All language subtitles for super surgeons a chance at life S01 E03_track3_[eng]

The human body
is an extraordinary machine.

Every day, billions of our cells
are being replaced with new ones.

But sometimes, things go wrong.

And when they're deemed untreatable,
people turn to us.

Because we take on some of
the world's most difficult cases.

Patients come from far away

with the most complex
medical problems in the world.

And we understand that this is
their only hope.

The patients we see
will die without our help.

And to save their lives,

we have to push the limits
of what is surgically possible.

We get only one chance
to get these cuts right.

If it goes wrong,
it can do patients terrible harm.

Ooh. Oh. We've got a hole
under the vein.

OK, hold it there.
Hold it in. Hold it. Quick, please!

In the worst circumstances,

it could even mean not making
it off the operating table.

You have to make sure that
the risk is justified by

the opportunity to cure them.

It's a lot of pressure on you
as a...as a doctor.

I sometimes have sleepless nights.

The stakes are tremendous.

So, you try your utmost to save
every life coming your way,

because you realise
how fragile life is.

This program me contains
discussion of life and death stories

and scenes of surgery that some
viewers may find distressing

So, it started two months ago,

when I had an operation
to remove a fibroid.

Lots of women get these in the womb.
They are quite common.

This is it.
That's 20 centimetres in diameter.

And I was like, "Wow, that's huge!"

I think it felt like being pregnant.

Big, all the time. And my clothes
obviously wouldn't fit.

You know, my consultant
did give me options, as to, er...

"Mel, would you just like to have
the fibroid taken out,

"or a total hysterectomy?"

And I thought to myself,
I've always wanted more kids,

so let's just have the fibroid
taken out and that's it.

That's what I opted for.

My surgeon took it out,

and then, he sent it off
to the pathology lab.

Called up, and he says,

unfortunately, they found
a few cancer cells in the fibroid,

and they're worried the cancer cells
might have spread into my womb.

And I was like, "Oh, my God!"

Lots of people ask me,

"Why do you do these long hours
and this stressful job?

It's probably, sort of,
the need to be able to help

and make a difference.

And what we are able to do
in this hospital

is push the boundaries surgically,
which is amazing.

So here we see Mel's CT scan

before her fibroid was removed.

And this round structure
is the fibroid.

It was as big as a grapefruit.

When Mel's fibre was removed,

they sent it to the lab,
and they found sarcoma cells.

Sarcoma in a fibroid is very rare.

Only five in a million women
will have sarcoma.

But the problem is that sarcoma
is an aggressive cancer,

and individual cancer cells
are too small to see on a scan.

So, we don't know if it has
already spread to the womb.

In order to give Mel
the best chance of survival,

we need to remove her whole
reproductive system.

I feel very responsible
for my patients.

When you're diagnosed with cancer,
which is a massive event,

and then suddenly, someone says,

"We will need to take
your ovaries and uterus,

"and you will not be able
to conceive"...

that's...that's a massive news.
It's horrible.

And it's...it's really,
really difficult

to tell patients this is probably
the only way to cure them.

Can I call you Mel or Melissa?

Anything. You can call me Mel,
that's fine.

OK. Mel, do you have children?
Yes. I have a daughter.

A daughter. How old is she?
She's 11. 11.

So I can imagine, this has probably
been an enormous shock,

because normally we don't think
about cancer cells in fibroids.

Mm-hm. Um...so the fibroid has been
peeled out.

Yes. But of course, it was inside
the wall of the womb,

so it might be that there's
still some cancer cells there. OK.

So, just leaving it like this

and just follow you up with
imaging wouldn't be safe.

Mm-hm. Yeah?

And that's why, erm...
we have to recommend now

for you to have a hysterectomy.

QUIETLY: OK.

Erm...because of the sarcomatous
element of the fibroid,

we would also recommend
your ovaries to be removed.

OK. That, of course,
has a major impact on, you know,

you will be in the menopause. Mm-hm.

Are you OK to talk about
the operation now? Yes.

So what we're going to do
is a total hysterectomy,

but we will use a robot
to help us to make it easier.

OK. Yeah?

We are able to magnify,
we can see everything 3D.

Post-operatively, you will have
significantly-less pain. OK.

Your recovery will be quicker.
Mm-hm.

