By Xiao Na of the International Health Magazine of Indonesia (Translated into English)
Recently while visiting a bookstore in Beijing, this reporter accidentally came across an elegantly printed, thick brown book entitled “Cryosurgery for Cancer”. The 500,000 word book with color diagrams and summaries in English for each chapter was written by Professor Kecheng Xu and Dr. Lizhi Niu,and published by the Shanghai Technology and Education Publishers.
The book had a foreword and commentaries by a total of six highly respected experts in the field of cryoablation therapy from China as well as from overseas. One of them, Professor Zhong Nam Shan, an academic of the Academy of Engineering Sciences of China and president of the Chinese Medical Association, wrote in the foreword “….as the first book on cryoablation therapy written in China, it has systematically introduced to readers to cryoablation and its application in treating various types of cancer….. The book reveals the most recent achievements by cryoablation on the treatment of cancer…. He continued “As a co-worker who has devoted my whole life in the study of lung cancer, I truly salute Dr. Lizhi Niu and his team on their achievements on lung cancer treatment.” Another scholar, Dr. Franco Lugnani of Italy, the chairman of the International Cryoablation Institute said in the foreword “I was very happy to be able to share the joy of the success of Professor Xu and Dr. Niu in applying cryoablation therapy in more than 3000 cancer cases. Most of these cases were done percutaneously. This is of utmost importance in the field of minimally invasive therapy. …. Their excellent works have contributed greatly in clinical application of cryoablation therapy…”
By using the information provided in the book, this reporter made a specific trip to the Fuda Cancer Center in Guangzhou, China to interview Professor Xu and Dr. Niu, the authors of the book.
Set Free from Lung Cancer, the No. 1 Killer
On the day that I was also in Guangzhou, a production team from Henan TV was also in Guangzhou to film a production for their program series, "The World of Senior Citizens". Accompanied by Dr. Niu, this reporter followed the team to Fan Yu, a small town at the outskirts of Guangzhou to interview an elderly lady by the name of Mrs. Zhang.
All four generations in her family were living together in a big house. Seeing us come, she enthusiastically asked us to take our seats, and offered us tea and fruit. She recognized Dr. Niu who had treated her and held his hands firmly while trying to slip in some money into his pocket. Only upon persuasion of other members of the medical team and her family, she gave up the idea to give Dr. Niu some money as a token of appreciation.
It dated back to June 2004, when Mrs. Zhang, then 94 years old, suddenly had severe back pain; she was unable to walk upright. Every night she groaned in bed and was unable to fall asleep. She went to an associate hospital of a university for medical examinations.
It was discovered that there was a lump in her left lung to the left of the sixth and seventh thoracic vertebra. The lump was pressing against the spinal cord. The doctor told her children that she had lung cancer which had spread. However, as she was too old to undergo surgical operation, it was advisable for her to spend the rest of her remaining life peacefully back home.
One of her grandchildren who happened to have watched a CCTV program on cryoabalation therapy by the Fuda Cancer Center saw a ray of hope. The next day the family escorted Mrs. Zhang to the hospital.
On 14th of June 2004, under the guidance of CT scan, Dr. Niu injected cryoprobes into the tumor to freeze and thaw the cancer mass using the argon-helium system. After more than 10 minutes, the tumor cells were killed. After recovering from the operation Mrs. Zhang felt relieved that her back pain had disappeared. Half a month later, the sixth and seven ribs were plastered, thus improving her general health even further.
During several fellow-ups in the hospital, no sign of new growth was detected. Mrs. Zhang could now take care of herself as well as doing some household chores. The hospital and her family were planning to celebrate her 98th birthday the following.
Lung cancer is currently the number one killer, especially non-small cell lung carcinoma which cannot be removed by surgical operation. The one-year survival rate for lung cancer is less than 20%.
For the past four years Mrs. Zhang, at her old age, had remained healthy and lived a happy life. Her recent CT scan showed that there was no progression of the disease. Dr. Niu pointed at a silhouette shown on the CT scan film and informed that it was what was left of the tumor that had been killed during the cryosurgery operation.
The chapter on lung cancer in the book gave data on the outcomes of cryoablation performed by the hospital. A total of 625 cases of unresectable, non-small cells lung carcinoma were treated. CT scans on 340 cases after a three-month period revealed that in 57.7% of the cases, tumors had either disappeared completely or diminished greatly. A 12 – 38 month~s follow-ups on 340 patients showed that the one-year, two-year, and three-year survival rates were 64%, 45% and 32% respectively.
According to Dr. Niu, cryoablation can be performed on all types of lung cancer. Percutaneous (through the skin) cryoablation and surgical operation produce identical results but percutaneous cryoblation is a minimally invasive therapy whereby the opening is small compared to the traditional surgical method. Though traditional surgical operation can be used to remove “small” lung tumor in elderly patients, the risk is much higher.
