The Indian lady, who smiled happily as soon as she met us, was Uma (pseudonym). She’s a gallbladder cancer patient. Before flying from India to Guangzhou for treatment, she had anxiety that caused high blood pressure. After proper treatment and intimate companionship from Guangzhou Fuda Cancer Hospital (Fuda), she became more and more cheerful, and often greeted and joked with medical staff here.
01 Stomachache ➨ Gallbladder cancer
At the beginning of 2022, Uma went to a local hospital for ultrasound because of stomachache, which showed an occupying space in gallbladder, and then the pathology result showed gallbladder adenocarcinoma. PET-CT also showed an occupying space in neck and body of gallbladder, multiple metastases in left clavicle and abdominal lymph nodes. These test results scared Uma. It was not just stomachache. How could it become gallbladder cancer?
Gallbladder cancer is a malignant tumor that occurs in gallbladder, and the main type of it is gallbladder adenocarcinoma. In China, more women suffer from gallbladder cancer than men, and the ratio of men to women is about 1:3. Most gallbladder cancers with an insidious onset are not specific, featuring indigestion, abdominal discomfort, weight loss, etc. The prognosis of gallbladder cancer is significantly related to the early and late detection, and the 5-year survival rate of early gallbladder cancer after treatment is significantly improved.
Please be careful if the following situation occurs:
1. Patients over 60 years old with a history of chronic cholecystitis or gallstones for more than 10 years, and recurrent pain;
2. Gallbladder-filled stones with a diameter of over 2 cm;
3. Long-term gallstones with gallbladder atrophy or with thickening and calcification of the gallbladder wall, especially porcelain gallbladder;
4. Cholecystadenomyosis, a single broad-based, sessile polyp which is over 1cm in diameter; especially if it has recently become significantly bigger, it can be highly suspected for gallbladder cancer.
02 A long journey to Fuda for new treatments
Following the advice of local doctors, Uma underwent multiple sessions of systemic chemotherapy, and fortunately, the tumor shrank afterwards. But systemic chemotherapy brought some side effects to Uma so she wanted to try another treatment that not only controlled the tumor but also reduced the damage caused by the drug. Then introduced by one of her relatives, she got in touch with Dr. Anup Aboti, head of Fuda's office in India to learn more about the difference between interventional chemotherapy and systemic chemotherapy, and finally decided to come to Fuda for treatment.
Advantages of interventional chemotherapy
l Minor side effects: by injection of drugs through arteries directly into the tumor to increase the concentration of drugs in the lesion, reduce the flow of drugs through other organs throughout the body and reduce the damaging effect of chemotherapy drugs on heart, brain, kidney and other organs, thereby reducing the side effects;
l Good efficacy: studies have shown that increased concentration of chemotherapy drugs can increase the chemotherapy effect by 10-20 times, especially platinum drugs (such as cis-platinum); the efficacy is directly positively correlated with the drug concentration;
l High accuracy: Accurate positioning can be achieved under the precise guidance of medical imaging equipment. Fuda has a DSA+MDCT composite intervention unit, allowing doctors to perform treatment in a precise and complete way through dual guidance, which reduces the damage to normal tissues.
The examinations done after admission to our hospital showed gallbladder is abnormal in shape with coarse wall, enhanced echo and uneven thickening; there are multiple slightly hypoechoic nodular foci on the inner wall; secondary malignant tumors of lymph nodes in multiple parts (such as vena cava, retrohilar hepatic, retroperitoneal, etc.). Based on the patient's medical history, and examination results from other hospitals and our hospital, Dr. Shi Juanjuan, deputy director of Medical Office I, fully communicated with the patient and her son, and suggested surgery because it is currently an active and effective treatment for gallbladder cancer, which can directly remove cancer tissue, providing patients with a chance of cure and long-term survival.
However, Uma and her son said no to surgery but asked for interventional chemotherapy. Then Uma underwent interventional chemotherapy for gallbladder adenocarcinoma and abdominal metastatic lymph nodes after exclusion of contraindications to chemotherapy. “Interventional chemotherapy has very little effect on my body and has few side effects. After interventional chemotherapy, I can walk normally and I don’t feel very tired.” The result pleased Uma.
To further reduce tumor burden, Uma underwent brachytherapy for abdominal lymph node after exclusion of contraindications to minimally invasive treatment. Compared with conventional radiotherapy, brachytherapy under CT and ultrasound guidance has the advantages of small internal radiation dose, longer action time, more accurate treatment positioning, uniform local effect on tumors, and minimal damage to surrounding normal tissues, which is a proper treatment for local lesions. Together with chemotherapy, the effect of brachytherapy is more obvious. For patients with metastases, brachytherapy can effectively control the growth of metastases, maintain organ function and reduce their pain.
03 Considerate services warm her heart: undergoing treatment while having fun
“When I found that Fuda provided interpretation service, I was half relieved.” Uma said that before she came, she had high blood pressure due to anxiety. “I'm afraid of language barriers, different diets, and different habits in a foreign country. All these worry me.” In addition to interpretation service, our hospital also provides airport pick-up service, foreign currency exchange, visa application, outside shopping services for foreign patients, which relieved her stress and enabled her to stay at our hospital with peace of mind.
“The people and environment here are good, and the service is also good. My son and I can go out for sightseeing in Guangzhou after treatment.” Uma was happy about the “treatment + fun” at Fuda and to a certain extent, it also helped her recover soon.
“For cancer patients, an optimistic mindset is very important, and prevention is more important than cure, so regular check-ups are necessary.” Uma advises everyone to eat more healthy food and live a healthy life. Even if you have cancer, don't be pessimistic. Nowadays, there are many anti-cancer treatments around the world, so if you don’t have financial problem, you can consult doctors from different places and try more treatments, maybe you can save your life.
