How an obscure Chinese hospital became a beacon of hope for foreign cancer patients

When Filipino housewife Divina Gracia Meer was diagnosed with stage-four lung cancer in April, her sister-in-law, a gynaecologist, advised her to seek treatment at a Guangzhou hospital.

Her suggestion was based on the experience of a friend, also a doctor, who had observed her own mother’s treatment at Guangzhou Fuda Cancer Hospital.

So Meer, who was living in the Philippine province of Batangas, contacted the Chinese facility’s representative office in Manila and four days later received a treatment plan and quote. She flew to Guangzhou with her husband in June, without receiving any treatment from Philippine hospitals.

In September, Meer was back at Fuda receiving her third cycle of treatment. Her overall condition is stable, but one of her 14 tumour cells is still active.

Over the past decade, this hospital, obscure in Guangzhou and largely unknown to local residents, has received more than 30,000 overseas patients, particularly those desperately seeking treatment for advanced cancers. They have been told by doctors in their own countries that there are no medical solutions for their diseases.

Compared with the number of wealthy Chinese who travel abroad to the United States or Japan for medical treatment, the number of foreign patients who visit mainland health centres is small.

Back in 2010 and 2011, foreign visitors rushed to the mainland seeking stem cell treatment, a globally controversial procedure. The stream of visitors dried up in 2012, however, when the mainland health authorities ordered an end to all stem cell clinical applications.

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In recent years, Fuda has treated around 1,000 foreign patients annually, far more than other mainland institutes. Its patients are mainly from Southeast Asia, the Middle East and Eastern Europe.

Xu Kecheng, chief president of the privately run hospital, said its approach was to offer minimally invasive cancer treatment and to strengthen patients’ immune systems.

The hospital’s major focus lies in cryotherapy, also known as cryosurgery ablation, on tumours, and nanoknife surgery. Xu said the hospital has had more than 10,000 cryotherapy cases, the most anywhere in the world, and performed more than 200 nanoknife surgeries – expensive procedures priced at 150,000 yuan (US$22,530) per case.

When performing cryotherapy, doctors use a probe to reach a targeted area and send liquefied gases such as argon and helium that have a temperature of minus 180 degrees Celsius to kill the cancer cells by freezing them. The process can be used on patients with liver, lung, kidney, pancreatic or breast cancer as well as soft tissue tumours, Xu said.

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Fuda started building up its cryotherapy surgery skills in 2002, when the speciality was relatively new in China, to gain an edge over the mainland’s public hospitals, the president said. In Guangzhou and other mainland cities, people flock to the crowded public hospitals that dominate the health care system for both minor ailments and serious illnesses.

To outdo its government-sponsored counterparts, Fuda shifted its focus from the domestic market to regions beyond the country’s borders.

About 40 per cent of its 400 beds are occupied by foreign patients – down from its peakeight years ago when 80 per cent of patients were from overseas.

The hospital has hired multilingual staff to communicate with foreign patients and Muslim chefs to cook halal food. On the top floor of its branch in Tianhe district, three separate rooms are provided for Muslims, Buddhists and Christians to pray. The hospital’s English website shows off VIP suites and hotel-like facilities.

Fuda’s doctors frequently speak in public globally to promote its treatments. Xu recalled that he received his first foreign patient, a Malaysian, in 2004 after speaking in that country.

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The hospital first gained renown among international cancer patients after Gurli Gregersen, a stage-four pancreatic cancer patient from Copenhagen, Denmark, in 2008 reportedly saw her condition improve following her treatment at Fuda. In that year alone, 113 patients from Denmark came to Fuda.

Gregersen, a retired teacher, is now in her late 60s.

While word-of-mouth marketing helps to boost the hospital’s business, it can also damage it, Xu said. For instance, Fuda has seen very few Danish patients in recent years after a patient from Demark died following treatment at the hospital.

Many overseas patients go to Fuda because cryotherapy is not available in their own countries, according to Xu.

The surgery is not widely used in the US, although the Food and Drug Administration approved the technology in 1998. In China it is also not seen as a common cancer treatment and its costs are not covered by the government-backed medical insurance scheme.

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An oncologist at one of Shanghai’s top hospitals said they had decided not to offer cryotherapy yet.

“Many hospitals won’t use it until it has been proven to be clinically effective,” he said, asking to remain anonymous. “We’re concerned about its side effects and we’re not sure whether the surgery will hurt nearby organs.”

