2024-07-19 17:39:20
Professor Kim Na-ri, Samsung Seoul Hospital – Liver metastasis, Mr. Jeong Yun-jae
After removing rectal cancer and kidney cancer, chemotherapy, liver metastasis confirmed 1 year later… surgery difficult
Severe side effects, unable to complete second round of chemotherapy… New technology discovered while looking for another method
Five proton beam shots… Only traces of cancer remain, very low chance of recurrence, ‘road to cure’
In December 2020, blood was mixed in the stool. Jeong Yun-jae (71) was scared. However, he tried to calm his surprised mind by saying that it was not a serious disease. Jeong thought that the fistula might have relapsed. He had been diagnosed with the fistula about 20 years ago. He wanted to think that the fistula could have worsened and that he was bleeding now.
He had a hemorrhoid surgery at a local hospital. There were no major problems up to this point. The problem arose the next morning. Even after the surgery, he still had blood coming out of his anus. The doctor performed a colonoscopy. He saw something like a lump in the rectal area. The doctor told him to go to a larger hospital. Mr. Jeong rushed to the nearby A University Hospital.
● I thought it was a fever, but it was cancer
I got tested again at University Hospital A. My worries became reality. It was stage 2 rectal cancer. They also suspected lymph node metastasis. If it had metastasized, it could be considered stage 3 rectal cancer. The cancer blocked two-thirds of the inside of the rectum.
Further tests revealed a renal cyst. I had known for a long time that I had a cyst. The cyst had grown larger. I had a biopsy, and it turned out to be cancerous. It wasn’t a metastasis of the rectal cancer, but a new cancer that had developed in the kidney itself. I was diagnosed with two types of cancer at the same time.
Both cancers had to be removed at the same time. In February 2021, Mr. Jeong went under the knife. The surgery itself took nearly 10 hours. Fortunately, the surgery was successful. The cancers in his rectum and kidney were both removed.
Still, I couldn’t let my guard down. Although it wasn’t immediately visible, there might still be tiny cancer cells remaining. In that case, the cancer could metastasize to other organs. The medical team decided to administer preventive chemotherapy.
I started chemotherapy in March 2021. I went to the hospital every two weeks to get injections. The chemotherapy was scheduled for a total of 12 times. However, it did not end smoothly. Up until the first three times, I had side effects such as a slight loss of appetite, but it was bearable. I had enough energy to walk three laps around the neighborhood and return home. However, from the fourth time I received chemotherapy, my energy dropped significantly. I couldn’t even exercise properly.
Still, I endured the treatment with a determined mind. However, after completing the 8th treatment, I could no longer endure it. After consulting with the medical staff, I stopped the treatment for about 2 weeks. After that, I started chemotherapy again. I still had no strength and no appetite. I couldn’t eat properly. I gritted my teeth and completed all 12 chemotherapy treatments.
● Metastasis to the liver, surgery is not possible
I was hopeful that I would no longer suffer from cancer after completing surgery and chemotherapy. I felt nervous every time I had a follow-up examination to check for metastasis or recurrence of the cancer.
About a year had passed. In March 2023, two cancers were discovered in the liver. The rectal cancer had metastasized to the liver. Treating the metastatic liver cancer did not seem easy. First of all, the cancer was close to the blood vessels, making it difficult to try radiation therapy. To make matters worse, the liver function was not in very good condition. If surgery had been attempted rashly, liver failure could have occurred. The medical team agreed to first reduce the size of the cancer with chemotherapy and then perform surgery.
Chemotherapy began again. This time, it was 12 rounds. The side effects were worse than the first round. I could barely walk. I had a hard time getting out of bed and going to the bathroom. I could barely eat. My hair completely fell out. I felt like I could never overcome cancer. “I wanted to give up on all treatments,” Jeong recalled.
In the end, the chemotherapy was not completed, but the surgery was scheduled for September 2023, thinking that it might be possible to have the surgery. However, the test conducted before the surgery showed that he was not eligible. The family was shocked. They did not know what to do anymore. The future was bleak.
