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Metastasis occurred less than 2 years after rectal cancer surgery? It turns out that surgery, radiotherapy, and chemotherapy are not the end!

时间:2026-04-15 人气:

           
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Do you take a second look after using the toilet every time?
Do you pay attention to changes in the frequency of your daily bowel movements?
A little attention can save your life at critical moments!      

     
In February 2020, Ms. Zhang noticed an increase in the frequency of her bowel movements and also observed blood in her stool. She went to the hospital for a colonoscopy, and the results showed an ulcerative infiltrative lesion at the junction of the rectum and the sigmoid colon, approximately 18cm from the entrance of the scope. The surface was significantly erosive, with irregular protrusions at the edges that were prone to bleeding upon contact. The lumen was slightly narrowed, and the biopsy specimen was firm. Pathology: high-grade intraepithelial neoplasia with carcinogenesis in the mucosal gland epithelium.


     


Canceration! Be vigilant against rectal cancer at age 40 and above!
Ms. Zhang was 47 years old when she was diagnosed with rectal cancer. She never thought she would get cancer at such a young age. In fact, what she didn't know was that the number of young patients with bowel cancer has been rapidly increasing over the past few decades.

     
According to the "Analysis of the Epidemic Situation of Colorectal Cancer in China and Globally in 2020", the risk of colorectal cancer begins to increase after the age of 40, with a significant increase at the age of 50[1]. The 2024 Cancer Report from the American Cancer Society shows that since 1995, the diagnosis rate of colorectal cancer in people under 50 years old has increased by 45%[2].      


     




01              

             

             
DiseaseOverview

Overview of the illness


     
On February 27, 2020, Ms. Zhang underwent a radical resection for rectal cancer.      

   
1. (Straight) intestinal adenocarcinoma, grade II, ulcerative type, approximately 3.1cm x 2.5cm x 1cm in size, with cancer tissue invading the extraserosal adipose tissue, and visible vascular invasion.      

     

2. No cancer tissue involvement was found in both circles of the specimen (stoma).


3. Mesenteric lymph node involvement (+) 8/22.


4. AJCC pTNM staging (8th Ed, 2017): pT4N2.


5. Immunohistochemical results: PMS2 (+), MSH2 (+), MSIH6 (+), MLH1 (+).


The initial postoperative TNM staging was T4N2M0, stage III (advanced). Ms. Zhang, who had seen the results, breathed a sigh of relief. Stage III was not too late, and she underwent 12 cycles of chemotherapy after surgery. She had thought that the treatment for rectal cancer had ended here, but unexpectedly, 16 months after surgery, a worse situation occurred. Ms. Zhang developed liver metastasis .      

   
A survey on the current status of diagnosis and treatment of patients with advanced colorectal cancer in China, jointly initiated by multiple institutions including the School of Public Health, Peking Union Medical College, revealed that: 83% of colorectal cancer patients in China are at an advanced stage when first diagnosed, with 44% of these patients already experiencing metastasis to organs such as the liver and lungs. Ms. Zhang had clearly gained an advantage by not experiencing metastasis, so why did she still develop stage IV rectal cancer after surgery?      


     

     
Crucial! Focus on immune enhancement after surgery, chemotherapy/radiotherapy
The reason why cancer patients develop tumors is that poor immunity is an important factor. The immune surveillance function of the immune system, the natural barrier of the human body, is dysfunctional, unable to eliminate mutated cancer cells in the body, which leads to the proliferation of cancer cells and ultimately the formation of tumors. Surgery, chemotherapy, and radiotherapy may further destroy the patient's immune system.


     


Therefore, it is crucial for cancer patients to promptly follow up with immune enhancement after mainstream treatments (surgery, chemotherapy, radiotherapy), so that cancer treatment can form a complete closed loop.      

     
Immunotherapy, hit the pause button for advanced rectal cancer!            
After experiencing the first metastasis of rectal cancer, Ms. Zhang underwent surgery for liver metastasis on July 28, 2021. After the surgery, she received chemotherapy with temozolomide and also consulted Professor Zhang Minghui, hoping to find a way out for her precarious condition.      

   
Professor Zhang Minghui and the team doctors found that after Ms. Zhang's intestinal cancer had liver metastasis, the tumor markers were relatively high. Using only temozolomide monotherapy may not be sufficient to effectively control the cancer cells, and there is still a risk of recurrence and metastasis. At this time, receiving vNKT cell immunotherapy to enhance immunity may yield better benefits.

