Luck, Perseverance, and the Patient-Doctor Bond Jointly Determine a Cancer Patient's Survival Time

I have known an older brother in the cancer community for over ten years. He has survived more than twenty years after a cancer diagnosis; he was treated purely with TCM by a now-deceased famous TCM anticancer physician. More than ten years after being cured, he relapsed, and he then taught himself TCM and treated himself, maintaining his condition up to the present. Along the way he has repeatedly gone through scares; several times he felt he was done for, but each time he pulled through. Not only did he survive, he has also treated other patients. Once, when the two of us were talking, he told me that his deepest feeling was that how long a cancer patient lives mainly depends on luck.

Had he said this ten years ago, I would not have agreed. I would have thought long-surviving cancer patients succeeded mainly because of proper treatment and highly skilled doctors. I think this older brother himself probably did not believe ten years ago that luck was the main factor in long-term cancer survival. Today, I largely agree with him.

I have seen too many cancer patients whom it seemed impossible to save survive, and too many who seemed likely to survive die early. Some long-term survivors' miracles of survival can only be described as uncanny.

For example, in 2012, at an anniversary gathering of Sina's cancer-patient circle held in Xinxiang, Henan, a breast cancer patient fainted on the spot. Several medically trained colleagues present tried to rescue her without success; her condition became increasingly critical, and everyone panicked, thinking she might not make it that time. I improvised by finding a large pin to use as an acupuncture needle, pricked her Shaoshang (LU-11) and Shangyang (LI-1) points, and brought her around.

Five years later, the Sina cancer circle held another reunion in Tianjin, and we met again. She came over to thank me specifically for saving her life that year, and told me that after returning home from Henan she had gone for a checkup and found the fainting spell had been caused by a brain metastatic tumor. She had had no treatment after that, relying entirely on her own will to control the tumor, and five years had passed with her still safe and sound.

Had this patient not been one I personally rescued, hearing her tell me such a story I would have thought she was talking nonsense to amuse me. But she truly was my rescue, and her gratitude to me was heartfelt, her indebtedness to my saving her life undying — there was no possibility of deception. So I can only describe her experience as uncanny, and can only attribute her successful anticancer journey to luck.

In the writings of Professor Zhang Jinhua, a neuroblastoma specialist, I have also seen similar cases. One child with late-stage neuroblastoma, when brought to her, was considered to have no further treatment value. The parents decided to give up treatment, took the child home, and did nothing; a few years later the child was miraculously cured, and on returning for follow-up at Professor Zhang's hospital, the recovery was confirmed. Professor Zhang also mentioned in her book that prominent pediatric oncology centers such as Beijing Children's Hospital had reported similar cases.

Why were these two patients' cancer cells brought under control? Presumably their tumor suppressor genes were activated, exercising their role in inhibiting cancer cell development and promoting cancer cell apoptosis. Why their tumor suppressor genes were activated is harder to explain.

I am now reluctant to give family members prognostic estimates of survival time for any patient, because our judgments are based on conventional understanding, and patients often break through the norm. I once treated a cancer patient whose lower body had completely ulcerated — the most appalling cancer patient I have ever seen. I told her family she had no further treatment value and that they should stop wasting money.

But at the time the patient insisted I write a prescription, so I prescribed some righteous-supporting, root-firming herbs with a small amount of anticancer herbs. Over a year later, this cancer patient suddenly asked me on WeChat whether, after taking her formula for over a year, she should change it. I was startled — I, and every other doctor who had treated her, had assumed she had long been dead.

There are many similar cases. Why did they survive? Today I can only explain such things by luck; these breakthroughs of the norm are unfathomable. Doctors can only make probabilistic judgments from statistics; they cannot accurately predict any individual patient's survival.

I am now in my forties, and I really have begun to believe in luck. I feel I have been lucky in this life; apart from my mother's illness, everything has gone smoothly for me, and my wishes have generally come true. In the past I might have attributed it all to my own effort, but I no longer think so. Into what family one is born, what genes one inherits, what education one receives, what teachers one meets — all involve an element of luck. These things together shape a person's character.

That I am who I am is not only the result of my own effort; it is also the contribution of my parents and teachers. If a person is born not foolish, if parents raise them to be hardworking, and if teachers lay a solid foundation of learning, that person benefits for a lifetime. To attribute it all to one's own effort is rather self-important. People who do well in society and stay healthy ought to be grateful for their luck.