Percutaneous cryoablation therapy can eliminate lung tumor fast and patients can return home within 2 to 3 days. An 87-year-old professor from Qingdao University-Shandong had a small tumor on his right lung. Doctors had prepared him for surgical operation. However he had a severe lung swelling which might lead to lung failure if traditional surgery was performed. His son-in-law, a film producer from Shenzhen, upon learning that cryoablation therapy for lung cancer was available at the Fuda Cancer Center, the son brought his father to Guangzhou for treatment.
On the third day after admission, CT-guided cryoablation therapy was performed; the patient was discharged on the 6th day. That was four years ago and upon follow-up, that the professor is still very active and travels extensively within China as well as overseas to give talks and lectures.
This reporter observed how lung cancer was treated in the hospital using cryoablation therapy in combination with other therapies. These therapies include 125-iodine seed knife therapy, radio-frequency ablation (RFA), photodynamic therapy and gene therapy, and others. A combination of these therapies produces much better results than cryoablation therapy performed alone.
A paper authored by Dr. Niu--which has been published both nationally and internationally--revealed that Fuda has treated a total of 840 cases of non-small cell lung carcinoma treated with cryoablation as the main therapy in combination with other therapies. In this study, 30.5% of these cases were at the 3rd and 4th stages. After these therapies, 14.4% of the cases experienced a total disappearance of the tumors, 70% of the cases showed that the tumors had greatly diminished in size. The survival rates for one-year, two-year, three-year, four-year and five-year were 68%, 52%, 34%, 26% and 21% respectively. These rates greatly supersede the rates of success using chemotherapy and radiotherapy.
Dr. Niu turned to page 132 of his book and pointed at a CT scan diagram and told a real life story. Liling, was a well known reporter of the Hunan San Xiang Metropolitan News, and well known for his news report and pictures of the inferno in the town of Heng Yang, Hunan. For his report on the inferno and the bravery he had displayed, he was awarded as one of the top ten reporters of the year.
In February 2006, his mother asked him to write a news report on Fuda Cancer Center because the hospital had cured her brother of cancer. Besides that, she was truly impressed by the hospital which had declined to accept the cash reward offered by the patient~s family as a gesture of appreciation to the hospital. However, Liling refused his mother~s request because he believed that many hospitals liked to boast and brag. His mother was frustrated and annoyed. She begged her son earnestly to do her the favor.
It was two years ago that her brother (Liling~s uncle), an engineer by profession, was diagnosed as suffering from terminal stage lung cancer. Doctors gave him only another 100 days to live. His uncle refused to give up and sought treatment in at Fuda Cancer Center.
After a series of cryoablation operations integrated with other therapies, the tumor disappeared. He resumed work and lived a great deal longer than the previously predicted 100 days. As Liling~s work required him to be away from home most of the time, he failed to empathize and understand the difficult period his uncle had gone through in his battle against cancer.
Liling found it hard to reject his mother~s request. Reluctantly he came to Guangzhou to interview the doctor who had treated his uncle~s disease. After listening and understanding the whole episode, the strong-willed reporter wept. He was sorry for the biased view he had held against hospitals.
He submitted an article to be published in his newspaper but it was rejected by the editor who was of the view that any article on hospitals should be dealt with great caution before publishing. Liling was offended and approached the chief editor personally and said, “this article is about my uncle~s struggle for his life against cancer and was written in tears.” At last the article was published in page 2 of the Hunan San Xiang Metropolitan News on 26th February 2006.
Conquer the King of Cancer – Liver Cancer
Even decades ago, this reporter was well aware of the fatality of liver cancer. It is the most common cancer in China and its occurrence is related to hepatitis B. Dr. Wu Meng Chao and Dr. Tang Zhao Xian, well known surgeons in China, had contributed greatly to the field of liver cancer treatment. The 5-year survival rate of their patients with small liver tumors reaches 70% and above. Liver cancer at its early stage shows little symptoms and is difficult to detect. When it is detected, more often than not, it is at an advanced stage and cannot be removed by surgical operation. The best therapy for non-resectable tumors is a much discussed topic in the field of oncology.
The Food & Drug Administration (USA) approved the use of cryoablation with “Argon-helium Knife” for the treatment of liver cancer and prostate cancer in the late 1990~s. However, as liver cancer is relatively infrequent in the U.S., the Americans~ experience in applying cryoablation therapy to treat this disease is quite limited. At Fuda Cancer Center in Guangzhou, one of the pioneers in China introduced cryoablation therapy to China in 2000.
