Come on, Dr. Wu

Chapter 351 Mixed Cancer

He has a history of hepatitis B for many years.

Looking at the patient's liver MRI, there is a liver mass, decreased anti-phase signal, and progressive enhancement.

However, the patient seems to be unaware of his condition.

Looking at her colleague next to her, she had not yet told Wu Xiaofu whether the patient knew about his condition.

"How is it, Doctor Wu?"

In addition to this colleague and the patient, there were other family members around the patient, who should be the patient's husband. Seeing that Wu Xiaofu had finished watching the film, he hurriedly asked.

His expression seems to be more tense than the patient's.

It seems that he had learned about the patient's condition in advance, or had asked other doctors to look at the X-rays. Now that he came here, he just made a diagnosis.

"I need surgery."

Operation!

The people on the opposite side had different expressions when they heard this.

Wu Xiaofu's colleagues were obviously relieved. What Wu Xiaofu had thought before was indeed correct. After the patient had a physical examination and abdominal color ultrasound, they found something wrong, so they quickly took him to the hospital for a recheck of the MRI. After a closer look, they found that something was wrong and there was an obvious mass.

Because the film was shot by someone I knew, no report was issued, just a film.

Until this point, the patient didn't know the specific situation, only the patient's husband knew something. Although this colleague worked in human resources, his understanding of the disease was not comparable to that of ordinary people due to what he saw and heard. It would be better if it was just liver cancer.

The patient's condition now is not just this. From what other doctors have said, it is more serious than liver cancer. No, although it is liver cancer, the type may not be that simple. The anti-phase signal is reduced and progressively enhanced. It seems that the malignancy is not low.

But there is no doubt that it is cancer, so the question is what to do next?

Should we first take a part of the tissue for pathological examination, and then do immunohistochemistry, and then decide on the subsequent treatment, or should we go directly to surgery and then do pathology after surgery? However, given the patient's current condition, many doctors are hesitant about doing surgery, because if it is a highly malignant type, the postoperative effect will not be very good.

Malignant tumors are highly differentiated and metastatic.

Even if the cancer is completely removed during surgery, the cancer will still spread quickly because it only removes the large pieces that you see. Some small cancerous tissues that you cannot see are still left, which are simply beyond the reach of doctors to detect and remove. Therefore, surgery can at best delay the progression of the patient's disease.

In fact, it can't even delay the disease, but will accelerate the course of the disease.

After all, the patient's physical condition will be worse after surgery. If it is combined with radiotherapy and chemotherapy, the immunity will be reduced, and some tumors with a higher degree of differentiation will even progress faster.

This is actually one of the reasons why some cancer patients say that they have undergone surgery, but the cancer has metastasized faster.

Surgery is undoubtedly still one of the best treatments for tumors at this stage, but it is not suitable for all tumors.

For example, the type of patient in front of us.

"I still need surgery. Is it that serious?"

The patient suddenly spoke, and it was obvious that he found it hard to accept. Well, the patient was only 31 years old, still young. In all these years, he had never had an operation, let alone a hospital stay or even some minor bumps. Now he suddenly had to undergo an operation. How could he accept this?

"Doctor Wu, what is wrong with me?"

When she heard that she needed surgery, the patient became a little skeptical. How could a common disease require surgery? Moreover, she didn't actually realize it. After all, her husband and other family members were so anxious that they even found a famous hepatobiliary surgeon from the First Affiliated Hospital to help her.

However, she could not associate herself with cancer no matter what. After all, she was only 31 years old. She should not have this disease at such a young age.

The patient's husband was a little hesitant at this time.

Surgery, it is said that once you are on the operating table, your life is equivalent to being handed over to you, even if it is handed over to Wu Xiaofu, the famous hepatobiliary surgeon of the First Affiliated Hospital.

"Doctor Wu, is there no other treatment method?"

"Yes, but surgery is the best way to treat the patient's disease."

Wu Xiaofu said this in a decisive tone. After he said this, the patient's husband and the colleague stopped talking, and the patient also fell silent.

Several people looked at each other, and it was the colleague who spoke first, "How about this, stay here first. Anyway, no matter what, we have to check it out first. As for the specific treatment, you stay here first, and then we can discuss it slowly."

