Diagnosis: From resisting screening to confronting advanced cancer.
Brian Beck, a nurse, had always considered himself sensitive to changes in his health, so when his family doctor recommended a colonoscopy after he turned 50, he chose to ignore it. Even when a home stool occult blood test came back positive in early 2019, he remained convinced it was a "false positive"—until a colonoscopy revealed a malignant tumor in his sigmoid colon, almost completely blocking his intestines. Even worse, imaging scans showed multiple metastases in his liver, confirming a diagnosis of stage four colorectal cancer.
According to the Hong Kong Colorectal Cancer Screening Programme, Hong Kong residents aged 50 to 75 without symptoms of colorectal cancer can receive government-subsidized screenings every two years. Data from the Centre for Health Protection (CHP) shows that colorectal cancer is the second leading cause of cancer death in Hong Kong, causing 2,266 deaths in 2023.
Treatment journey: From chemotherapy to targeted therapy
1. Initial treatment
- Following emergency surgery, the patient received six rounds of pre-operative FOLFOX chemotherapy (fluorouracil + oxaliplatin), followed by surgical removal of the colon tumor and ablation of liver metastases, and then completed six rounds of post-operative chemotherapy.
- The cancer has recurred: new tumors have appeared in the liver.
2. Second-line treatment
- Switching to FOLFIRI chemotherapy (fluorouracil + irinotecan) combined with bevacizumab and cisplatin, although it caused significant side effects, allowed him to continue working and maintain his mental stability.
- After a brief remission of nine months, the cancer recurred, requiring a second surgery and Yttrium-90 radioembolization treatment of the liver.
3. Immunotherapy and targeted therapy breakthroughs
- Clinical trials (with ipilimumab + nivolumab + panitumumab) showed limited effectiveness until genetic testing revealed the tumor was HER2-positive and RAS wild-type.
- Treatment with the targeted therapy combination (Tucatinib + Trastuzumab) began in 2023. One year later, imaging showed no evidence of disease, and the patient is currently continuing treatment with Trastuzumab.
Life Lessons: The Teachings of Screening and the Mission of Helping Others
- The regret of delayed screening: Beck admitted that if he had followed the advice to undergo regular colonoscopies, he might have avoided a late-stage diagnosis. Now he actively encourages patients to get screened, emphasizing that "prevention is better than cure."
- The meaning of living with cancer: Despite the recurring nature of his illness, he continued to work and participate in international medical missions (such as in Honduras and El Salvador), believing that "helping others" was the best therapy for fighting the disease.
Advice to patients
- Don't neglect screening: Even without symptoms, regular check-ups can save lives.
- Maintain life goals: Work or volunteer service can distract from anxiety and improve treatment outcomes.
- Embracing targeted therapy: Genetic testing may uncover crucial breakthroughs in treatment.
"Cancer taught me the most important lesson: tell your loved ones how you feel every day and live a life without regrets."
——Brian Beck, NP
Source of information：Original report by ASCO Post
Find out more about treatment information：
Contact information
If you or your family members would like to learn more about colorectal cancer treatment services, please feel free to contact Hong Kong United Oncology Centre. Our professional team will provide you with detailed medical consultations and assist in developing the most suitable personalized treatment plan.
- Telephone：+852 2386 8002
- WhatsApp：+852 5518 2992
- Email：Enquiry@hkuoc.hk
- Address：Rooms 01-06, 20th Floor, 238 Nathan Road, Kowloon(MTR Jordan Station Exit E).
