Jianying Min, Deputy Party Secretary of Renji Hospital, as an representative of hospital leaders, congratulated on the establishment of the center. She hoped that the consultation center would bring more Gospel for the majority of patients with difficult tumors by the precision treatment modalities, through consultation from cross-region and inter-department team of experts to maximize the limited medical resources.

Targeted Precision Treatment

Aunt Deng, who was diagnosed with advanced pancreatic cancer shortly after 50 years old, had fallen in despaired. But who would have thought that she has been living as a normal person until the third year after "judgment".

In 2011, aunt Deng was conducted a radical surgery due to pancreatic cancer in a hospital. Unfortunately, she had recurrence with multiple lung metastases two years later. Facing the forecast of "only a maximum of six-month-survival" by doctor, she felt life come to the end. Try holding the mentality, aunt Deng came to find Professor Liwei Wang in Pancreatic Cancer Diagnosis and Treatment Center of Shanghai Jiao Tong University. Professor Wang organized a joint multi-disciplinary clinic to develop a comprehensive individualized precision treatment plan for her, which was systemic therapy combined with local intervention. Beyond all expectations, aunt Deng is not only alive today, but has maintained the normal work and life during the past three years.

Professor Liwei Wang said that the significant therapeutic effect achieved in the patients, was first of all owing to our individualized precision treatment concept based on tumor genetic test results of the patients, which is "The different diseases with the same treatment, and the same disease with different treatments". The so-called "The different diseases with the same treatment", is based on genetic test results in patients with tumor specific targeted therapy. Targeted drugs could be chosen to target tumor cells and kill them, because the patients are suffering from different cancers with the same gene. "The same disease with different treatments" is to use different drugs for patients with the same cancer, because of their different genotypes from genetic test results.

This treatment concept is very different from the previously used "Rather victimized, not to be missed" strategy, in which once cancer was found, especially if the cancer had spread and metastasized, radiotherapy and chemotherapy drugs were all "In battle". The treatment strategy of "The different diseases with the same treatment, and the same disease with different treatments", more reflects the precision and individualized treatment concept of modern medicine, and pay more attention to the patients’ quality of life.

MDT (Multidisciplinary team) Supported Diagnosis and Treatment

Uncle Huang, a 75-years-old patient, went to a hospital due to repeated dizziness and unsteady gait in March this year. He was diagnosed with cerebral infarction and hospitalized. During the hospital examination, the patient was found with systemic multiple swollen lymph nodes, and then suspected as lymphoma. In June, the patient went to a specialized cancer hospital, and results from his lymph node biopsy demonstrated that the pathological diagnosis tendency was cancer. Then he went to a number of major hospitals in Shanghai, but failed to find the primary tumor lesion.

When uncle Huang came to the Department of Oncology of Renji Hospital, it had been 3 months since the onset of disease. The Department of Oncology of Renji Hospital organized a MDT discussion. Based on the diagnosis principles of cancers with unknown primary tumor lesion and international treatment guidelines, further relevant examinations found that PSA (Prostate specific antigen) was slightly increased in the patient, and this sign had become important clue to solve the case. Medical team flew for the first time to carry out prostate examination for the patient, and the pathologic biopsy diagnosis demonstrated prostate cancer! Once diagnosed, the patient has been receiving timely surgery and endocrine therapy, and is currently being restored.

As we all know, the diagnosis of tumor mainly relied on detection of primary lesions or metastases. For such an occult primary tumor, it is only possible to detect the culprits in two weeks owing to the strong support from the MDT experts, as well as individualized application of the guidelines for the patients. Professor LiWei Wang bluntly said that, once the primary tumor lesion is found, the metastasizing cancer cells in many cases are just like water without a source and a tree without roots. To find the primary lesion is the key, which relies heavily on the clinical analysis from pathologists and imaging medical experts in radiology, ultrasound, nuclear medicine and others, as well as their first time strong support for clinicians.

Said Qiang Liu, director of the Department of Pathology, MDT discussion of difficult cases, have detailed face to face discussion and analysis between pathologists and clinical departments. Therefore, the pathologists are more clearly aware of the doubts and difficulties encountered in the diagnosis by the clinicians. Some cases can be determined for the spot and immediately clarified the qualities; otherwise, some cases are lack of clues, so that the pathologists will look out and review all the pathological data of the difficult cases in the past. Meanwhile imaging experts in radiology, ultrasound and nuclear medicine will further improve CT, MRI, and other targeted inspections considering the existing problems to get maximize information and clues, so that providing a powerful guarantee for "solving the case". Compared to previously, when pathologists and imaging physicians saw samples, read the films and wrote the report behind closed doors to work separately, MDT can bring out the “1 + 1> 2” advantages of the team, to facilitate the development of standardized, scientific and reasonable precision diagnosis and treatment program, winning more time for the treatment of patients.

Standardized Treatment Benefiting Patients

The consultation center covers Department of Oncology, Pathology, Radiology, Nuclear Medicine and other cancer-related clinical departments from more than 20 secondary and tertiary hospitals in the eastern part of Shanghai, including Ruijin hospital, Renji hospital, Xinhua hospital, Changhai hospital, Changzheng hospital, Shuguang hospital, General hospital, the Eastern Division of the Sixth Hospital, Huangpu Central Hospital, Chongming Central Hospital, etc.

The convener of the consultation center, Professor LiWei Wang stressed that the establishment of the Shanghai Eastern Difficult Tumor Cases Consultation Center, is intended to benefit patients in the region, so that the patients can accept consultation from a full range of campus-wide, cross-department experts to give individualized precision treatment plan to strengthen the regional hospital intergenerational collaboration. On the one hand, the consultation center will further standardize the diagnosis and treatment of difficult tumor cases, and improve clinical diagnosis and treatment capacity of difficult tumor cases in hospitals at all levels, through MDT discussion in the eastern part of Shanghai. On the other hand, after the clear diagnosis for the difficult cases and the development of treatment program in the consultation center, the patient will return to the secondary hospitals to receive appropriate treatment according to their situation, so that the homogenized treatment among secondary and tertiary hospitals integrated and utilized health care resources to benefit more patients.