It's ten o'clock in the morning at the largest cancer hospital in Asia, a sprawling complex of buildings in Tianjin, a polluted city on China's eastern coast.
Dr Zhang Jing is already scrubbing up for her fourth operation of the day. She has the tired resignation of someone who knows she's in for a long shift at work.
Ten years ago, surgeons here removed tumours once or twice daily. Now they perform at least seven operations every shift.
The cancer hospital recently doubled in size but is still struggling to cope with demand.
"Even if we diagnose 50 patients every day, we cannot keep up," Dr Zhang says. "No matter where you go in this hospital, you will never find an empty bed."
Cancer rates may be falling in many Western countries but they are steadily rising in China.
Blame the effects of pollution and unhealthy habits on the country's aging citizens.
In the lobby of the Tianjin Cancer Hospital, the tension is palpable. Patients and their families jostle with one another in line as they push to make appointments.
It is a situation that is echoed in busy cancer hospitals across the country.
Statistics on cancer cases nationwide are hard to find as China does not maintain a national database
'Leading cause of death'
China has approximately 20% of the world's population, but it has 22% of new cancer cases and 27% of the world's cancer deaths.
“Chinese people think that cancer is a terrible thing; once you have it, you won't last long”
Wang Hui - Cancer patient
Cancer is now the leading cause of death in China but the health ministry seems ill-equipped to deal with the problem.
There are no obvious national campaigns to educate citizens on the avoidable causes of cancer, like smoking.
The country's National Cancer Centre, which was supposed to open in 2012, doesn't even have a website.
Reliable cancer statistics are also hard to find.
In 2008, the Chinese Academy of Medical Science launched the China Cancer Registration Project, with 219 registration spots across China documenting cancer data. However, it has yielded little new information.
The project's last report was released in 2013, using data from 2010. To date, China lacks a single database tracking national cancer rates.
Cancer screening programs are virtually non-existent. The country's fragile healthcare system also means that many aren't diagnosed until it is too late.
There have been no obvious campaigns to warn against smoking and other cancer-causing habits
'Little we can do'
Liver cancer is a particular problem among Chinese men, many of whom carry the hepatitis B virus.
“For terminal patients, there's little we can do”
Dr Song Jing - Chinese doctor
Around 130 million people in China are believed to be carrying the hepatitis B virus and 30 million have developed a chronic hepatitis B virus.
This is a serious problem because, without regular health checks, the virus can easily morph into liver cancer. China now accounts for half of the world's cases of the disease.
In a single morning, one of the hospital's most respected doctors, Song Jing, meets 10 new patients. All of them are found to have late stage liver cancer.
When asked if it is stressful telling so many people a day that they have less than a year to live, Dr Song nodded.
"Yes, it is. For terminal patients, there's little we can do," he said.
China's major cities are plagued by increasingly dangerous levels of air pollution
But even patients with a good chance of recovering are afraid to mention the illness by name.
In a hospital tower devoted to breast cancer treatment, one patient - Wang Hui - admits that even there, the word "cancer" is rarely spoken out loud.
"Chinese people think that cancer is a terrible thing. Once you have it, you won't last long," she says.
Ms Wang normally commands attention in her job as a Chinese opera singer. But her cancer diagnosis has forced her into hiding. Very few know that she is sick.
Breast cancer has become increasingly common in China and is now the number one killer of Chinese women.
But like many other women, Ms Wang suffers in near-silence. Only her daughter and older sister stand next to her hospital bed, working as her faithful attendants.
"I didn't tell my colleagues or relatives because I didn't want them to worry," she says. "But when I came to the hospital, I saw so many people here with the same illness and I felt better."
Wang Hui and millions of others in China affected by cancer are beginning to accept a hard truth. This country is facing an epidemic, one that increasingly can't be hidden or ignored.
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