Author: Xue Li.
one
As soon as he got his father's review report home, Sun Qiang (pseudonym) couldn't wait to open it to check the results of his father's review this year. In addition to the high blood pressure, most of the indicators are within the normal range, turning to the page of lung CT, the results show that "there is no mass in the lungs", which made Sun Qiang breathe a sigh of relief, and recalled what the doctor said before, "Uncle Sun is really good at present,."The lesions in the lungs have disappearedContinue to maintain this state, and consider stopping the drug after two years of medication. ”
Sorting out and looking at his father's examination reports in recent years, Sun Qiang's eyes fell on the physical examination report at the beginning of 2021, and when he opened the first page, the words "There is a large mass in the lower left lung, it is recommended to go to the relevant department for further examination" came into view, and the past hit like a tide in an instant.
II. II. II
Sun Qiang and his father are both old smokers, and for the sake of health, Sun Qiang and his father made an appointment to quit smoking. Since then, in addition to the unbearable addiction to cigarettes from time to time every day, there are also coughing voices from father and son. At first, Sun Qiang thought that this was a normal phenomenon to quit smoking, until his cough had stopped, and his father's cough became more and more aggravated, and even coughed in the middle of the night, accompanied by his father's weight loss day by day, so that Sun Qiang had a bad premonition in his heart.
Because his father was in his hometown and the medical conditions were not convenient, Sun Qiang hurriedly took his father to the provincial capital to arrange a physical examination. The next day, a ** in the hospital completely broke the peaceful life of the family. The doctor informed Sun Qiang that his father's imaging examination showed a large mass in the left lower lung and recommended further examination as soon as possible.
The experience of lung cancer patients didn't have time to think about it, so Sun Qiang hurried to the hospital with his father for an examination, and couldn't help but think in the worst direction but hoped that it was just a false alarm. After an extraordinarily long wait for the results of the examination, Sun Qiang got the result he did not want to accept - a malignant tumor in the left lower lung, swollen lymph nodes, combined with immunohistochemical results, consistent with small cell lung cancer.
At that moment, Sun Qiang only felt that the world was spinning, and his mind was blank, and he had the impression that his father had always been strong and had few diseases, so how could he suddenly get cancer. Reason told him to calm down now, but the trembling hands betrayed his near-collapse mood.
Doctor, what should I do with my father's illness now?Sun Qiang asked in a dumb voice.
Your father has extensive small cell lung cancer, the traditional means are chemotherapy and radiotherapy, most of the drugs are in the medical insurance, the cost is relatively cheap, but the prognosis will be very average. At present, first-line ** can also consider immunotherapy combined with chemotherapy drugs**, and the effect of atezolizumab currently in clinical use is still good from the **data, but this drug has not been included in medical insurance for the time being because it has not been on the market for a long time, and it will be more expensive. ”
Tips: According to the CSCO Guidelines for the Diagnosis and Treatment of Small Cell Lung Cancer 2023, the first-line regimen for extensive-stage small cell lung cancer is chemotherapy + immunity. Taking atezolizumab as an example, in the IMPOWER133 study (a phase study of the efficacy and safety of atezolizumab + etoposide carboplatin vs. placebo + etoposide carboplatin first-line** extensive-stage small cell lung cancer), the median overall survival (MOS) of chemotherapy combined with atezolizumab was 15At 7 months, the median overall survival (MOS) of patients in the placebo group who entered the maintenance** phase was only 113 months (hr=0.)67；95%ci：0.49-0.90), the former has a significant effect, and the overall prolongation of the patient44 months of survival;At this year's 2023 World Conference on Lung Cancer, this data was updated again, and the five-year OS rate (overall survival) of atezolizumab combined with chemotherapy increased by 6 times compared with traditional chemotherapy.
From the doctor, Sun Qiang learned that although atezolizumab has not yet entered the medical insurance, it costs more than 30,000 yuan at a time, but he can apply for the patient assistance plan, and the first stage is to "buy two injections to assist three injections". Sun Qiang wrote down the name of the immune drug that the doctor said, and decided to go back and discuss it with his family as soon as possible.
Walking out of the consultation room, Sun Qiang saw his father sitting in the corridor, once his father used his broad and powerful arms to support the family and sent his children who grew up in the countryside to the big city for further study, but now he is such a thin body, as if all his spirit has been sucked away by the years. It was at this moment that Sun Qiang made a decision. He took out his mobile phone to check his expression, walked quickly to his father, clasped his father's slightly cold hands, and said in a calm tone as much as possible: "Dad, the doctor said that there is nothing serious, but you have a bullae on your lungs, let's come to ** a few times on a regular basis." ”
The father, who was still full of sadness, suddenly breathed a sigh of relief after hearing his son say this, and muttered "I'll just say it's nothing", and his steps were much lighter than when he came, in contrast to Sun Qiang's heavier and heavier steps.
After returning home, Sun Qiang contacted his sister to inform his father of his illness and the current ** plan, and the brother and sister discussed it and decided to fight at all costs to take back their father from the hands of the "Grim Reaper".
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Three
In March 2021, Sun Qiang's father's anti-cancer journey officially set sail, and the doctor formulated etoposide, carboplatin plus atezolizumab as the first-line plan.
