The word “cancer” always makes people’s bones swish, because it is almost a substitute name for death.
It has been more than 15 years since I changed from a general urologist in a general hospital to an oncology hospital specializing in the diagnosis and treatment of male genital tumors, and I have personally diagnosed, treated and consulted more than 10,000 cancer patients. I think we have too many unknowns and misunderstandings about cancer. These unknowns and misunderstandings have tormented countless cancer patients and their families and even friends, wasted countless taxpayers’ money and caused many medical disputes, and even made countless medical personnel who work day and night in the front line of medical treatment gloomy and sad.
How far is cancer from us?
For some people, it is far away and they will never get it in their lifetime, while for others, it is close at hand and they will find out that there is cancer on their body as soon as they check. To some people, it is far away and they will never get it in their lifetime, while to others, it is close at hand. But the reality is that in 2013, the number of new cancer cases in China was 3.12 million (accounting for one-fifth of the total number of cancer cases in the world), that is, one person found cancer every six minutes; in 2013, the number of cancer deaths in China was 2.7 million (accounting for one-fourth of the global deaths due to cancer). What is even more frightening is that the cancer incidence rate is increasing rapidly. Based on the growth trend in these years, it is projected that the number of new cancer cases in China will reach 4 million per year by 2020. According to the current trend of cancer incidence, the chance of getting cancer in each person’s life is 1 in 5. From this current situation, is cancer far from us? Who is not responsible for fighting against cancer?
How can we get cancer?
How can I get cancer? This is one of the most urgent questions that almost every patient has to ask after finding out that he or she has cancer. It is a great pity that there is no definite answer to this question yet. Despite countless scientific researches, money spent and the efforts of countless scientists, at best we only know some factors related to the development of cancer, such as smoking and certain chemicals can cause cancer, or we know that certain genes in the body are related to certain cancers, but how and under what circumstances cancer actually occurs We are still in the darkness of the night before the dawn. However, from the macroscopic point of view of epidemiology, we know the current situation is that cancer incidence is related to age, young people seldom get cancer, and the older people get cancer, the more people get cancer, our country is rapidly aging, the rapid increase of cancer is expected; smoking is closely related to lung cancer, bladder cancer and many other cancers, the more people smoke the more lung cancer incidence, the United States has strictly banned smoking many years ago, its lung cancer incidence rate The incidence of lung cancer is still increasing rapidly and will continue to do so for many years; high protein and high fat diet is related to kidney cancer (of course, it is also related to many other diseases), so the higher the incidence of kidney cancer in a good place of life; food, water and air pollution are closely related to our health, which we all understand, and they are also important factors to increase the incidence of cancer. They are also important factors that increase the incidence of cancer.
How can we get cancer? If we take a closer look and think carefully: how much tobacco we have consumed and how much smoke we have inhaled over the years; how much animal protein and fat we have consumed over the years, overloading our heart, blood vessels, liver and kidneys, which are our vital organs for survival; how much labor and exercise we have reduced over the years, and how much cholesterol, amino acids, and other substances that our body does not need have accumulated in our body. Over the years, we have reduced our work and exercise, and accumulated in our bodies a lot of cholesterol, amino acids, sugars and fats that our bodies do not need; over the years, we have concentrated on money and endlessly aspired to a life of illusory luxury, so that we have accumulated a lot of unsatisfied desires and worries.” We will then understand that cancer is a kind of return or revenge of nature to human behavior.
How can I get cancer? This is the question that oncologists have heard countless times and cannot answer clearly. At the beginning, I always repeatedly parsed and explained this or that with scientific thinking, which is simply the darker the description. Now, I simply say that people are like cars, they will inevitably have this or that kind of problem after using them for a long time and running more miles. It is found that few people continue to ask questions.
Cancer patients 1/3 are scared to death, 1/3 are treated to death, only 1/3 die of cancer
I don’t know who counted out that cancer is such a way to die. The fact is that early stage cancer, after timely and correct treatment, most or even most of them can be completely cured, for example, more than 90% of early stage kidney cancer can be cured after simple surgery, and only a few of them die of recurrence or metastasis later; if the cancer is found and treated at an advanced stage, with the current medical technology, no matter who gets the disease or who treats it, it is difficult to change the ending, that is, most patients will Therefore, in my opinion, for patients with advanced cancer, it is better to try to treat them with conventional methods and continue to treat them if they are effective, or to comfort them if they are not effective to reduce their pain. In addition to over-consumption of medical resources, it will only increase patients’ suffering or accelerate their death.
