lucky favored this girl for the first time. In January 2020, after the second injection, the pain in Cheng Yi miraculously disappeared.
Cheng Yi’s chief physician, Peng Jin, believes that although the road to fighting cancer is more difficult for young cancer patients, as cancer treatment enters the era of precision medicine, we are more concerned about the molecular biology hidden under the tumor. The variation of science is also known more and more, and more targeted special drugs will emerge as the times require.
April 20, 2020
My Father Has No Prose Poems
“Nevertheless/I am still grateful to him/He gave me life/Let me taste the ups and downs of the world/Experience the childhood father’s love in the past twenty years The bitterness of the missing / I felt the care of my friend / I experienced the suffering of repeated illnesses / I understand that life is alive / Health is very important, and family love is greater than the sky”
As the condition gradually stabilized, Cheng Yi’s physical strength recovered as well as ordinary people. Every two weeks, she went to Wuhan alone for PD-1 treatment. At the same time, she also began to share her story and cancer on the public account.
(Cheng Yi rides to the hospital alone)
She records the physical signs before the diagnosis, the mental journey through three surgeries, Lynch syndrome and family ties, and memories of her parents; at the same time, she is also happy to share practical experiences in life. Skills, the hospitalization process during the epidemic, how unemployed patients pay medical insurance, etc.
In addition to these heart-wrenching words, Cheng Yi always posted a few funny pictures and made a surprise joke to relieve the readers’ psychological burden.
(Cheng Yi’s public account self-introduction is: post-90s anti-cancer girl, Lynch syndrome)
Of course, she still has many worries about her future, about her family. But on the Internet, she is more willing to share things that make people smile, those small hopes that are within reach.
Like she was alone, sitting in an unmanned ward singing Zheng Jun’s “Cinderella”, that smiling face seemed to have never experienced suffering.
References:
[1]http:https://wsjkw.sh.gov.cn/zl/20191230/e3d0a95fc75e4266b91ab4714fd5bfcf.html How to detect bowel cancer early? Author: Fu Chuangang, Director of General Surgery and Director of Gastrointestinal and Anorectal Surgery, Dongfang Hospital Affiliated to Tongji University
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