From Diagnosis to Hope – A Story of Resilience and Determination

In December 2016, a woman in her mid-sixties, with no significant medical history, began experiencing persistent epigastric pain. Concerned, she underwent an upper endoscopy, which revealed gastric adenocarcinoma. A CT scan was performed to assess the extent of the disease, and though a liver lesion was detected, it was initially deemed benign. A multidisciplinary team decided surgery was the best course of action.

During surgery, the malignant tumor was found extending from the incisura angularis to the posterior gastric wall. The surgeons also identified the liver lesion, but it lacked characteristics of malignancy. She underwent a radical subtotal gastrectomy with Billroth II reconstruction. The pathology report confirmed a stage IIA gastric adenocarcinoma, with no metastasis in the 47 lymph nodes examined. Given the findings, the medical team opted for close follow-up instead of additional treatment.

Three months later, she experienced severe upper abdominal pain. A follow-up CT scan revealed that the liver lesion had grown significantly. A PET-CT confirmed a large, hypermetabolic mass in the right hepatic lobe. A biopsy confirmed that the lesion was metastatic, changing the course of treatment. The cancer had progressed.

With the liver metastasis deemed unresectable, a new plan was needed. A multidisciplinary team recommended palliative chemotherapy, aiming to improve her quality of life and slow disease progression. She began a regimen of FOLFIRI, a combination of irinotecan, folinic acid, and 5-FU, in June 2017. The treatment was well tolerated, and the results were promising—a partial response and significant pain relief. By late 2018, she had completed 30 cycles, and her condition had improved dramatically, allowing her to maintain an active life.

However, in October 2018, new challenges arose when she developed persistent back pain. Imaging revealed multiple vertebral bone lesions, though the liver mass remained stable. In February 2018, she underwent cementoplasty to stabilize her spine. By March, she transitioned to a second-line chemotherapy regimen, mFOLFOX6, along with zoledronic acid to strengthen her bones. The treatment once again proved effective, stabilizing her disease and improving her overall well-being.

As of April 2020, she continues regular follow-ups with stable disease. Despite the long and arduous journey, her strength and resilience have been remarkable. With ongoing medical support and a positive outlook, she continues to embrace life, proving that even in the face of adversity, hope prevails.