Second Aunt is back for chemo …… It’s been a long time since I’ve blogged because I’ve been too busy! The mood is also bad …… Before the Spring Festival this year (2012), it was time for another review. Second aunt routinely rechecked blood routine, liver and kidney function, lung cancer markers, chest CT, ultrasound. I hadn’t had a bone scan in six months, so I had a full body bone scan. The results came out quickly. Everything else was fine, but the bone scan showed multiple bone metastases, mainly in the (fourth and fifth) lumbar vertebrae, sacrum and iliac bone (the so-called pelvis). When I saw this result, my head was suddenly baffled – how could there be bone metastases without any warning! The results of the thoracic surgery department of Henan Provincial Cancer Hospital Yan Ming quickly told his aunt, he said, could it be a mistake, a few days ago she fell to the ground playing shuttlecock and fell very hard, and this is related? Now it still hurts vaguely! I said, “It’s possible. Bone trauma often causes false-positive bone scans (meaning wrong results). So, I immediately rushed to the nuclear medicine department and got someone to pull up my second aunt’s films specifically. Their results were discouraging to me: still highly suspicious of bone metastases – because the metabolic presentation was not quite the same. An MRI was recommended to further confirm the diagnosis. I had no choice but to reassure my aunt while having the MRI done as soon as possible. The results soon came back: bone metastasis was confirmed – because not only was there bone destruction, but there was also new tissue around the bone destruction (it is impossible for new organisms to appear in a fracture, which is metastatic). When it came to this point, there was no way out. I had to tell all my relatives truthfully and choose a treatment option …… To be honest, there is nothing to choose from for multiple bone metastases, and the vast majority of them choose chemotherapy. Because multiple bone metastases are cancer cells transferred through the blood, there are countless cancer cells within the blood. The only way to kill these cancer cells is to use drugs in the blood, and to bring anti-cancer drugs to the metastases through the blood to kill the cancer cells. Radiation therapy is to kill cancer cells by radioactive targeting locally, and cannot kill cancer cells within the blood, nor can it irradiate too many parts at the same time (it has many side effects and is not easy to operate). Under the deliberation of grandparents, aunts and uncles, while the back pain began to worsen day by day, I was finally admitted to the hospital to start chemotherapy before the Spring Festival. The aunt only made one condition: in order to avoid too much damage to the body from side effects, can the dose of chemotherapy drugs be smaller? I said, “Yes, we can use “low-dose chemotherapy” ah! Foreign countries have always promoted individualized treatment, advocating the use of chemotherapy drugs for each patient according to the situation, and now there is “low-dose chemotherapy” for patients with weak constitution. But in China, because many people do not understand or are not willing to reduce the dose of chemotherapy drugs for economic reasons, so only a few people in a few places to carry out. Once it was agreed upon, it went well. The regimen of cisplatin + vp-16 was used. Chemotherapy was given for 3 days with cisplatin 30MG*3 days and VP-16 100MG*3 days, then chemotherapy was stopped. During this period, antiemetic (toltestrone), acid suppressant (omeprazole), and medication to promote use (megestrol) can be used as appropriate. About a week after the chemotherapy was finished, my second aunt said that her back pain was significantly better and her leg movement was more flexible, but her hair was falling down in a clamorous manner (the most common side effect of VP-16) …… This made it more certain that it was bone metastasis …… In order to reduce chemotherapy side effects and at the same time In order to reduce the side effects of chemotherapy and at the same time increase resistance, during the chemotherapy period, Aunt Yee has been eating the Chinese medicine powder I prepared for her, which strengthens the spleen and tonifies the kidneys, increases white blood cells and improves appetite. After the Lantern Festival, about 1.5 months after the last chemotherapy, Aunt Yee said that her back and leg pain had become obvious again! There was no choice – it was still chemotherapy! The same regimen was used, also for 3 days …… That’s it, almost every month and a half chemotherapy, each time a small dose of chemotherapy for 3 days. The chemo interval eating Chinese medicine, and so on until June 2012. The second aunt felt that the remission time after each chemotherapy was getting shorter and shorter, and finally almost less than 4 weeks before she had back and leg pain again – indicating that drug resistance may have developed! Had to switch drugs: used a cisplatin + irinotecan regimen, still at a smaller than normal dose. Irinotecan has more side effects than VP-16, and many colleagues warned me that patients can develop severe diarrhea. My second aunt has always had a poor spleen and stomach, and I was particularly worried, so I took herbal medicine and dietary therapy directly along with the chemotherapy to prevent diarrhea. The result was not bad, the diarrhea was not obvious! Only the stool was loose for about 1 week. After using Irinotecan, I felt that the remission period was slightly longer than before, about 6-8 weeks before I needed the next chemotherapy. During this period, I also reviewed all the tests, except for the lumbar spine bone metastasis which remained the same, and the other small bone metastases were significantly reduced. The white blood cells, red blood cells, liver and kidney functions were also normal. That’s how the situation has been maintained until now …… Summary: Through the above personal experience, I found that individualized low-dose chemotherapy has great benefits for some patients with weaker constitution, especially with the adjuvant treatment of Chinese medicine, which has a good balance in controlling tumor metastases, reducing pain and improving quality of life and prolonging survival time. We may have heard of many patients with advanced metastases, who underwent chemotherapy once every 3 weeks according to the rules, with a high dose of chemotherapy, and after a few cycles, their bodies could not stand it anymore, they could not eat or sleep well, they were uncomfortable, their lives were worse than death, and some of them were gone in less than a year. The large number of such cases has made patients and their families shy away from chemotherapy and avoid it like a tiger! Some patients refuse chemotherapy even if they know they are going to die. Therefore, as a doctor, we should reflect on this phenomenon, rather than just blame the patient’s “ignorance”. If the patient knows that the quality of life is not significantly reduced while prolonging the survival time, the patient will make the appropriate choice! To be honest, Aunt Er’s small cell lung cancer, even after total lung resection and recovery to normal health with Chinese herbal medicine, still had bone metastasis in the whole body 1 year after surgery; it was resistant to chemotherapy after a few times, which means that this kind of small cell lung cancer is highly malignant and difficult to treat. (There is still no clear research result on the specific mechanism of malignancy of the same kind of cancer cells), the family is very satisfied to be able to control this! The reason is that many nurses also believe that if it was in the medical oncology department, like your aunt’s physique, she would have been “beaten” to death by chemotherapy! ……