A 76-year-old mother with liver cancer and cirrhosis received proton therapy and her tumor shrank and her index dropped to normal.

Grandma Zhang, 76, has a family history of liver cancer. She was diagnosed with liver cancer after undergoing a physical examination. There was a 7.2-centimeter tumor deep in the liver, combined with cirrhosis. The tumor index alpha-fetoprotein (AFP) was as high as 5183 ng/mL (normal value is less than 9). Surgical resection may increase the risk of acute liver failure. She received proton radiation therapy at her own expense. The tumor shrank significantly, the tumor index also dropped to normal, and her condition was stable.

Liver cancer ranks fifth in Taiwan in terms of cancer incidence and second in mortality. Zhao Kunshan, director of the Proton Therapy Center of the China Medical University Hospital, pointed out that alpha-fetoprotein is a key tumor marker for liver cancer, and the normal value is usually less than 9 ng/mL. During Ms. Zhang’s health check-up, the value was as high as 5183 ng/mL, which is more than 500 times higher than the standard, reflecting the large number and extremely active cancer cells in the body. Imaging examination confirmed that she had liver cancer combined with cirrhosis, and she was transferred to China Medical University for treatment.

Zhao Kunshan said that liver cancer often lacks obvious symptoms in its early stages. Some patients are not discovered until the tumor becomes larger or they become unwell, which may make subsequent treatment more difficult. Some liver cancer patients may not be suitable for surgical treatment due to factors such as age, cirrhosis, tumor location or physical condition.

Grandma Zhang has liver cirrhosis and a 7.2-centimeter tumor. Surgical resection may increase the risk of acute liver failure. She received proton therapy 22 times. During the treatment, she occasionally experienced abdominal distension and fatigue. Her daily routine was basically normal. After 3 months of treatment, her AFP dropped from 5183 ng/mL to 37 ng/mL. After one year of follow-up, it further dropped to 3.77 ng/mL. Computed tomography imaging also showed that the tumor shrank significantly to 2.5 centimeters. Her current condition is stable.

Zhao Kunshan said that liver cancer patients often suffer from chronic liver diseases such as cirrhosis. In addition to controlling the tumor, treatment must also preserve normal liver function as much as possible. Proton therapy can focus the main energy on the tumor area and reduce the unnecessary radiation dose received by normal liver tissue and adjacent organs such as the duodenum and kidneys, taking into account both tumor treatment and normal tissue protection.

Zhao Kunshan said that since its opening, the first treatment room of the proton center has treated more than 400 patients, covering a variety of cancer types such as head and neck cancer, liver cancer, and breast cancer. The survival rate of non-metastatic cancer cases is more than 98%, and the rate of severe side effects of grade III or above is less than 2%. Now the second treatment room has also joined the service.