I started looking into other treatments. Mr. Jeong’s son Seok-il (44) said, “If it doesn’t work out, I thought I should go overseas to get treatment.” In that situation, I heard that proton therapy is effective in treating metastatic liver cancer. I heard that proton therapy is being performed at two places: Samsung Seoul Hospital and the National Cancer Center.
● Get rid of cancer with proton therapy
Last October, Ms. Jeong visited Samsung Seoul Hospital with half anticipation and half worry. At that time, she met Professor Kim Na-ri of the Department of Radiation Oncology. Professor Kim said, “This is a treatment option that can be chosen when surgery or chemotherapy is difficult. Ms. Jeong was just like that. Proton therapy was the best method to significantly reduce cancer and improve quality of life.”
Before the proton therapy, I had breathing training to ensure that the proton beam was properly injected. This training and other preparations took about a week. The treatment date came. I received the proton beam every day from Monday to Friday for 30 minutes. This was the end of the proton therapy. Professor Kim explained, “It depends on the patient’s condition, but once the proton beam is continuously shot, we observe the progress.”
Mr. Jeong has also been regularly monitored since then. Surprisingly, only a trace remained of one of the two cancers in the liver. The other one was also reduced to the point where it was almost invisible. The treatment effect was better than expected. However, is it possible that the cancer will grow again? Professor Kim said, “That is highly unlikely.” In fact, he is on the path to complete recovery. Of course, he has not been declared completely cured yet. His rectum and kidney condition are being monitored regularly at a local hospital A. Fortunately, there are no signs of the cancer recurring or metastasizing yet.
These days, Mr. Jeong is living a healthier life than ever. His body has improved rapidly. He is able to eat again. He eats everything properly and well, except for the foods that his doctor told him not to eat. He also resumed walking. He likes mountains, so he often goes there. He walks for two hours every day. Mr. Jeong laughed, saying, “It feels like I came close to death and came back to life.”
The family had a hard time while he was fighting the disease. Everyone was on edge. At those times, Seok-il tried very hard. Seok-il would often stop by the house to check on his father. He always accompanied him when he went to the hospital. Seok-il also looked into proton therapy for cancer. Seok-il said, “It’s something a son should do.” The father said, “No. It’s like my son saved me.”
●“The probability of cancer cells growing again is not high”
Proton cancer treatment is mainly used for liver cancer, lung cancer, metastatic liver cancer, lung cancer, head and neck cancer, and pediatric cancer. It is a type of radiation therapy. When a proton beam is fired, it selects and destroys cancer cells. It is more precise than radiation therapy and can increase the treatment effect with fewer treatments. Radiation generally reaches a wide area. Because of this, it destroys not only diseased tissue but also surrounding healthy organs. On the other hand, protons have the advantage of not destroying surrounding organs or tissues because they hit the target area exactly. Professor Kim said, “General radiation therapy varies depending on the area, but generally requires 10 to 30 treatments. On the other hand, proton therapy often ends in 10 to 15 treatments at most.”
Proton therapy is usually performed every day. There is a reason for this. Tumor cells grow back even after treatment, so it is best to suppress them as often as possible. However, if proton beams are shot more than twice a day, it may be difficult for normal organs to recover their functions. For this reason, it is performed once a day, but continuously for several days.
What is the probability that cancer cells that disappeared or decreased after proton therapy will grow back? Professor Kim said, “It is not high.” Usually, the probability that cancer will not grow until about 5 years after proton therapy is completed is 80-90%. However, since cancer can metastasize to other parts, regular observation is necessary. Usually, regular examinations are conducted every 3 months for the first year after treatment, and every 6 months thereafter.
Recently, a hadron therapy machine called the ‘dream cancer treatment machine’ has been introduced to a domestic university hospital. Hadron therapy has a high cure rate, but it has the disadvantage of not being covered by health insurance, so the treatment cost is tens of millions of won. On the other hand, proton therapy is covered by health insurance for most cancers except prostate cancer and breast cancer.
Reporter Kim Sang-hoon [email protected]
2024-07-19 17:39:20