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Ragnhild is the first to receive new cancer treatment:
"I hope I can live a little longer"
Ragnhild Langli is the first person in Norway to receive personalised chemotherapy for bowel cancer. She is participating in a research study that's the first of its kind in the world.
Just a few months ago, Ragnhild Vigdis Langli, 70, was planning her own funeral.
She contacted her local church and wrote a letter to her husband detailing her wishes for the end of her life.
“I was in such bad shape. When the doctor said I had incurable cancer, I was not that surprised. I was sure I was going to die,” she says.
More good days
The letter about the funeral has now been put away in a drawer. Langli has just returned home from a weekend at her cabin, where she's now planning a new strawberry patch in her garden.
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After a few rounds of chemotherapy, her cancer has been reduced by half. The chemotherapy was chosen after the researchers first tested two different treatments on Langli’s cancer cells in the lab.
“I hope I can live a little longer. A few more years, not just days. My Christmas wish for 2025 is that the cancer recedes even more,” she says.
New lab test for bowel cancer
It's Friday morning, and we are at home in the apartment of Langli and her husband Harald. On the table is a freshly ironed tablecloth and warm apple pie with custard.
In the spring of 2025 she was diagnosed with aggressive metastatic bowel cancer. The cancer was no longer just in her colon, but had spread to her liver and lymph nodes.
As if by chance in life’s unpredictable lottery, Langli was offered the opportunity to take part in a research project at NTNU.
She is now the first patient at St. Olavs Hospital to receive chemotherapy selected through a new lab test for bowel cancer. Langli is participating in a future-oriented study to identify the choice of first-line treatment for metastatic bowel cancer.
"Everyone likes to help people"
The treatment cannot save her life, but it can make it easier to live. More quality time with her husband enjoying a hot coffee in the morning. More afternoons solving crosswords.
The treatment is extending her life, although for how long, no one knows.
“Chemotherapy is a very harsh treatment,” says Åsmund Flobak, senior consultant at St. Olavs Hospital Cancer Clinic, professor at NTNU, and senior researcher at SINTEF.
Here at the Gastro Centre at St. Olavs Hospital, large sections of the different floors are for cancer patients.
Many are admitted to hospital because the treatment is so harsh
On this floor, the cancer patients who become very ill from chemotherapy are admitted, Flobak explains, as we pass by a hair salon on the ground floor. There is a glass display case with wigs in various hair colours, lengths, and styles.
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“All rapidly growing cells in the body are affected by chemotherapy. The cancer cells are targeted, but hair cells and the immune system are also affected. Many cancer patients have to be admitted to hospital because the treatment is so harsh, as opposed to because of the cancer,” says Flobak.
After completing his medical degree, he went on to become a civil engineer in nanotechnology.
Norway is one of the countries where most people get bowel cancer
He is now part of a research team conducting several studies that will hopefully provide more personalised treatment for patients with incurable metastatic bowel cancer.
“Unfortunately, if this type of cancer has spread everywhere, very few of the patients will survive. The only thing we can do is try to make the rest of their days as good as possible,” says Flobak.
According to the Norwegian Institute of Public Health (NIPH), cancer is now the most common cause of death in Norway.
“Norway has one of the highest incidences of bowel cancer in the world. That's why I want to focus my work on this specific type of cancer,” he says
He is currently engaged in a kind of research marathon spread over several stages, where the first stage is almost finished.
Created a catalogue of cancer cells
Flobak has created a catalogue of cancer cells from over a hundred patients.
The cancer cells were donated for research and collected from tumours that had been surgically removed. First, the tumours were cut up into tiny pieces, and then the different pieces were tested with various types and doses of chemotherapy.
Patients with incurable metastatic bowel cancer receive two types of chemotherapy. No one currently knows which one works best. You simply have to pick one and try it for two or three months.
"If it works, you continue. If it doesn’t work, you change it. Some people receive medication that makes them very sick without the treatment even affecting the cancer,” says Flobak.
The aim of his current research is to start the best possible treatment right away.
The goal is to avoid a possible delay of two to three months of trial and error. Because the catalogue documents how different types of cancer respond to various doses of chemotherapy, he can now compare the patients’ cancer cells and determine which treatment is most appropriate.
"I feel so much better now"
For Langli, the chemotherapy has been relatively easy to live with.
“I wasn’t very optimistic. That's why I feel so happy when things go well. I'm pretty worn out after the first few days following a round of chemotherapy, but then I recover. I feel so much better now than before I started,” says Langli.
She has lost 13 kilograms since starting chemotherapy, and some of her hair has fallen out, but she has also started exercising and her appetite has returned.
The goal is 133 patients
There are three categories of patients that see the cancer doctors at St. Olavs Hospital.
The first are patients who only have bowel cancer, where the cancer can be surgically removed. The second category of patients need chemotherapy in addition to surgery. The third is people who have incurable metastatic bowel cancer, where only chemotherapy is given.
All patients who fall into the third category are currently being considered for the opportunity to participate in Flobak’s research project. There are certain criteria for participation, and after assessment some will receive an offer.
"I usually manage to stay composed"
So far, three patients have been invited to participate, and all of them have accepted. The goal is to get 133 patients. The third stage of the research marathon will begin at some point in the near future, where the aim is to use artificial intelligence in the work.
“Everyone likes to help people, and I am no exception,” says Flobak.
He finds it difficult to tell patients that the disease they have cannot be cured.
“I usually manage to stay composed and professional, but it's harder when I get home and share my thoughts with my wife. That's when the tears tend to come. It's comforting to know, both for the patients and myself, that we're working to ensure each individual gets the best possible treatment currently available, and that we're striving to improve cancer treatment in the future,” he says.
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Read the Norwegian version of this article on forskning.no
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