   
Since September 2021, Ms. Zhang has commenced vNKT cell immunotherapy. For the initial two months, she underwent an enhanced regimen of vNKT cell reinfusion twice a month, followed by a maintenance regimen of once a month. To date, she has completed 40 treatment courses, achieving long-term disease stability and progressing towards clinical cure within five years.
     
vNKT cell immunotherapy              


Natural killer T (NKT) cells, are a special T cell subset with both T cell receptor (TCR) and NK cell receptors on their surface. They possess important characteristics of both NK cells and T cells, with the dual ability to recognize tumor cells nonspecifically and specifically, and can rapidly kill tumor cells. Among the NKT cell subsets, there is a larger and more potent special type of soldier discovered by the experimental team led by Professor Zhang Minghui of Tsinghua University, namely variant natural killer T (vNKT) cells.


The population of vNKT cells in the body is very small and they are not easily activated. However, once activated, they can effectively eliminate those tumor cells that may remain undetected in the body. In addition, research has also found that vNKT cells have a dual anti-tumor effect. They can not only directly kill cancer cells but also regulate the immune microenvironment within tumor tissues, kill inhibitory immune cells (MDSCs), break tumor immune escape, rebuild the normal immune system, and further prevent recurrence and metastasis.              
             

Experimental conditions: In the presence of vNKT cells, after 16 hours, nearly all B16 tumor cells were killed!



04

             

       

Conclusion and Review< H66>

Conclusion and Commentary       
Compared to other cancers, bowel cancer has actually given us many chances. Bowel cancer takes 5 to 10 years to develop, so as long as regular physical examinations are conducted, there is a high chance of early detection.

   
①90% of tumors within 7 cm of the anus can be detected through digital rectal examination;

     
②Areas that cannot be detected through anal digital examination can be identified through colonoscopy;      

     
③80% of colorectal cancers present with hematochezia, which can be detected through fecal occult blood testing.      

     
     


The earlier it is detected, the higher the possibility of cure. Polyp stage can be cured with minimally invasive surgery. Even if it develops into cancer, the 5-year survival rate for early-stage colon cancer is as high as 91.8%, while for advanced-stage colon cancer, the 5-year survival rate drops to only 10.8% [3].      



Professor Zhang Minghui's tips

         
Even in the early stages of bowel cancer, one should not take it lightly. It is important to enhance immunity and take control of the disease treatment.        



       
         
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Reference source:      
[1] Yan Chao, Shaanxi Fei, Li Ziyu. Analysis of the Epidemic Situation of Colorectal Cancer in China and Globally in 2020 [J]. Chinese Journal of Cancer, 2023, 45(03): 221-229. DOI: 10.3760/cma.j.cn112152-20221008-00682      
[2]Demb et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis.JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.13157. jamanetwork.com/journals/jaman … /fullarticle/2819248      
[3]MillerKD , Nogueira L , Devasia T ,et al. Cancer treatment and survivorship statistics, 2022[J]. CA Cancer J Clin, 2022,72(5):409-436. DOI:10.3322/caac.21731 .      



     



         

         
Zhang Minghui          

Founder of Lehe New Medicine


         

Professor Zhang Minghui, who holds a PhD in Immunology from Tsinghua University School of Medicine, has led a research team for over 20 years since the discovery of vNKT cells in 2002. They have accumulated treatment experience in over 700 cases of solid tumors, covering almost all common solid tumors. The research results fully demonstrate the great value of vNKT cells in the treatment of solid tumors.



It is suitable for postoperative patients with high pathological malignancy or a risk of recurrence; patients whose tumors have been basically controlled but not cured after conventional treatments such as chemotherapy, radiotherapy, and targeted therapy; patients with persistent high carcinogenic factors; and patients intolerant to radiotherapy and chemotherapy. If these patients do not receive effective follow-up treatment after traditional anti-tumor therapy, recurrence, metastasis, or reoccurrence of tumors will be highly probable. In this case, vNKT cell therapy is an ideal follow-up treatment method, which can significantly improve the prognosis of patients.




Written by: Zhang Tuo      
Reviewed by: Qiao Jiacheng, Wang Ying, Gao Chen      
Edited/typeset by Zhang Jiao      

   

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