So we will blow up the tummy
with CO2,

and then we will remove your uterus,

with the ovaries and the tubes,
inside your tummy

and take it out through
the vagina. OK. Yeah?

You know, you're losing your womb,
your ovaries.

It's not easy for women,
especially in your age.

So, we completely understand
that now. Yeah?

Are you all right? I'm sorry.

The concept of, like, not, sort of,
ever having another kid...

I just feel, like,
not so great about it. Erm...

I don't know, it's just...

BIRDSONG

How would you have reacted
if you were put in that situation?

Oh, awful! I-I...

You know, my life was destined
to have children.

That's what I always wanted to be.
You know, a mother.

|—| don't know. I would be dev...

I would've been devastated. Yeah.

But Melissa is an unusual case

with a very aggressive
type of cancer.

So, we need to do the operation
without spreading any cancer cells,

which is difficult.

PLAYFUL CHATTER

Erm...shall I get a vase,
and then, do the flowers?

Yeah, yeah...
I'll go and get a vase.

So, when did you first notice
something was a bit awry?

I suppose it must have been

I had a croaky voice
one morning when I woke up.

The GP was very good and referred me
straight to the hospital.

At the beginning, you think,
it's only a sore throat,

it's only laryngitis.

And then, it goes a bit further,
and you think,

"Oh, it's not quite
what we were thinking."

And then he says,

"It's definitely cancer."

How many times
has your cancer reoccurred?

Three times.

William and I have been together
for 25 years.

And when you're faced
with the possibility

that you might actually

not go into the next
10, 20, 25 years,

it completely changes your future.

It's such a small part of him,
this is the thing.

|t's...it's that size.

You know, it's the size of
my thumbnail, if that —

and yet, it's...

It might as well be everything.

Your local hospital,
what were they offering you?

Complete removal of the voice box.

A full laryngectomy.

We obviously asked
for a second opinion.

So he arranged, very kindly arranged

to see the professor down
at the Marsden.

The voice box is integral
to us as humans.

It expresses our personality.

So, taking that away is almost like
removing part of a person's being.

And some patients will seek
any mode of cure

to avoid having their voice box out.

But with recurrent cancer,
there's less chance of cure,

more chance of complications,

and more chance of impact on
the patient's quality of life.

So, the stakes are tremendous.

Will's been very unlucky, because
these are rapidly-growing tumours.

On the scan here, we can see
that Will's cancer involves

the entire length of the vocal cord
on the right-hand side.

And if left long enough,
it will grow sufficiently

to obstruct Will's
breathing passage,

and it will threaten Will's life.

For cancer of the voice box,

a conventional operation is
to do a total laryngectomy,

where the entire voice box
is removed.

But there is something I hope I can
do for Will, which is rarely done.

Which side are you...? This side.

That's the one we've had
the luck on, anyway.

And if we can do that successfully,
we can save his voice and his life.

WILL COUGHS

just breathe naturally.

There's the tumour there.

You can see both sides are mobile.

OK, I'm happy.
Yeah, he can come out.

Well done.

Thank you. You did very well.

So, that was really useful.

Your cancer is about there.

When we do a laryngectomy
in the conventional way,

we take the entire voice box out.

And that means people can't speak.

Yes. OK?

But in your case,
what we think we can do

is to remove just part of
the voice box.

So, that's...?
A partial laryngectomy?

Yes, correct.

,So we'll take away the cancer,

take away some elements of
the voice box,

but leave behind two key cartilages.

We can use those cartilages
and use the nerve supply

and the muscle to make sound.

So, does that mean my voice
will be my own voice? Yes.

Your voice won't be as good as
it is now, but you'll have

a pretty reasonable voice.

But there's no way of
sugar-coating this.

Your swallow will take
a pretty long time to recover.

We're talking six months
before you get to a stage

where you can manage your
food on your own.

A partial laryngectomy
sounds like a lesser operation,

but ironically, it's a much
more complex operation.

As a surgeon,
it's a massive challenge.

And I'm invested heavily in
getting this right for Will.

It's got to work for me,
and the family.

INCOMING CALL

Good morning, you're through
to Macmillan Cancer Support.

When was it you were diagnosed?

Uh-huh. I'm sure it is.
I'm sure it is.

We can have a chat through
your situation with you.

Cancer can arrive
without any warning.

But how it affects each patient
can be very different.

