腎癌骨轉移-菲律賓 Kidney cancer with bone metastasis-Philippines

　　一年前在菲律賓馬尼拉一個會議上，突然一個50多歲女士來到廣州復大腫瘤醫院徐克成院長面前，徐院長對她的面孔很熟，但一下子想不起她是什麽病患者。她說：“徐教授，妳是大恩大德的貴人，妳看，我有病嗎？”徐院長想起來了，她是一位轉移性腎癌患者，叫Rus。5年前做過手術切除。3年前，即2008年，來到廣州復大腫瘤醫院，已有骨轉移。對於這種進展性腎癌，化療和放療無效，患者5年生存率從0%到13%。徐院長對她實施了聯合免疫（CIC）治療。看了她最近在菲律賓檢查的CT片，基本上看不到病變了。她送給徐院長兩個啤酒瓶，上面是繪制的花朵，說這是她親手繪的，按照她家族的風俗，這些“瓶上畫”代表了最尊敬人的感激。她怕徐院長不肯收下，說：她是窮人，不能送貴重物件給他，也不敢送值錢東西給他，因為她知道復大醫院拒收禮品的規矩，但這是不值錢的東西，但代表了她的心。徐院長接受了，雖然不完全理解這種畫的含義，但他帶回了這兩個啤酒瓶，把它放在辦公桌後書櫥裏，天天能看到。

　　One year ago， at a seminar in Manila， Philippines， a fifty-year-old lady suddenly came to Prof. Xu Kecheng， her face was familiar， but Prof. Xu could not recall which kind of cancer she had(Figure 9). She said， “Professor Xu， you are my great benefactor， do you think that I am still sick？” I recognized that she was a patient with metastatic renal carcinoma， her name was Rus. Five years ago she had surgery. Three years ago， the patient came to our hospital with bone metastasis. For this kind of progressive renal cancer， chemotherapy and radiotherapy do not work at all. There are ten reports showing that patients with a 5-year survival rate vary from 0-13%. Prof. Xu treated her with Combined Immunotherapy for Cancer (CIC)， which she unexpectedly greatly benefited from. Prof. Xu read her latest CT films done in the Philippines and no lesions could be seen. She gave Prof. Xu  two beer bottles with flowers that she herself had painted on as gifts. According to her family's custom， these flowers on beer bottle represent their cordial respects and gratitude. She was afraid Prof. Xu would not accept them， saying that she was too poor to send him valuables， she also did not dare send him valuables as she knew there is a rule in our hospital that all staffs are not allowed to accept gifts from patients. These were not valuables， but a token of her regards， so Prof. Xu accepted. Although Prof. Xu cannot fully understand the true meaning of the painting， he brought back these two beer bottles and put them on the bookcase in his office where he can see them everyday.

　　2011年11月19日，徐克成院長在馬尼拉受到菲律賓副總統比奈的約見。Rus聽說副總統要見徐院長，大早就來到徐院長住的酒店，跟著進了副總統府。比奈副總統聽了徐院長介紹後，很激動，高興地與Rus姐妹照相。

　　On November 19， 2011， the vice president Mr. Binay made an appointment with Prof. Xu in Manila. Mrs. Rus heard that Mr. Binay wanted to meet Prof. Xu， she came to the hotel that he stayed in early that morning， following Prof. Xu to go to the Vice Presidential Palace. Mr. Binay was very excited after listening to Prof. Xu’s presentation and had his photo taken with Mrs. Rus and her sister.

　　幾年過去了，Rus依然健康地生存。徐院長每次到菲律賓，她總全程陪同，而且發表講話，介紹她起死回生的經歷。

　　Several years have passed， Rus is still alive and healthy. Every time Professor Xu goes to the Philippines， she always accompanies him， and shares her anti-cancer experience with those cancer patients who still live in great misery.　　

　　菲律賓副總統比奈（中）接見Rus女士（左）和她的妹妹

　　Vice President of the Philippines Binay received Ms. Rus(Left) and her younger sister

Rus 成為復大志願者，正在講述癌癥康復

　　Rus is sharing her cancer rehabilitation experience as a volunteer of Fuda

　　Rus

　　腎癌骨轉移 Kidney cancer with bone metastases

　　女性，58歲。腎癌，腎切除後復發骨轉移。給予聯合免疫治療，轉移竈消失，無病生存已6年。

　　Female， 58 years old， kidney cancer， nephrectomy with recurrent bone metastases.  After she received combined immunotherapy， the metastatic lesion disappeared. She has cancer-free survived for 6 years.

　　Rus治療成功經驗  Treatment Experience

　　轉移性腎癌，尤其已進行過手術和化放療者，預後很差，中位生存期不超過一年。但該患者無病生存已是第6年。究其原因，與正確施行免疫治療有關。

　　Those patients with metastatic kidney cancer who have undergone surgery， chemotherapy and radiotherapy have poor prognosis and their median survival period is less than one year. However， this patient has disease-free survived for 6 years， for which is closely related to immunotherapy.

　　癌細胞具有異質性，就是說癌癥基因表達多種多樣，在分化過程中又十分不穩定，換句話說，今天的癌細胞不等於明天的癌細胞。免疫療法抗擊癌細胞，必須‘千軍萬馬’、‘隨機應變’，不能僅用一種免疫方法，要用多種，要隨著癌細胞的變化采用不同的免疫措施。

　　Cancer cell is heterogeneous， which means cancer gene expression varies and it is very unstable during the differentiation. In other words， cancer cells change day by day. Immunotherapy shall be powerful and adaptable to fight cancer. The immunological measures used shall vary with cancer cells.

　　基於上述認識，復大腫瘤醫院把各種免疫促進的方法組合起來，形成聯合免疫療法，還有非特異性免疫刺激療法。這就好比打仗時，必須有陸軍、海軍、空軍，甚至警察（免疫細胞和細胞因子）、情報人員（DC細胞），不僅要“擴軍”，增加它們的數目，還要采取措施（非特異性療法），“刺激”它們的積極性，讓他們敢於“沖鋒陷陣”。當然，在某個病人，用哪一種或幾種免疫療法，需要預先做一些特殊檢查，按照具體病情作出決策，即個體化。

　　Based on the above understanding， Fuda Cancer Hospital combine a variety of immunological measures， which is so-called combined immunotherapy (CIC)， including CIK， DC， T cell transfusion therapy， cytokines injection and non-specific immunostimulating therapy. This would be like fighting a battle， the Army， Navy， Air Force， and even the police (immune cells and cytokines)， intelligence agent (DC cells) are indispensable. For immune cells， it shall not only increase their number， but also take measures (non-specific therapy) to stimulate their enthusiasm， so that they dare to make a frontal attack on cancer cells. Of course， in some patients， before they receive one or more immunological measures， some special pre-tests shall be carried out to understand individual differences， on which personalized treatment will be made.

　　按照Rus的具體情況，復大專家給她CIC治療，並特別給她長期的非特異性免疫促進治療，重在調動患者天生的抗癌能力，從而使得癌細胞受到抑制，甚至被消滅（實際上是雕亡），讓患者長期生存。這是巨大的成功，可稱為奇跡！

　　According to Rus’s specific condition， she was recommended to undergo CIC long-term non-specific immune therapy， focusing on mobilizing the initiative of innate anti-cancer ability to inhibit or even eliminate cancer cells (apoptosis)， so she manage to obtain long-term survival. It is a great success， which can be called a miracle！