Most of the cancer patients in China are already in advanced stage when they are detected and treated, which makes treatment very difficult, costly and ineffective. In the United States and other developed countries, the proportion of early stage cancer patients is very high, for example, in prostate cancer, the proportion of late stage patients is only 5%, while in China, the proportion of late stage prostate cancer patients is more than 60%, so the total treatment effect of cancer is better than ours. Zhongshan University Cancer Control Center statistics of new cancer patients admitted to the center from January to June 2014 found that only 38.80% of early stage cancer patients and another 61.20% belong to late stage. This is the case of Sun Yat-sen University Cancer Center, which is the strongest comprehensive cancer hospital in China, and the situation of the whole country can be imagined.
Why can’t we detect cancer earlier and treat it earlier? This involves the national investment in health care and medical industry, medical insurance system, medical level and hospital operation mechanism, medical personnel and general national health awareness and so on. As an oncology surgeon, I believe that as long as we insist on detailed medical examination every year, even if we have tumors, most of them are in early stage and almost all of them can be cured. However, today’s reality is that people think it is worthwhile to spend as much money as they can on eating, drinking and buying luxury goods, but they always feel expensive or ignored when they spend some money on medical checkups or “maintenance”.
”Living with tumor”, cancer can be treated as a chronic disease
”Living with tumor” is more of a beautiful lie than a good wish, and more of a helplessness in today’s medical science. Except for a few types of cancer that can be treated in a few people, you should never believe this lie. “It is better to die than to live”, especially in today’s materialistic era, where there are so many enjoyments, who does not have the desire to live? But God is ironclad in this matter, and everyone should recognize this (but many people do not, including some big names). Nowadays, there are many new drugs and technologies for cancer treatment, some of them are very expensive, but who can tell us how many advanced cancer patients have been cured as a result? How many patients with advanced cancer have not been cured? The new expensive anti-cancer drugs launched one after another are obviously very similar to placebo or cheap old drugs in terms of survival time or survival curve, but someone can make a statistical difference and attach a typical case with academic exaggeration, which can always ignite the hope of those desperate advanced cancer patients and their families, so they raise funds and fight a protracted war to treat advanced cancer like a chronic disease, and the final outcome is As you can imagine, both doctors and patients are hurt.
Why does cancer recur and metastasize?
After radical treatment (radical surgery or radical radiotherapy, etc.), local lesions of early and mid-stage cancer disappear or are controlled, but a few people have local recurrence or distant metastasis after many years. It can be explained that it is related to the different degrees of malignancy of cancer and the difference of individual immunity, but why the outcome of cancer with the same degree of malignancy is different? How do cancer cells migrate to distant places and incubate for a long time before developing into metastatic cancer? What changes in our body’s internal environment allow cancer cells to develop metastatic cancer in other places? These are not yet known. The “tumor stem cell theory” seems to be able to solve these questions and is a hot topic of research today, but which is the “stem cell” in the vast ocean of cancer cells and what does it look like? Who has the courage to tell us clearly at present? A few early stage cancers (such as kidney cancer) have distant metastases 5 or even 10 years after radical surgery; adult sarcomas, no matter what type and how to treat them, will almost invariably recur or metastasize; no matter what kind of cancer, as long as there are spindle-like cancer cells in it, the treatment effect and prognosis will be much worse than those without spindle-shaped cancer cells. cells) why are they so malignant? These are just phenomena, and we do not know their substance yet, so we cannot explain them. If recurrence and metastasis can be eliminated, the era of curing cancer (whether early or late) will really come.
Can late-stage cancer be cured?
With only a very few lucky exceptions, for the vast majority of patients with advanced cancer, a cure remains a dream. The definitive and repeatable results now are that most early-stage cancers can be cured with radical local treatment (surgery or radiotherapy) and a few advanced cancers can be controlled or cured in the long term with local radical treatment combined with systemic treatment (chemotherapy, bioimmunotherapy or molecular targeted drug therapy). Although there are countless new drugs and technologies available for the treatment of cancer, there are not many tools that can play a decisive role, and each has its own strict indications and principles of application.