Still, more Chinese clinics and hospitals have started using cryotherapy to treat cancer in the past five years, according to Meng Zhiqiang, a doctor who specialises in minimally invasive treatment at the Fudan University Shanghai Cancer Centre – one of the top five such clinics on the mainland.

Its advantages are it is less harmful to patients than traditional cancer treatment – such as radiation and chemotherapy and surgery – and it “apparently kills” cancer cells, said Meng.

“But the equipment for carrying out this surgery is expensive and it requires doctors to be very skilful,” he said, adding it was not suitable for cancer cells located near the stomach, main blood vessels or brain.

Xu, who founded Fuda in 2001, said he developed his “cancer control model” mainly because of his own experience as a patient. Now 78, he was diagnosed with liver cancer and received surgery in 2006. When doctors offered him radiotherapy and chemotherapy, the digestion specialist believed these options would have no effect on his cancer cells and declined the treatment.

“My doctors said that it’s their routine procedure to do radiotherapy and chemotherapy for cancer patients, but in my eyes, these treatments are unnecessary,” he said. “I decided to control the cancer by myself.”

Xu is an advocate for immunotherapy – the use of the immune system to treat cancer. The technique was banned in China following the death of a university student in May last year.

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But Xu said immunotherapy was “a good method” and it was “not appropriate” for the health authorities to ban it. Immunotherapy is still considered an experimental treatment in many countries, including the US and western Europe.

“Now, immunotherapy is in fashion in the international medical field,” Xu said. “China’s immunotherapy was the most advanced in the world. But the crackdown has set back its development ... Some patients [on the mainland] now go to Japan for this treatment.”

Xu said Fuda avoided immunotherapy but provided “other ways for patients to strengthen their immunity”. However, the hospital’s English website says it offers “combined immunotherapy for cancer”.

Hu Xichun, an oncologist from the Fudan University Shanghai Cancer Centre, noted that some types of immunotherapy treatment that are legal overseas had not been approved in China even before the ban. He said hospitals on the mainland could still do clinical experiments using immunotherapy. “But for advanced cancer patients ... treatment to do with immunity is an important research direction,” he added.

Among the foreigners currently accommodated at Fuda is Indian fashion designer Vicky, who took his 52-year-old mother to the hospital to be treated for stage-four breast cancer.

His mother was diagnosed with the disease in February and received four cycles of treatment at one of the best hospitals in New Delhi from March to May, said Vicky, not his real name. During this period, his mother was happy and her condition improved.

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But a PET scan in June found the cancer had spread to his mother’s liver. Doctors stopped giving her medicine, only carrying out physical tests. Vicky said he was frustrated with the delay in treatment.

He did some research on the internet and asked around to find a better option for his mother, visiting more than 10 doctors in India and consulting experts on the use of traditional Indian herbal medicine.

“In that situation, almost everybody will try everything, and I did the same. I wanted to know everything about this disease,” he said.

Three Indian friends recommended Fuda to him. He contacted the hospital and an institute in the US state of Florida. Both hospitals gave him the same view – his mother’s disease was not curable but treatment could improve her general condition.

It was not a difficult decision to take his mother to Fuda since it cost a lot less than the Florida facility and the flight time from New Delhi to Guangzhou is five hours, rather than the 15 hours to the US.

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Vicky’s mother received her first treatment at Fuda from July to August at a cost of 217,000 yuan. The hospital charges the same price for Chinese and international patients.

The mother and son are now on their second trip to Fuda, where Vicky said he had met nine Indian families, and they had become friends. “All of us are satisfied with the service here,” he said.

For Filipino patient Meer, it has been a time of hope and disappointment. With tumours in both lungs, she was given cryotherapy and brachytherapy – a type of radiotherapy – on some of her cancer cells on her first trip to Fuda. But when she returned, doctors found that the cryotherapy had not shrunk her biggest tumour to the size they expected, so she was given more brachytherapy to treat it. The news was worse in September, when she was told that one of the cancer cells had grown bigger despite the combined treatment.

“We were angry at the time. The doctors explained to me that maybe it was because my tumour is too big and some part of it wasn’t covered by the previous therapies. In the centre of that tumour, it is dying,” Meer said, adding she had been given more brachytherapy and medicine to boost her immunity. “I have to wait for two months for the result. I hope it’s gone,” she said.