INCOMING CALL

The operation is very real
and very looming.

And, yeah, that's quite frightening.

You can pretend that
this isn't really happening,

and then, suddenly,
it slam—dunks you.

It's like the conveyor belt, isn't
it, going towards the...the big...

...teeth, really.

There's an inevitability to it.

We're going to do
something about it. Yeah.

Doing nothing isn't an option.

SHE CHUCKLES

Yes, very.

So, what we're going to offer Will
is a partial laryngectomy,

as opposed to a total laryngectomy.

But a partial laryngectomy is a
more difficult procedure to perform,

and precision is key.

When you're doing something that is
not your day-to-day procedure,

you have that rush of adrenaline.

I probably have the maximum
experience in the country for this,

but I'm anxious that I give Will

the best outcome
we can possibly give him.

So, he's got two young children,
and I'm thinking

what I do will ensure
how well he communicates

with this family for the
rest of his life.

But that's what drives us.

MACHINES BEEP STEADILY

So, we're making
the skin incision now.

So my first job is to open
the throat and expose the voice box.

So that's the voice box.

This is the Adam's apple.

And the vocal cords
are underneath that,

which is where the cancer's growing.

I now need to cut
around the voice box,

so that I can remove
the vocal cords,

but without damaging
any of the nerves or muscles

that are used for swallowing.

Because if these nerves are damaged,

Will will never be able to
speak and swallow,

and he may drown
in his own secretions.

I have to systematically find the
nerves and preserve them.

And these are very small nerves.

DeBakey to me, thanks.

We're going to enter it here.

So, this is an important nerve here.

This nerve goes in to supply
sensation to the voice box.

So, don't cause any bleeding
underneath it.

That's it. Excellent, excellent.

Excellent. Beautifully done.

We've now cut around the voice box
and mobilised it on both sides,

so we can now lift it up

to see the vocal cords underneath.

So, there's my vocal cord.

I'm going to cut through that.

The cartilage behind it is
needed to help to speak

and breathe and swallow.

And that's why we fight to save
that cartilage.

So, we done it all on one side,

so now I'm going to fracture
the voice box.

I need to see more clearly
where to cut around the tumour,

and to get better access to it.

The crack along the Adam's apple

is more precise when done
with the fingers.

You'll hear a crack.

OK.

So sorry about this, voice box.

CRACK!

GROANING

OK, that's cracked wide open now,

and I can see the cancer
ever so well now.

Now I can cut out
the cancerous section

with just the right margin
of healthy tissue.

So, let's cut here, then.

SUCTION

That's lovely. Look at it!
It's beautiful.

This is the voice box. This is the
Adam's apple we see from the front.

And if we turn this around...

...that is the cancer,

and the tumour extends
all the way across.

So, the lining is healthy,
it's nice and smooth.

But when it's cancer,
it's irregular and it's bumpy.

And that's all the cancer tissue.

So that's a nice, clean,
happy resection.

For the last stage of the operation,

to reconstruct
the section we've removed,

we're going to pull up
the windpipe to close the gap

and reconnect his throat.

I'm going to put three sutures,

and that's all that holds
the entire voice box together.

If it's a complex case,
things can go wrong easily.

And, er...| doubt what
I do all the time.

BELLS PEAL

Come on, William! Come on, William!

Ladies, gentlemen,
on behalf of my wife and I...

CHEERING

APPLAUSE AND WHISTLING

When I first met him,
he just had a nice,

very masculine, deep voice.

For a big man, he's very gentle.

He's always made me laugh.

Those little throwaway comments,

and it would have me crying
with laughter.

That's it...

I don't know, it's been so long
since I've heard it.

MACHINES BEEP STEADILY

Pass me that, er...big suture.

We're sewing these two fragile
sections of windpipe together

and hoping it will hold.

If the join fails, we'll have
to resort to a full laryngectomy.

There are no second chances,
no other options.

OK, we're going to tighten them.

It's really important
to get this right.

Let's tie the side ones first.

Yeah. So, we pull this up.

OK, please hand-tie it.

Wait, wait, wait, wait, wait, wait!

Right, are we...are we good?
Are we good?

Did it definitely knot? Lift a bit.

Yeah, I think it did.

You want to start again?
You want to tighten that again?

Come together.

Careful. Yeah.

OK...releasing gently. Coming away.