As soon as these words were spoken, the patient's husband also nodded. Yes, no matter what, he had to be treated in the First Affiliated Hospital. After all, this was the best hospital in Donghai and even in China. Staying there first was the best option.

"Okay, then stay here first. Please, Doctor Wu."

Wu Xiaofu didn't say much and directly asked Peng Xia to arrange for the patient to be hospitalized. This patient really had to be hospitalized and received treatment as soon as possible. From the imaging, the patient's tumor had not yet metastasized to a large extent, only to the liver and bile duct. Of course, for a tumor of this size, after the abdominal cavity was opened, the tumor tissue would probably be more than what was seen.

Therefore, the surgery must be performed as soon as possible. One day later will make the operation more difficult and the patient's future prognosis worse.

As for conservative treatment, whether it is radiotherapy, chemotherapy, or targeted drugs, they are actually not very effective. They may allow the patient to extend his life by one or two years, but only one or two years, or even shorter.

In the medical office.

After the patient was settled in the bed, the colleague brought the patient's husband to see Wu Xiaofu.

"Doctor Wu, is it really cancer?"

The patient's husband's eyes were full of hope, as if he wanted to hear a different answer from Wu Xiaofu.

"Mixed hepatocellular and cholangiocellular carcinoma!"

Unfortunately, after hearing what Wu Xiaofu said, this glimmer of hope was gone. In fact, when they were examined in other hospitals, the doctors there told them about the possible situation. The tumor was definitely there. As for the classification, they mentioned several situations, and hepatocellular carcinoma was the least ideal one they said.

Originally they thought that their luck would never be so bad, but their luck was just that bad.

"How could that be? She is so young."

If there were no patient, there would be no need for Wu Xiaofu to be so secretive. The person standing in front of him is the patient's husband, who will accompany the patient in treatment and be the person the patient can rely on. If even he is not strong and cannot withstand the blow of the disease, then what will happen to the patients behind him?

"The patient has a history of hepatitis B for many years, which may be the cause of the patient's symptoms. However, his age is indeed a bit young, but the disease has already taken shape. His young age is actually an advantage for the patient in fighting cancer."

The patient's husband was still somewhat unwilling.

"Should we do a pathology test first? I heard from an acquaintance that for this type of liver cancer, surgery may not be very effective."

Upon hearing this, Wu Xiaofu looked at his colleague. What was going on?

Upon hearing this, the colleague also pulled the patient's husband and said, "Doctor Wu, don't get me wrong. He is just worried and confused. He is not questioning your professionalism. Why don't you tell us about the situation first so that he can be mentally prepared."

Wu Xiaofu didn't care too much about it. In fact, when you arrive at the hospital, the doctor you see has already made a diagnosis and given a treatment method. It is very impolite to question it based on the results you found online or from other doctors. Since you are here, you should trust this doctor.

Of course, the mood is understandable, and in fact the patient’s family also knows that surgery is the best way.

The doctor over there told him that it would be best not to have surgery, so he hesitated and wanted to look for another doctor to see if there was any possibility and hope of surgery. But when the doctor here said that surgery was possible, he remembered what the previous doctors had said and became doubtful and hesitant again.

After all, they are the people he cares about, and he would not want them to be in any danger at all, so it is understandable. However, as a doctor, Wu Xiaofu inevitably does not want to hear such doubts.

When the patient’s husband heard what his colleague from the HR department said, he understood what was going on and quickly apologized.

Wu Xiaofu waved his hand and said, "I think you will understand after I put it this way. Stem cell bile duct cell mixed carcinoma is very malignant. If you don't have surgery and choose conservative treatment, your survival period will not exceed three years, or even only one year, even if you use the best chemotherapy drugs and targeted drugs now.

What's more, there are not many targets and the clinical effect is not that good.

Then comes surgery. If the tumor is not completely removed, or the patient's condition is more serious, the possibility of metastasis and recurrence after surgery will be very high. In existing examples, the fastest recurrence occurred within one month, and the disease progressed rapidly, with the patient being in critical condition in less than half a year.

Of course, this is the fastest and best case scenario. Relapse will occur after one year, and with the subsequent use of various measures, the life expectancy is about two years."

Ah!
The patient's husband turned pale when he heard this. Why bother with surgery? Without surgery, he could live one to three years. With surgery, he could live only one to two years. In the worst case, he couldn't even survive half a year. What was the point of hospitalizing him then?

