Oncology Physician Life

Chapter 81 Chapter 80 Arsenic for cancer
"This result surprised me!"

Zhang Ru'an, director of the TCM Department of Oncology, angrily threw the latest TCM tumor drug review report on the desk.

Song Zhiguo, the director of the Oncology Department, glanced at Wei Ran beside him, patted him on the shoulder, and comforted him: "Although the new treatment plan has not passed the review, the latest set of lymphatic-targeted drugs that Xiao Wei and Lao Zhang have studied I agree with the combined traditional Chinese and Western medicine treatment plan for tumors!"

Zhang Ru'an is the old director of the TCM Department of Oncology who has worked for more than 20 years. In the two times when the country formulated the review standards for new traditional Chinese medicines, Zhang Ru'an participated in the content compilation of TCM oncology drugs.

However, because the current domestic drug evaluation follows the standards of the United States and international standards, some evaluation standards proposed by traditional Chinese medicine are not recognized internationally, nor are they recognized by some domestic Western medicine experts.

If you say that traditional Chinese medicine is effective for tumors, then you must show effective evidence.

But it's a very difficult job.

In Western medicine, if a patient vomits, the doctor only needs to prescribe antiemetic drugs to the patient.

If the patient needs to increase platelets, then simply prescribe the medicine to increase platelets.

Western medicine has a single function, but Chinese medicine is not.

Many traditional Chinese medicines are compound prescriptions. A qi-invigorating medicine can not only invigorate qi, but also nourish blood, and even stop vomiting and stop bleeding.

According to the standards of western medicine, it is impossible to mix the two aspects of antiemetic and hemostasis, but the syndrome differentiation of traditional Chinese medicine is to replenish qi and blood, so the two can be mixed together.

In this way, it is impossible to evaluate that this traditional Chinese medicine is effective in stopping bleeding.

But because it also has the function of replenishing qi, it is impossible to prove which function has played a role, so it must be proved by scientific evaluation methods.

Song Zhiguo glanced at Director Zhang Ruan Zhang, smiled, and comforted him: "Old Zhang, don't worry about this matter, at least for so many years, our hospital has carried out a lot of international cooperation with foreign countries, and invited many Western medicine experts and consultants. Let’s discuss the characteristics and evaluation methods of traditional Chinese medicine together with medical experts! Many Western medicine experts and foreign experts have recognized and accepted Chinese medicine. The article you wrote this time on the treatment of tumors with traditional Chinese medicine will not be published in American journals. Already!"

Hearing what he said, Zhang Ru'an calmed down: "I know I was too anxious and wanted to become fat in one go, but we Chinese medicine experts can wait, you old Song can let those cancer patients wait!"

Song Zhiguo took a deep breath, "Well, I will discuss this matter with President Li in the afternoon, and discuss it with Director Bi of the Medical Department. At least try to make it available to a small number of patients in the oncology department of our hospital. After all, this program is effective for patients.”

Wei Ran finished the meeting with the Oncology Department of Traditional Chinese Medicine and walked towards the ICU ward.

The ICU does not allow family members to visit casually. As soon as Wei Ran turned around the corner of the department door, he saw quilts, flashlights, chargers, washbasins, towels, and many daily necessities piled up in the corner, making this place a small habitat.

In fact, in order to ensure that the family members can be contacted in time, the emergency contact information of one or two family members of the patient will be kept in the ICU ward. Night watch at the door of the ICU.

But even if the nurse has repeatedly persuaded the family members, these family members will still wait at the door of the ICU.

There are even a lot of patients who don't come out of the ICU for a day, and they wait forever. It seems that they have no other place to live except here.

After seeing the patients in the ICU ward, Wei Ran just walked out the door when he was surrounded by several family members like a tide.

Kang Jun tried to resist these family members with his body and squeezed a way for Wei Ran, but Wei Ran patted his shoulder and signaled him not to do so.

Soon, the family surrounded Wei Ran, and couldn't wait to ask about the patient's condition. Some even talked about topics that had nothing to do with the patient's condition, but Wei Ran patiently listened to them with a smile on his face. until these family members dispersed with satisfaction.

Kang Jun glanced at Wei Ran who was a little tired and even dry-mouthed, and asked curiously: "Teacher Wei, actually you don't need to listen to the nagging of those family members."

Wei Ran smiled: "Do you think these people talk nonsense?"