Maybe it's because my father has always been in good physical condition, and the process is very smooth, except for occasional nausea, hair loss, and low white blood cells caused by chemotherapy, most of the time my father's body feels very good. While accompanying his father, Sun Qiang also learned how to deal with it online, closely monitored his father's physical indicators, and followed the doctor's guidance to give white injections and nutritional support to help his father fight cancer. After the end of the third **, the tumor that was originally six centimeters in size disappeared, even the attending doctor sighed, "The ** effect of atezolizumab on Uncle Sun is really good, and you must continue to use it." ”
Compared with the smooth process, taking my father to the hospital has become a problem. The father who has a strong nature has always felt that this is just a small problem, and the people in the same village who have this disease will recuperate at home, but he has to run to the hospital all day long, which makes his father feel that Sun Qiang is making a big fuss, and often says like an "old child" before going to the hospital that he doesn't want to go to the hospital again. Sun Qiang, who knew the truth, was a little crying and laughing, and often used the excuse of taking his father to the provincial capital to travel, patiently coaxing his father to go to the hospital**, and the words he most often said were "This is the last time**, and we won't go if we are cured this time." And this sentence is also Sun Qiang's most sincere wish.
After 8 times of immune** combined chemotherapy, the attending doctor happily said to Sun Qiang, "Uncle Sun is currently doing good indicators."The lesion in the left lower lung is also no longer visible, a single immunization can be tried**.
Hearing this, Sun Qiang's eyes turned red all of a sudden, and he kept thanking the doctor with his hands together, and after asking the doctor about the precautions for changing to single immunity, Sun Qiang walked out of the consultation room and met his father who was anxiously waiting for the results at the door. Looking at Sun Qiang's slightly red eyes, his father's expression was obviously flustered, and he was a little stunned to ask if he had a bad result in this review, but Sun Qiang replied with a tight hug.
Dad, the doctor said that the results of your re-examination this time are very good, the bullae are gone, we can take less medicine and consolidate it soon. ”
After hearing this, his father was also a little excited, comforting Sun Qiang on his lips, saying, "What a big deal, I still have to cry when I am such an adult", while pulling Sun Qiang to walk home with a smile.
After changing to single immunity**, all those *** disappeared, and the once sparse top of the head is slowly growing new black hair, and the father's weight is also visibly increasing, people are also a lot more energetic, and they also have the strength to take care of the small courtyard and fiddle with flowers and plants in their spare time.
Although his father's physical condition has become close to that of ordinary people, Sun Qiang still can't help but be worried. During the epidemic, Sun Qiang reminded his father from time to time to go out less, gather less, and remember to wear a mask. When the epidemic broke out intensively, seeing that his father was infected with the new crown and had a low-grade fever, Sun Qiang's heart rose to his throat, and he stayed with his father all night for fear of something missing. Who would have thought that the next day, his father would have a fever and the person would recover his spirits, but it was Sun Qiang who was "hit" and fell down with a high fever. Except for the father, the family's new crown symptoms were more severe, and in the end, the whole family was taken care of by the father who was in the best condition.
Looking at his father's busy back, Sun Qiang's eyes suddenly felt so sour that he wanted to cry, from the initial diagnosis of small cell lung cancer by his father to now, he felt it at this momentMy father's body is indeed getting better little by little, and there is no difference between him and ordinary people。Awakened by countless midnights dreaming of his father's deterioration, and now he has finally regained his father from the hands of the "Grim Reaper", and his strong hands can finally be firmly held in the palm of his hand.
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Four
In the evening, Sun Qiang returned to his father's residence, and as soon as he entered the door, his father came up to ask him about the results of this examination, Sun Qiang smiled and quipped, "Don't worry, Dad, your test results are healthier than mine." ”
What about tumor marker tests?Father asked with a slightly nervous look in his eyes and a pretense of composure.
Sun Qiang was stunned, and then replied, "It's all normal, there's nothing wrong with it." After saying that, he watched his father bow his head and breathe a sigh of relief, and when he looked up again, there were faint tears in his eyes. In the next second, his father turned his back and urged Sun Qiang to wash his hands and eat quickly.
In fact, after so many years, Sun Qiang has vaguely noticed that his father may have guessed his condition a long time ago, perhaps because of unnatural hair loss again and again, maybe it is too frequent to go to the hospital, or maybe he is communicating with other patients in the hospital. It's just that he doesn't say that he doesn't ask, and a tacit understanding has been formed between the father and son.
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Now, Sun Qiang has been fighting cancer with his father for more than two years, because of the remarkable effect of medication, under the advice of the doctor, his father is still using single exemption maintenance**, but the interval between reexaminations has changed to once every six months, and he plans to start a period of drug vacation recently. The financial burden that Sun Qiang was most worried about has also been greatly reduced by the updated charity assistance policy of atezolizumab (trade name: Taishengqi).(For details of the latest charity assistance program, please refer to the China Charity Federation project**:.)
Looking at the back of his father leisurely watering the flowers, Sun Qiang suddenly remembered that there were also relatives of friends around him who were diagnosed with cancer, and some chose to drink traditional Chinese medicine**, and some of them chose to go to a big hospital after the barefoot doctor in the village used some "earthwork"** after ** was ineffective, but it was too late. Fortunately, from the very beginning, I firmly chose to take my father to the provincial hospital to cooperate with the doctors to actively fight cancer**,Having small cell lung cancer is not scary, with such advanced medical resources and excellent doctors, and with the continuous development of drugs and more and more combined means to help my fatherIn the future, the family will still be able to enjoy the beautiful scenery of the world together, walk together in the next three or five years, and move towards a happy future.
To protect patient privacy, names have been changed.