No hope or little hope is not the same as despair. One type of cancer is enough to kill a person, can you still live with multiple cancers? I have such a case: the first time he had bowel cancer, after surgery, he found that there were lymph nodes metastasis and invasion to the outside of the intestine, he received conventional systemic chemotherapy, recovered completely and returned to normal work and life. Many years later, he had lung cancer, which was again surgically removed and treated with chemotherapy, and the tumor had metastasized to the pericardium and caused pericardial hemoptysis, which almost killed him, but he was rescued in time and still survived. The previous year, hematuria appeared in his eyes and he was diagnosed with right renal pelvis cancer, and prostate cancer was diagnosed before the radical surgery for renal pelvis cancer. The prostate cancer was poorly differentiated, which means it was highly malignant. After a few months of internal treatment, I was forced to undergo radical surgery for prostate cancer because of the side effects (which are very rare), but the worrying complication of urinary incontinence did not occur, but the anastomotic stricture occurred and the urethra needed to be dilated regularly. Soon after, hematuria returned and bladder cancer was detected, and surgery to preserve the bladder was performed. He has endured 5 types of cancer over the decades and is still alive and healthy and working, soon to turn 80 years old. Can you believe the results of each treatment he received, which was the standard or conventional treatment at the time? But how many people can have this luck?
The question now is, in advanced cancer, how to determine whether the treatment is effective and what treatment will benefit the patient, when to give up ineffective treatment efforts and waste, and when to continue to persist and let the patient really benefit? This is not only a question that doctors should think about, but also a question that patients and families should face, and a question that the medical industry and system should study and solve.
Is there a way to prevent cancer?
Prevention means treating the disease before it happens. Can cancer be prevented? For countries, societies or groups, cancer can be prevented, for example, by reducing air, water and food pollution, banning smoking, promoting good living habits (controlling protein and fat diet, maintaining moderate physical exercise and good mind), but it is difficult to prevent some individuals from developing cancer. It is not known whether these preventive measures are effective for individuals or individuals until the true causes and mechanisms of cancer are understood. There are many examples of people with good lifestyle habits getting cancer, while people with bad lifestyle habits remain unscathed for life. For example, people with a history of hepatitis and cirrhosis should undergo liver cancer examination every 2-3 months to detect early liver cancer. For kidney cancer, an annual ultrasound examination of both kidneys is enough to detect early kidney cancer; for prostate cancer, if there is no family history of prostate cancer, PSA examination should be done once every six months or once a year after the age of 50, and PSA examination should be started after the age of 40 if there is a family history, so that early prostate cancer can be detected; if there is no intestinal polyp, a colonoscopy once every three years will almost never get late stage intestinal cancer; as already mentioned earlier As mentioned earlier, most of the early stage cancers can be cured by local radical treatment, and the treatment time is short, less painful and less costly. The cost and medical resources spent on one advanced cancer patient are enough to cure dozens or even hundreds of early stage cancer patients. In this sense, cancer prevention checkups are of extraordinary significance to individuals, families, society and the country. With the development of science and technology and the advancement of medicine, the effectiveness of cancer prevention medical checkups can be greatly improved and medical costs and resources can be saved by conducting key tests for certain people with high risk of cancer.
Where is the hope for curing advanced cancer?
With the currently available means or methods, the situation of poor treatment effect of advanced cancer cannot be fundamentally changed. Why is it so pessimistic? Please look at the reality, how many weapons we have: surgical resection, cryoablation, thermal ablation (microwave or radiofrequency), chemical ablation, external radiation radiotherapy (various machines and techniques) and internal radiation radiotherapy (insertion of implants or radioactive particle implantation, etc.), multi-drug combination chemotherapy, hormonal endocrine therapy, immunomodulatory biological therapy, molecular targeted drug therapy to inhibit tumor angiogenesis, applied alone or in combination With these means, almost all cancer foci visible to the naked eye can be removed from the body of first-treatment advanced cancer patients. Although some cancers (such as testicular cancer) can be cured, or a few patients can survive for a long time, most of them will appear in other parts of the body after a period of time, and it can no longer be controlled with the above methods or means. The onset of cancer is a natural process that starts from nothing and grows from small to large. Cancer is very small and weak at the beginning, why does the immune system in the body not warn and destroy it? Why does the immune system not warn and destroy it? Why is it allowed to develop and abuse? What is wrong with the immune system in the body? Without clarifying this question, it is only a dream to fundamentally cure advanced cancer, and for this dream, medical workers and scientists need to keep working and moving forward.