Besides luck, the patient's own perseverance matters. Treating cancer almost requires the patient to be reborn and reshape a new self. Cancer is closely linked to psychological state, lifestyle, and environmental factors; most cancer patients need, after diagnosis, to comprehensively re-examine their former habits. Some people love smoking, drinking, and chewing betel nut — all first-class carcinogens. Such bad habits must be changed through perseverance; a considerable proportion of patients cannot change them, and even if they change for a while, as soon as the condition eases they relapse.

I previously treated a peritoneal mesothelioma patient. I advised him to do weighted running to improve his constitution and to avoid all seafood and pickled foods; he complied. During the years he persisted, not only was his cancer and ascites very well controlled, his overall physical condition was excellent. He is a powerfully built Shandong man; after several years of exercise he became so strong it was intimidating.

But after five years of treatment he grew complacent, stopped exercising and observing dietary restrictions, and neglected his psychological regulation. He had a major quarrel with someone, and quickly relapsed and metastasized. Many cancer patients mistakenly believe that after five years they are safe; this is linked to cancer books often using five-year survival as the criterion for clinical cure. This notion has clearly misled patients — there are plenty who relapse after five years. The five-year survival rate is only a measure of treatment effect. Every oncologist should know that concepts like radical surgery and clinical cure are only comforting terms; once you have cancer, anticancer is for life.

In reality, most dieters, even if weight briefly drops, eventually rebound to where they were. The reason is simple: these dieters only make temporary changes rather than a complete overhaul of their lifestyle. In fact, only those who completely change their lifestyle can truly lose weight. Temporary measures that keep weight down for a year or two cannot fundamentally turn an obese person into a slim one. Similarly, cancer patients need to fundamentally change their lifestyle to keep the high-risk factors that lead to recurrence at bay.

An ovarian cancer patient I recently treated went for follow-up; although the cancer-related tests were all normal, her blood lipids and blood sugar were both elevated. She told me herself that it was because she had let herself go on diet these past two years. Her tumor markers had been completely normal two years earlier, and several metastatic tumors had regressed; perhaps that was why she grew complacent, and her requirements on herself were no longer as strict.

Similar cases are too numerous to list. Cancer is a disease deeply tied to lifestyle; to achieve long-term control, the patient must, with enormous perseverance, transform themselves. Cancer cells are unlikely to be completely eradicated. Once a tumor is detectable, the patient has at least a hundred million cancer cells. Even if treatment kills ninety-nine million, a million remain — and those residual cells are undetectable. If the patient is weak-willed, forgets the pain once the scar heals, and after successful treatment reverts to the old unhealthy lifestyle, it will not be long before those silent cancer cells erupt again.

The doctor does matter, but TCM emphasizes that "the doctor is the branch, the patient is the root"; the doctor can at best offer limited help. And this limited help can only take effect when the patient has high adherence to the doctor, and sufficient understanding and trust. If the patient is stubborn, or lacks understanding and trust, it is hard to follow medical advice; then good results are impossible, let alone adherence during rehabilitation.

Family members often tell me that their relative does not listen to them but will listen to the doctor. This way of putting it is actually flawed: most stubborn patients only listen to themselves and do not truly listen to the doctor. I have a lymphoma patient with whom I am close; he is loyal and brotherly, but as a patient he is enough to make one's lungs burst. Every time I earnestly urge him to quit smoking, he grins and says smoking does not affect him much, and continues lighting one cigarette after another.

I have another lymphoma patient who is also excellent brother material, but who is likewise lackluster at following medical advice; staying up all night gaming is his norm. I am a very self-disciplined person, but as I said earlier, my self-discipline too is a matter of luck. If, while growing up, I had not met people who helped me form disciplined habits, I could not be self-disciplined. I think these patients' casualness probably stems from failing to develop disciplined habits in childhood.

So today I am convinced that the bond between doctor and patient has depth and shallowness. Patients to whom I am a stranger, and who are strangers to me, are truly difficult to treat with good results. The anticancer road is long and the success rate low; during treatment and rehabilitation many things require mutual cooperation, and if the doctor-patient bond is too shallow, good cooperation is impossible. To be factual: I am only an average TCM apprentice; that I occasionally cure a patient has much to do with my writings reaching these patients, stirring their inner strength, forming a tacit understanding between us, and, with their own luck, ultimately producing a survival miracle.