Surgery Godfather-Chapter 1847 - 1292: International Perspective

Li Gaoyang’s treatment has entered the third cycle, the final stage of the originally planned treatment period. Song Zimo and Xu Zhiliang take turns monitoring various indicators.

Dr. John Ansen asked, "If after several treatments the tumor is not completely eliminated, should we increase the dose of the K Virus?"

Yang Ping shook his head, "No need, arbitrarily increasing the dose can trigger a new immune storm, which can sometimes be deadly."

"Then what should we do?" Dr. John Ansen meant after three cycles, if the tumor hasn’t completely disappeared.

"We need to change our mindset." Yang Ping pulled up metabolic images of Li Gaoyang’s brain, circling the tumor core area with his finger. "The traditional treatment concept is total annihilation, but for a functional area like the brainstem, perhaps we can slowly and gradually eliminate it or coexist with the tumor, like hypertension or diabetes, controlling the tumor as a chronic disease. In traditional treatment, the idea is total annihilation, which is practically impossible."

Song Zimo looked up, "Are you suggesting putting the tumor into a dormant state?"

"Yes, if it can’t be completely removed, change its behavior." Yang Ping started drawing diagrams on the whiteboard. "Our viral vector carries not only the K Factor but also gene editing components. By adjusting editing targets, we can make tumor cells highly express senescence-related genes, entering irreversible growth arrest..."

"This requires... redesigning the vector." Xu Zhiliang reminded.

"No need to redesign, just adjust the expression control sequences." Yang Ping was already contemplating the technical details. "We can use ultrasound microbubble focus technology to temporarily open the blood-brain barrier locally in the tumor and then administer a small molecule inducer intravenously. This inducer itself is harmless, but in the presence of our vector-edited tumor cells, it would trigger the senescence program."

Dr. John Ansen quickly took notes but couldn’t help asking, "Professor Yang, have you done similar experiments before?"

"We have conducted proof-of-concept studies on animal models, but never tried it on humans." Yang Ping admitted, "So we need Li Gaoyang’s own consent."

This statement left everyone silent. Switching to an unproven clinical plan midway through treatment had obvious risks.

Rolf’s face turned pale after the translation as he asked with a trembling voice, "Professor Yang, what is the success rate of this new scheme?"

"There are no data, it’s impossible to evaluate." Yang Ping looked directly at him, "Continuing with the current plan could extend the treatment cycles, which is also a method. If we can’t completely annihilate it now, we’d have to undergo the current K Therapy repeatedly in the future, whereas the first method could be a one-time solution without the need for repeated K Therapy."

Rolf closed his eyes, remembering the words Li Gaoyang had typed on his tablet yesterday — "If my treatment can pave the way for others, then it’s worth a try."

"I need to confirm with him personally."

In the ward, Li Gaoyang’s consciousness was clearer than a few days ago, and the ventilator had been removed, allowing him to speak in a weak but clear voice.

After Rolf’s recount, he remained silent for a long time.

He thought of the day he was diagnosed with a recurrence, when the Doctor calmly told him, "About six months." Back then, he thought six months was too short, too short to settle affairs, to say goodbye to everyone he loved.

Now he had lived two months longer, seen sixty more sunrises and sunsets, eavesdropped on sixty more video calls with his children, and experienced sixty more days as a "living person."

"Professor Yang," he finally spoke, his voice hoarse but firm, "if I fail, will my data help others?"

"It would be of great help," Yang Ping said. "Whether the treatment is successful or not, you will be the first person to undergo this combined treatment plan, and every data point of yours will give the next patient a little more hope."

Li Gaoyang nodded and then smiled for the first time since his illness, his pale face lighting up like a child.

"Then let’s do it," he said. "After all, it’s time I wouldn’t have had otherwise."

"There’s something else I should tell you. In primate experiments, this therapy actually has a high success rate, but you are the first human volunteer in a clinical trial," Yang Ping told him.

...

While Li Gaoyang was preparing to undergo the innovative plan, Li Xiaoyun’s standardized treatment had already begun.

Unlike Li Gaoyang’s turmoil, her treatment was so smooth it was almost monotonous. Weekly medication was administered, with all data monitored after each session, and then they waited for the next week. The tumor was shrinking at a visible rate, from an initial 5.8 cm to 3.2 cm, and now down to 1.7 cm.

But today, the routine examination revealed an unexpected situation.

"A new enhanced lesion has appeared in the left temporal lobe." The radiologist pointed out on the MRI scan, "It’s about 0.8 cm in size, and its shape doesn’t look like typical tumor recurrence, but it warrants caution."

Her husband, Wang Jianjun, was so shocked by the news that his legs gave out: "Wasn’t... wasn’t the treatment supposed to be effective? Hasn’t the tumor been shrinking all along?"

Yang Ping personally reviewed the images and then asked Li Xiaoyun, "Teacher Li, have you recently experienced headaches, blurred vision, or memory decline?"

"I have a bit of a headache... but it’s not very severe." Li Xiaoyun weakly replied, "It just feels like my brain is a bit foggy, like there’s a mist over it."

"Was a cognitive function assessment done?"

Song Zimo brought up the assessment report, "Down by 12% compared to last week, mainly affecting short-term memory and attention."

Yang Ping pondered for a moment, "It might be pseudo-progression."

"Pseudo-progression?" Wang Jianjun didn’t understand.

"This is a phenomenon that one might encounter theoretically with K treatment." Yang Ping explained, "Sometimes when the K Virus attacks a tumor, it causes local inflammatory reactions, which may look like a new lesion on imaging, but it’s actually a sign of effective treatment. However, we need to rule out real tumor progression."