Kang Jun's eyes wandered, but that's what he meant. The time of every oncologist is precious, and he felt that Wei Ran should not waste his time on these family members.

Wei Ran recalled the questions asked by those family members: "Doctor Wei, can my mother's intracerebral hemorrhage be stopped?"

"Doctor Wei, my father will survive the dangerous period, right?"

"Doctor Wei, how long will it take for my mother to wake up?"

"Doctor Wei, can my daughter regain her consciousness?"

Wei Ran repeated these questions, and looked at the young Kang Jun with a smile: "You think these people are talking nonsense that has nothing to do with the patient's condition, but I think these are the most warm words in the world that can feel a person's warmth."

"Lengnuan?" Kang Jun was a little confused.

"If one day you were sick, like those people in the ICU, it was cancer, and you were lying alone in it, and no one outside expected to see you again, how would you feel at that time?"

Kang Jun imagined himself like that, and hurriedly shook his head: "Lonely, without any thoughts of survival!"

Wei Ran posed a question and gave an answer: "So, as an oncologist, we know that these words are completely irrelevant to the patient's condition, but we still have to listen to them patiently, because this It is the only channel for them to release their anxiety and fear!"

"Worried about the relatives in the ward, fearing that their condition will worsen again. Although I know that there is only half an hour of visiting time at four o'clock in the afternoon every day, I still guard the door night and night. Xiaokang, you should come here at night. Take a look, here you can hear more sincere prayers than the Buddhas in the temple."

Before stepping into the elevator, Wei Ran looked back at the closed door of the ICU: "Probably because the patients lying in the ICU heard the calls and prayers of their loved ones outside, so they were able to turn the corner in the end. After all, no matter how cruel the illness is, it can't stop a son from going to see his mother."

"As oncologists, when we cannot provide better treatment for those patients, the social significance of giving them even a cup of hot water for assistance or comfort to the family members who are in grief will far exceed their social significance. The meaning of 'healing', because as a doctor, what we face is not just a single individual patient, but a huge population of human beings!"

Kang Jun stared blankly at Wei Ran who disappeared in the elevator, the other's words pierced his heart like a steel needle.

He couldn't help recalling the question the teacher asked him when he graduated: "When you become an oncologist, you have to become a doctor who is worthy of 'patients', so that you will live up to the teacher's respect for you in the past few years. teach."

In the past, Kang Jun never understood what kind of doctor is a doctor worthy of the "patient", but at this moment, after Wei Ran's words, he seemed to understand the meaning of this sentence in his heart.

At seven o'clock in the morning, Jiang Li took Lu Jiajia and Yang Xiaolan to attend the MDT diagnosis and treatment meeting with the Department of Hematology and Chemotherapy and Radiology. It didn't end until eight o'clock, and then hurried to the outpatient clinic with the two of them. building.

An outpatient room on the third floor of the outpatient clinic, which is close to the cardiopulmonary function testing room, is used by the Department of Pediatric Oncology. As soon as Jiang Li sat down, he received a patient case from the Department of Hematology on his mobile phone. It was a patient with APL (acute promyelocytic leukemia) .

Lu Jiajia looked at the cases shared in the diagnosis and treatment group, and his eyes showed surprise: "I heard that this patient was only discovered after undergoing gene sequencing. Isn't this APL a very rare leukemia?"

Yang Xiaolan stood aside, and continued: "APL, also known as acute promyelocytic leukemia, is a blood disease caused by mutations in two independent protein genes, PML-RARa, in the human body, but what is rare is that these two proteins The genes are not on the same chromosome, one is on chromosome 15 and one is on chromosome 17."

"Under normal circumstances, if there is no special situation, these two protein genes will never meet in this life, and these two protein genes themselves are not carcinogenic, but what is strange and rare is that if someone has 15 Chromosomes No. 17 and No. [-] were broken, and then the genes were recombined to form a new chromosome. During this process, the two proteins PML and RARa would combine unexpectedly. Once these two proteins were assembled together, they became Very strong cancer-causing gene!"

After hearing Yang Xiaolan's explanation, Lu Jiajia had a look of enlightenment on his face: "I understand, it's like in Gongdou's novels, the two kinds of food are originally non-toxic, but when they are put together to make the same food, it will become poisonous." It is highly poisonous!"

Jiang Li smiled: "It seems that you haven't watched Gongdouju in vain all these years."

