The secrets of chemotherapy you must not know

  ”There is a plague that everyone catches, no matter how far you flee to the ends of the earth, you can’t avoid him”.  In Jin Yong’s masterpiece “The Legend of the Shooting Hero”, one of my most impressive passages is when Zhou Botong forces Guo Jing to listen to the story and tells him the origin of “The Nine Yin Sutra”. Huang Shang, the author of “The Book of the Nine Netherworlds”, was retaliated by his enemies because of his high martial arts skills, and all his family members were killed. He lived in seclusion and practiced martial arts to take revenge. Years later, when he finally developed the best martial arts skills, he reappeared in the world, but because of too long and too long, his enemies were all dead.  The world’s most invincible, is nothing but time. Life is the same, for life, time is limited. Everyone cannot escape death.  For the treatment of disease, there are two directions to go to work on. First, cure, that is, the disease disappears completely, but only a few diseases can be cured; second, chronicity. Since most diseases are incurable, the natural length of the disease itself determines how terrible it is. For example, a patient with hypertension, without any treatment, takes on average decades from the time the blood pressure rises to the time it produces complications (mostly cardiovascular diseases) causing death; in contrast, acute leukemia, if left untreated, takes only a few weeks from diagnosis to death.  So, although hypertension and diabetes are actually incurable, they are not as scary as cancer or leukemia. For most diseases, prolonging their course is the main goal of treatment. For example, in patients with hypertension, the blood pressure can be controlled by long-term oral antihypertensive drugs, and if the hypertension still does not cause fatal complications at the time of the patient’s death, the effect of chronicity and the effect of cure are equivalent.  In other words, when the disease is prolonged to a duration longer than the natural survival time, it is equivalent to the disease having been cured.  Many chronic diseases have been treated with this aim and have achieved good results, for example, for chronic hepatitis B, which can be controlled by antiviral drugs, and for patients with kidney failure, who can be on regular dialysis and survive significantly longer, although not cured. AIDS is also a typical example. Through “cocktail” therapy, many patients can remain free of the virus for many years.  Early stage cancers can be cured by surgery (and in a few cases by radiotherapy). However, advanced cancers are often incurable. The purpose of chemotherapy is to prolong the course of cancer as long as possible and ultimately increase the survival of the patient. After nearly 50 years of development, some tumors, such as choriocarcinoma, Hodgkin’s lymphoma, and some leukemias, can already be treated with chemotherapy-based therapy to enable patients to survive for a long time; many patients with breast cancer, prostate cancer, and germ cell tumors can also survive for a long time. Unfortunately, most common tumors, such as lung cancer, gastrointestinal cancer, and liver cancer, are not yet well treated, and only a small percentage of patients with advanced disease can survive for more than 5 years.  Clinical oncologists are working to control the course of cancer through various treatments. For example, advanced lung adenocarcinoma had an average survival of less than one year a decade ago, but after the development of molecularly targeted drugs in the last decade, many patients can now survive for more than 2 years with regular comprehensive treatment. However, for a disease as difficult to overcome as cancer, progress is slow and difficult. For patients, they should also understand that it is impossible to cure advanced cancer, but with the joint efforts of patients and doctors, it is possible to obtain a longer survival period, which is a stage victory for both patients and doctors, although it is not the ultimate goal.