Chapter 1782： 【1782】Cruel
Chapter 1782 [1782] Cruel
Mr. Du's hesitation, several students can understand the reason just by looking at the patient's medical records.
"Her tumor was pathologically made and belongs to Luminal B type." Du Haiwei read the results of the pathology report written on the medical record.
The family member who accompanied the patient should be the patient's mother, and replied: "Yes, yes, the doctor over there got the report after the operation and told us that this type is good, and the treatment effect will be better. No. I know why after taking the medicine, it is said that the index cannot go down."
"One-third of patients are resistant to these drugs, which means that they do not have the therapeutic effect that doctors want to achieve after taking them." Du Haiwei said, "Her pathology report shows that the tumor in her body is They are estrogen-dependent, and these drugs, if effective, can interfere with estrogen receptors. Now it seems to be ineffective..."
The two classmates sitting opposite found that Mr. Du is not reluctant to talk, he will definitely say what he needs to say, and he is very patient with the patient's family.
The family said: "We heard these words from the doctor of breast surgery, saying that we need to come to your gynecology department for surgery."
"She is too young and has lymph node metastasis. Has the breast surgeon talked to you about these issues?" Du Haiwei continued to ask in a calm voice.
To judge the condition of a cancer patient, including the prognosis, it is necessary to comprehensively analyze all the data. It is not enough to only look at the pathological type. It is absolutely necessary to combine factors such as staging and patient age.
The so-called Luminal B type of this patient is a very delicate situation. The test results showed that the estrogen receptor ER progesterone receptor PR was positive, and the human epidermal growth factor receptor HER2 was negative. These indicators indicate that endocrine therapy may have a targeted effect on the tumor cells of this patient. For breast cancer patients, endocrine therapy can be said to be the most life-saving method. Like Sanyin, which is the most terrifying for doctors and patients clinically, endocrine therapy is not used, so the survival rate of these patients is the lowest.
The worst part of LuminalB type compared to the best LuminalA type is that another indicator Ki-67 is not very good. High Ki-67 indicates that the tumor cell proliferation status is high expression. In vivo tumor cell proliferation is too active. Therefore, in the staging of this patient, the results shown by Ki-67 can be seen: the tumor was found to be large in size, with lymph node metastasis, and the staging was 100% unsatisfactory. It is certainly impossible to remove all cancer cells in a patient's body. The patient is too young, has a fast metabolism, and the possibility of tumor cell recurrence is too high. Taken together, according to the clinical experience of doctors, the prognosis of this patient is not ideal.
"I heard from the doctor over there." The family members lowered their heads, and their voices were full of sorrow.
"After the cut, the tumor may continue to recur. If this is the case, are you sure you want her to be cut again?" Du Haiwei asked.
Sometimes the cruelest part of being a doctor is that you have to explain the consequences to patients and their families again and again.
The patient's mother wiped the tears from the corners of her eyes and said the most serious words: "Doctor, she is only in her early twenties."
Doctors are the most aware of the topic of young people getting sick, and they don’t know how many they encounter every day. Refer to the classmates of classmate Pan before. Like Teacher Du, it's really numb to watch too much.
(end of this chapter)
Mr. Du's hesitation, several students can understand the reason just by looking at the patient's medical records.
"Her tumor was pathologically made and belongs to Luminal B type." Du Haiwei read the results of the pathology report written on the medical record.
The family member who accompanied the patient should be the patient's mother, and replied: "Yes, yes, the doctor over there got the report after the operation and told us that this type is good, and the treatment effect will be better. No. I know why after taking the medicine, it is said that the index cannot go down."
"One-third of patients are resistant to these drugs, which means that they do not have the therapeutic effect that doctors want to achieve after taking them." Du Haiwei said, "Her pathology report shows that the tumor in her body is They are estrogen-dependent, and these drugs, if effective, can interfere with estrogen receptors. Now it seems to be ineffective..."
The two classmates sitting opposite found that Mr. Du is not reluctant to talk, he will definitely say what he needs to say, and he is very patient with the patient's family.
The family said: "We heard these words from the doctor of breast surgery, saying that we need to come to your gynecology department for surgery."
"She is too young and has lymph node metastasis. Has the breast surgeon talked to you about these issues?" Du Haiwei continued to ask in a calm voice.
To judge the condition of a cancer patient, including the prognosis, it is necessary to comprehensively analyze all the data. It is not enough to only look at the pathological type. It is absolutely necessary to combine factors such as staging and patient age.
The so-called Luminal B type of this patient is a very delicate situation. The test results showed that the estrogen receptor ER progesterone receptor PR was positive, and the human epidermal growth factor receptor HER2 was negative. These indicators indicate that endocrine therapy may have a targeted effect on the tumor cells of this patient. For breast cancer patients, endocrine therapy can be said to be the most life-saving method. Like Sanyin, which is the most terrifying for doctors and patients clinically, endocrine therapy is not used, so the survival rate of these patients is the lowest.
The worst part of LuminalB type compared to the best LuminalA type is that another indicator Ki-67 is not very good. High Ki-67 indicates that the tumor cell proliferation status is high expression. In vivo tumor cell proliferation is too active. Therefore, in the staging of this patient, the results shown by Ki-67 can be seen: the tumor was found to be large in size, with lymph node metastasis, and the staging was 100% unsatisfactory. It is certainly impossible to remove all cancer cells in a patient's body. The patient is too young, has a fast metabolism, and the possibility of tumor cell recurrence is too high. Taken together, according to the clinical experience of doctors, the prognosis of this patient is not ideal.
"I heard from the doctor over there." The family members lowered their heads, and their voices were full of sorrow.
"After the cut, the tumor may continue to recur. If this is the case, are you sure you want her to be cut again?" Du Haiwei asked.
Sometimes the cruelest part of being a doctor is that you have to explain the consequences to patients and their families again and again.
The patient's mother wiped the tears from the corners of her eyes and said the most serious words: "Doctor, she is only in her early twenties."
Doctors are the most aware of the topic of young people getting sick, and they don’t know how many they encounter every day. Refer to the classmates of classmate Pan before. Like Teacher Du, it's really numb to watch too much.
(end of this chapter)
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