Good. OK.

Yeah. That's excellent.

Perfect. That looks good.

So, the voice box has been
put back together.

From now on, his voice is going
to be quite harsh and breathy.

What voice he gets six weeks,
12 weeks down the line

will be what he will have for life.

Hello, Bebe. Hello, gorgeous.

It's much easier to burn
£10 notes than to keep horses,

but horses are much more
satisfying emotionally.

Come on. Come on, Bebe.

There you go.
They are lovely things.

My first encounter with cancer
was actually way back when I was 23,

and I was diagnosed with
a testicular tumour.

That didn't stop me being a man.

Er...it didn't stop me doing
things I wanted to do.

It stopped me having children,
which is a great loss.

But who I am grew out of
all that experience.

I've had 45 years,
and I'm very grateful.

But if there's a chance to grab
some more of it, I will.

So, erm...|'m not going
to give up yet.

This thing is called
a retroperitoneal liposarcoma.

A fatty soft tissue tumour.

When I first started noticing it,
it was kind of about

the size of a book here,
sitting on...

And it's gradually spread.

So, it now stretches from here.

It's basically...basically
the size of a rugby ball.

They did a biopsy and decided it is

this particular sort of cancer.

Erm...the team said, basically,
we can't do anything,

and concluded
that it was untreatable.

And so, we were basically into
palliative care. Erm...

The Macmillan nurse
was very quick to say,

you must talk to Marsden, cos they
have some expertise in this area.

As a surgeon, sarcomas are
a really fascinating job.

It's very much an umbrella term

for lots of different types
of cancers.

It can affect either the bone
or the soft tissue,

and is very, very rare.

If you look at the UK,
in a whole year,

there will only be 3,500 cases.

So it's a very privileged
position to be in,

to be able to help a patient
with a rare, complex problem.

Ian's cancer is a very large tumour

in the back of his tummy.

It involves several organs.

So, below the under surface
of the liver, and the right kidney

is completely encased by the tumour.

It has only one curative treatment,
and that is surgery,

where you have to remove
the whole of the tumour,

as well as the organs involved.

That is quite an undertaking.

So, we need to be very careful,

so that we don't risk
the patient's life.

Morning. Good morning, sir.
How are you? I'm well. Good.

As well as can be expected.

So, Ian, I think we can
help you with this.

But it is a complex and
very major surgery. Right.

The aim is to remove the whole
of the tumour and the organs

that is adherent to this tumour.

And that will most certainly
be the kidney and probably the bowel

on the right—hand side.

I think we're doing the right thing.

But all this is based
on the judgment of the scans,

which are very, very helpful
and accurate. Yes, yes.

But we are sometimes surprised
at the surgery. Yes.

And we find that it is not possible

to remove the whole of the tumour

because of important things
it's grown into.

And then, we have to make a very
difficult decision at the surgery,

whether we proceed or not.

OK. You're giving me
a potential future.

I'm quite happy with that.

We're going to try our best.

That's all I can ask. you do your
best job, and I'll be happy.

If we do not do anything about it,
it'll get bigger,

and patients will
usually die of organ failure.

You have to make sure that
when you put someone

through a major operation,
where we're going to remove organs

and expose them to significant risk,

that the risk is justified

by the opportunity to cure them
from the cancer.

It's quite risky, but I would think

he has a chance to be cured
from this disease.

So, I think that's...
it's the right decision.

My daughter, she said a little
prayer for me,

and she asked, "God, please,
Mummy should have safe surgery,

"and that she comes
back home to us."

Bye, mummy-

I trust in God.

But sometimes things don't go
the way you plan it to.

When we see these patients...

...we completely understand
that they're frightened.

We understand that this is maybe
their only hope.

OK, do you want to come in?

Hello, are you ready? Hello, hello,
welcome, welcome, welcome. Hi.

They're coming to us because they...

...they hope that we can solve it.

And for us, it's daunting.

It's difficult.

Melissa is an unusual case

because her fibroid
has sarcoma cancer cells,

which is a very rare and a very
aggressive type of cancer.

So, I now need to remove
all her reproductive organs

to save her life.

Because she's had
a previous operation,

we know that scar tissue can
develop, which makes it difficult

to remove these reproductive organs
without spreading cancer cells.

And this is what we want to avoid.

So we've got a five-millimetre
scope, laparoscope?