"But surgery has an advantage that conservative treatment cannot match, which is that it can potentially allow patients to survive for more than three years. Even if the hope is slim, it is more hopeful than counting the days with conservative treatment."

Is there a difference between a slim hope and no hope?

Is it really worth it to take such a big risk and get stabbed just for that elusive hope?
Unfortunately, deep down, the patient's husband was still eager to try, because he heard Wu Xiaofu say that the patient could survive for more than three years, and he deep down hoped that the patient could stay with him for a longer time.

But reason told him that he should refuse.

"Director Wu, you should be very confident, otherwise you wouldn't recommend surgery to the patient?"

This is the advantage of being brought along by someone you know. When doctors and patients are explaining their conditions, they have to think about protecting themselves. There are many truths that cannot be told. For example, in this case, the risk of having surgery is too great. If it is done well, it won't be very good. If it is not done well, there may be a chance of being held accountable. In this case, why should the surgery be performed?

Just like the doctors the patient had met before, they thought the same.

But if an acquaintance comes over, you can tell them the real situation and some sincere words, but leave some room for them. You can talk to them properly. After all, there is such a relationship, so it is always more reliable.

"I have performed so many surgeries before, and Chief Lin should know that the degree of cleanliness of the resection is still acceptable. In fact, the principle of mixed hepatocellular and cholangiocarcinoma is the same as other tumors. The cleaner you resect, the smaller the chance of recurrence. I still have some confidence in this.

But I can't guarantee anything, I can only say I'll do my best, so the choice is up to you."

Wu Xiaofu naturally had the confidence to say this.

With his skills and the patient being so young, as long as he follows the doctor's orders after the operation and takes good care of himself, to be honest, Wu Xiaofu feels that there is good hope that the patient will survive more than three years. At least one or two years will not be a problem. But he cannot say that. What if it doesn't work? Wu Xiaofu is not a god, and there is a difference between probability and certainty.

It is not worth it to be too sure and cause yourself trouble later.

This colleague has been working in the hospital for so long, how could she not recognize Wu Xiaofu's words? Besides, Wu Xiaofu's skills were well-known. She came to Wu Xiaofu because she was impressed by his skills. The statement that since Wu Xiaofu could not perform hepatobiliary surgery, there was little hope for others to be able to do it was not said in vain.

Looking at the patient's family, Section Chief Lin said, "Director Wu, I know everything, but it's impossible for him to make a decision now for such a big matter. How about this, you first check these according to the surgical procedures, and I'll let him think about it."

Section Chief Lin was not in a position to persuade the patient's family in person, and some things could only be said in private. Wu Xiaofu could naturally understand that.

"Okay, you guys go back and discuss it first, but you have to make a decision as soon as possible. This disease, no matter how it is treated, should not be delayed."

Section Chief Lin readily agreed and left with the patient's family.

In the corridor.

"Director Wu's skills are almost the best in hepatobiliary surgery. We all know his personality. He rarely does things that he is not sure of. Since he speaks so confidently, he must be sure of it. Think about it carefully. Others may think that the operation is not effective, but it depends on who is doing it. When Director Wu does it, it is different."

The patient's family members were also a little hesitant when they heard this. "But he didn't guarantee anything. Sister, you are colleagues, and you are the section chief. Why don't you talk to him again? If he can guarantee that he can be 90% sure, yes, even if it doesn't have to be 100%, I will agree to do it."

Section Chief Lin's expression was somewhat unchanged when he heard this.
"Xiao Jiang, who do you think I am? With Director Wu's status, why should I ask for a guarantee? To be honest, he doesn't lack surgeries to perform. He is willing to perform surgeries because he is responsible. Why do you still want a guarantee from him?

Isn't this unreasonable? Anyway, now that we have come to this point, you can go back and think about it again. You also have to talk to Hongfen's family. Such a big matter is not something you can decide alone.

You guys should work out a set of rules as soon as possible so I can talk to Director Wu."

After saying that, Section Chief Lin left immediately. This was a relationship on Section Chief Lin's husband's side. The two families were cousins, and Section Chief Lin felt that she had done her best to be able to help here. After all, she was not her biological sister, and she could not make the final decision. She just did everything she could.

(End of this chapter)