Lu Jiajia grinned and frowned again: "Mr. Jiang, this disease is so rare, isn't that little girl..."

Jiang Li sent good news to the Department of Hematology, and then he looked at the two of them: "I'm afraid you can't think of the interesting thing about this rare disease. Guess what is the specific drug for treating this acute promyelocytic leukemia?"

Lu Jiajia looked at Yang Xiaolan, who was also confused.

Jiang Li pointed to Lu Jiajia: "Watching Gongdou drama, if you want to poison a noble concubine, what kind of poison would you use?"

Lu Jiajia blurted out: "The crane's top is red?"

Jiang Li shook his head: "Think again."

"It's arsenic!" Lu Jiajia opened his mouth wide in surprise, "Mr. Jiang means that the special drug for treating this acute promyelocytic leukemia is actually arsenic?"

Jiang Li nodded: "That's right, but arsenic is what we Chinese call it. The main component of arsenic in the world is actually dikun trioxide. In recent years, large-scale clinical trials have found that dikun trioxide and all-trans retinoic acid Combined treatment of acute promyelocytic leukemia is more effective than standard chemotherapy plus all-trans retinoic acid. It is gratifying that this very rare acute promyelocytic leukemia, after the addition of arsenic , It has achieved amazing curative effect, and the two-year survival rate of patients is as high as 99%, which can be said to be one of the great contributions of traditional Chinese medicine to modern medicine!"

Lu Jiajia exclaimed: "Unexpectedly, arsenic, which was originally highly toxic in traditional Chinese medicine, has become a special medicine for acute promyelocytic leukemia. It seems that the culture left by our ancestors is really a treasure for our future generations."

"Of course," Jiang Li smiled softly, "When I was working in a laboratory in California, I was at the home of an old immigrant Chinese medicine doctor, and saw the handwriting of Chinese medicine left by his ancestors. In China before, there were folk records of arsenic + toad venom + light powder for treating cancer. Arsenic should be regarded as the first anti-cancer targeted drug used by human beings, and it can also be regarded as a gift of nature to human beings. In fact, arsenic and artemisinin They are all found in traditional Chinese medicine, and the whole world should be grateful for the records of this prescription in Chinese medicine literature.”

After a while, the first patient came to the outpatient room.

A woman in her 30s brought her teenage daughter to the clinic for consultation.

Jiang Li put the little girl's cranial CT film on the map reader. There was a tumor in the optic nerve area of ​​the girl's brain, which had already compressed the little girl's optic nerve. If it was not removed in time, the girl might become blind.

Jiang Li glanced at the young mother who was obviously haggard and restless sitting in front of her. The little girl in her arms also felt the mother's state on her face, showing a very disturbed expression.

Obviously the little guy also knew that there was something bad growing in his head.

The young mother asked in a trembling voice: "Doctor...doctor, I saw it at our local hospital. They said that if my daughter doesn't have a craniotomy to remove this thing, she will become blind?"

Jiang Li nodded: "They are right. Now the tumor has seriously oppressed your daughter's optic nerve. If you don't cut it off in time and let the tumor continue to grow, your daughter will become blind. Judging from the results, the tumor is still stable at present, with a very clear boundary, and the degree of malignancy is not very high."

The woman stroked her daughter in her arms, and asked hesitantly: "Doctor, my child is only ten years old. If this is a craniotomy, what should she do if there are sequelae or brain nerve damage? She is only ten years old, and her future is still very long."

Jiang Li looked at the CT scan of the girl's brain again, bowed his head in thought for a moment, and said with a smile, "Don't worry about it, I don't need to have a craniotomy for this operation."

"Can this tumor be removed without craniotomy?" The young mother obviously couldn't believe it. She went to several hospitals, and the doctor's advice was all craniotomy.

Jiang Li nodded: "The tumor in your daughter's brain is relatively close to the vestibular area. I can completely use the method of nasal endoscopic skull base resection to remove the tumor."

The woman wept with joy: "Then doctor, we will use this method, as long as there is no craniotomy, we can do anything."

Jiang Li took out a lollipop from the drawer and handed it to the little girl in front of him. Seeing that the uneasy expression on the girl's face dissipated and she showed a bright smile again, her mood also eased a lot.

"Then you go through the admission procedures first. This operation is not a big problem. After confirming the specific operation plan with the brain, the operation can be performed."

(End of this chapter)