Yes. Yes. Perfect.

Knife to skin. Thank you.

Gas on, please.

The first thing we do is inflate

the abdomen with carbon dioxide.

What we can see is this will blow
up as a balloon.

This will let us see the organs
more clearly

and gives us more room to work.

Now for the cords that will
attach to the robots.

I like to think
of them as spider arms.

Each has a different function.

To grasp, to cut, and a 3D camera.

Can I have the camera, please?

OK, can we have head down
and the gas on to 12?

Let me have a look here.

So, you can see the uterus is here.

And we see that
a fibroid was removed

from this bit of the uterus.

Marie, if you could just move
the uterus up and down.

It's a little bit stuck here.

It seems like bowel is actually
stuck to her uterus,

and that's not good.

I didn't expect this to happen.

This could just be scar tissue,
but the worry is that it's actually

cancer spreading from her uterus
to the bowel.

I love you!

I love you! Have a nice day.

I will miss you. I will come soon.

With Zoe, it wasn't planned,
let's put it that way.

But she's the best thing in my life.

That feeling of being needed,

I think that's the biggest thing,
you know?

And of looking after
another human being,

nurturing them,
making them better people.

But over the years,
I feel I've done pretty well

for her, because she's
turned out amazing.

Laparo LIP-

We'll do a Pfannenstiel incision.

We'll just give her lots
of local, yeah? Right.

The uterus is stuck to bowel.

This could mean
that there is more cancer.

So, we have to abandon the robot
and do this by hand.

That was not the plan.

But you can't anticipate
everything.

OK, knife to skin again.

We need to make sure we remove it

in a safe way, without spreading it.

Otherwise, you change her prognosis
from good to significantly worse.

So, here it is.

This is where the disease is, yeah?

Yeah.

We need to make sure
we do this safely.

Let's have a look. This is bowel.

This is all uterus.

I need to run my fingers
along the adhesions

between the bowel and the uterus
to feel for disease and find areas

I can separate safely.

This is stuck.

So, can I have Mclndoe scissors,
please?

Yeah. Just go through here.

It's just very stuck.

There's a loop of bowel, there.

OK, I just need to pick it up,
and we just do it gently.

We must avoid cutting into the organ

and risk spreading cancer cells.

So, you know, you can't
do this robotically

and you're just tearing it apart.

You don't have a clue what
you're doing. Look at this.

Then it will start bleeding,
and then... Yeah.

Yeah? OK. Let's do a
little bit more.

It's just one final push as we cut

around the last few structures

to get the uterus out.

Join the dots.

This is a really big step.

So we're just going to release it
now from the vagina.

The uterus is out now.

This is her cervix.

So this was attached to the vagina.

The vagina is normally here.

And this is one big muscle,

and it can stretch to have
a full-term baby in.

It's just amazing.

So, on both sides,
you've got tubes and the ovary.

So, what you can see
is there is something here.

And this is where
she had her fibroid removed.

So, that's in the back
of the uterus.

And you can see, there's...

This was attached to it.

This is what we call omentum,

which is a fatty curtain hanging

in everybody's abdomen.

And why we have released this
and not just taken it off here

is because we want to know
if there is any breakthrough

of cancer cells.

The pathologists will
be able to tell us.

PHONE RINGS

Hello. You're speaking with
Macmillan. How can I help?

I've always had in the back of my
head the feeling that at some point,

cancer is going to come knocking
on the door again.

After you, my lovely. OK.

I just want to get on with it
and get to the point where somebody

can bring me a cup of tea.

Hello, again. Hello.
Can you spin yourself around?

The plan today is to completely
remove this vast cancer

from Ian's abdomen.

The tumour is enormous,

and it's already encased
some of his organs.

So, we have to remove
this with the tumour.

This will be a significant
insult to his body,

and there's a high risk of
causing catastrophic bleeding

from the major blood vessels
behind the tumour.

Enormous tumours
are quite a challenge.

There always will be a
huge responsibility

on the surgeon's shoulders.

So, the focus in your mind is just,

you've got to make sure you do
the best for this patient.

Their life's in your hands.

You happy for us to start?
Yes, please.

Here we go.

The first step is to get to
the tumour without cutting into it.

We don't want to spill any
cancer cells.

Currently, everything is contained
within the tumour capsule.