The hospital developed and used percutaneous cryoablation therapy on liver cancer patients. To date, it has treated more than 1000 cases of liver cancer. As recorded in the book “Cryosurgery for Cancer” for the period from March 2001 until March 2005, 550 cases of liver cancer were treated at the hospital. The 1-, 2-, 3- and 4-year survival rates of the patients were 86.4%, 72.9%, 51.6% and 45.4% respectively. In addition, there were 360 patients with liver cancer who received combination therapy of cryoablation with transarterial chemoembolization (TACE), 65 cases of cryoablation with alcohol injection abalation (PEI), and 61 cases cryoablation with 125-iodine seed implantation (brachytherapy). Their survival rates were much higher than cyoablation therapy performed alone.
As cryoablation alone or with other therapies is applicable on patients with non-resectable tumours, it can be considered a superior therapy to conventional surgical method. In a letter from Professor Tang Zhao You--an academic at the Academy of Engineering Sciences of China and famous specialist in liver cancer--to Professor Xu, Professor Tang praised Professor Xu and Dr. Niu on their achievements in using cryoablation therapy to treat liver cancer patients and complimented them for publishing their hallmark text book “Cryosurgery for Cancer”.
There are more than a hundred hospitals in China that have adopted cryoablation therapy, but only a handful of them have mastered the skills necessary to truly make cryoablation successful. To find out the success formula of the hospital, this reporter visited and had an interview with Professor Xu who is a well-known digestive disease specialist and the author of the book “Modern Therapy of Gastrointestinal Diseases”, which is extensively used as a compulsory reference text in many hospitals and medical schools. He was trained at Chiba University, Japan where he did his research on liver cancer under the guidance of Professor Kunio Okuda, a world-renowned specialist of liver cancer. The GGTII, which, as a marker for liver cancer, has been widely adopted by many hospitals in China, and was invented by Professor Xu in the 1980~s.
Professor Xu said that a doctor must be like a skillful craftsman in delivering treatments to patients. He praised Dr. Niu who, with his training in cardiothoracic surgery, had exhibited great skills and precision in performing percutaneous abalation. Of the more than 3000 cases of cryoablation performed by Dr. Niu, none of them encountered any serious mishap.
While interviewing Professor Xu, this reporter happened to meet the vice editor of the book “Cryosurgery for Cancer”, Professor Hu Yi Ze who graduated from the Royal College of Surgery (U.K) as a specialist of hepatobiliary surgery. He had treated several hundred cases of liver cancer by integrating surgery with cryoablation therapy.
He said that the biggest problem encountered in removing liver tumors solely by surgery was the recurrence of tumors. Cryoablation therapy freezes and thus kills non-resectable liver tumors and the destruction in situ of neoplasms which also elicits an immunologic reaction (cryo-immunolization ) against cancer and reduces the recurrence of tumors. In the foreword of the book, Dr. Zhong Nan Shan complemented Professor Hu for incorporating cryoablation with surgery which, besides providing one more integrative therapy for liver cancer treatment, had also raised the success rate in liver cancer treatment and the survival rate of cancer patients.
While in the hospital, this reporter also met a former liver cancer patient by the name of Tan You Hao, who came back for a regular medical examination. He was an ex-police officer. In 2002, he experienced pain in his upper abdomen. He went to a hospital for investigation and discovered that he had liver cancer in his right liver, about 14mm x 15mm in size. It was unresectable. He received percutaneous cryoabalation therapy in at Fuda Cancer Center. After he had been cured, he left the police force and started his own business. The former police officer greatly treasured his remaining life, which he termed as extra life-earned.
According to Professor Xu, treating cancer demands an integration of science, technology and art. Each patient~s condition differs from that of others and hence each patient requires tailor-made therapies for his/her disease.
In treating liver cancer, it requires an integration of various therapies such as iodine seed implantation therapy with cryoablation therapy, cryoablation therapy with vascular stanching therapy, cryoablation therapy with chemical therapy and cryoablation with immunotherapy, etc. The integration of these therapies leads to a synergistic effect and produces better outcomes.
On 26th January 2007, on the eve of the Chinese New Year, Fuda Cancer Center organized a gathering for their cancer patients. Many of these patients had been declared incurable before, but they had survived for more than two years after receiving treatment at the hospital. During the gathering, all of them went up to the stage one-by-one to share their experience in their battle against death in the hospital. The Hunan engineer, who suffered from liver cancer mentioned earlier, told the audience how he had managed to break the “prophecy” that he had been told he had “only 100 more days to live”. He said in a slow and steady voice that “I told myself that I must not die as I have a 90-year-old mother and a university-attending son to take care of…..”
Many in the audience were deeply touched by his shared story and wept. A young man among the audience rushed up the stage and hugged him. That young man was none other than his nephew, the reporter of the Hunan San Xiang Metropolitan News.
Before he could utter any words, he started to weep openly. “I am not staging a show! Without Fuda Hospital