Good. So this is the tumour here,
under my hand,

this big lump here.

This is the large bowel,

and it's completely stuck
onto the tumour.

We won't be able to separate that.

It's going to have to
come out with the tumour.

The kidney is somewhere in here,
in the middle.

I can maybe just feel it there.

These vessels that feed it
just disappear into the cancer.

That will have to go.

But he has a normal kidney
on the other side, which is fine.

You can survive with one kidney.

I think we should start
with the bowel.

So, we're going to divide
the colon now.

We're going to cut through the bowel

where it starts and ends
on each side of the tumour.

I think we're going to have
quite a bit of trouble,

because this is where it goes in.

But we'll have to see.

We have to be really careful
not to damage any healthy bowel

that he needs.

Induja, a stapler.

I think just divide it through here.

OK, thank you.

So, right at the back,

we're starting now to see
the big blood vessels.

I think this is the left renal,
here.

It's a blood vessel going off
towards the kidney,

but it needs to come
with the tumour.

As long as we divide the blood
vessels, then the whole kidney

will come with the specimen.

Let's cut through them carefully.

The blood pressure is
quite high here.

Bleeding here.

Stitch ready?

Erm, give me the smaller needle. OK.

We should be able to see,
as long as we keep a view. Yeah.

Surgery always has inherent risk,

and sometimes things do go wrong.

You've got the end.
You just take the end.

Just, just the end. Give me...

Let it go. Yeah.

You have decide what is the best
way to stop the bleeding.

Erm, get a stitch, please.

Even a small injury
can cause catastrophic,

life—threatening bleeding.

It can be very difficult
and challenging.

It would be great if everything
in surgery always goes well,

but it does sometimes go wrong.

Get a 4-0 prolene suture...

Although inside, you may panic,

you have to be able
to control the bleeding.

That's got it, I think. That's good.

Yeah, it's under control. Yeah.

OK. A bit of a breather.

Well done. Good.

We're making progress.

The kidney is divided from
the main blood supply it receives,

so the kidney's free.

So, just the last bit of the tumour

right at the top, top, top, top.

We're there, we're done.
That's good.

Have we got a table, guys?

The table behind, there.

This is basically
the whole of the tumour.

Just for reference, this is a little
ruler that's 15 centimetres long.

The one issue is our normal
theatre scales

only measures up to 2—3kg.

So we've got to put it on
a human weighing scales.

Good. Let's see.

It weighs 7.5 kgs.

It's always a worry, especially when
patients get turned down elsewhere

for surgery, whether your judgment
is accurate in whether

the tumour's actually resectable.

So, it's a great relief
when it is actually possible

to remove it completely.

And it all went well,
so I'm very happy.

Our role is to come up with ways
of taking cancer out,

while allowing the patient to enjoy
near-complete quality of life.

For Will, that has meant
a long recovery

and learning to swallow
all over again.

HE COUGHS

But I am constantly amazed
by the resilience

and the determination
of the patients we see.

For Mel, luckily,
there was no residual disease,

so her prognosis is extremely good

and we've given her
that positive news.

One of the reasons why I keep doing
this job is because of patients

like Mel, where you think,

OK, well, hopefully,
it was good what we did. Yeah.

It just feels like a weight
has been lifted, and I feel,

like, a free spirit, you know,

like I can sort of now go off and
do whatever I want to do,

not be afraid about anything.

It's a happy ending, which...
I'm thrilled.

It's just amazing.

The scans and the blood tests
so far say I'm clear

as far as the cancer is concerned.

I've got my strength back.
Most things I can do.

So, if I needed to move a bale
or whatever, I could do it.

But I couldn't do half a dozen.

Come on, you, walk up.

We start off as doctors
with the goal to help people.

So when things go well for patients,
it makes you proud of what

you've been able to do for them.

I want to go back in time and start
retraining as a cancer surgeon

today, which would be just amazing
because in 20, 30 years' time,

the cancer cells in the future
will be completely unrecognisable.

There is so much
development happening

about different techniques,

different robotic platforms.

That's one of the amazing things
about this hospital.

It's not just the treatment
of the patients,

but it's also the support.

How do we make things better
for the future,

and how do we learn more
about each cancer?

It's a fascinating future
we have ahead for cancer surgery

and for cancer treatment in general,

because we're understanding
cancer so much better.

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