Tag Archives: bone metastasis

Someone wrote: The Oncologist Had Prostate-Bone-Liver Cancer. And He Died

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After posting the article, Malaysia’s Well Known Oncologist Died of Cancer, some readers wrote to ask what cancer he had and what he did that he died. Unfortunately, I was unable to answer these two important questions. Then out of the blue, someone wrote to fill in the gap. So here it is – the e-mail (reproduced with the kind permission of the writer).

Another question left unanswered. What medical treatments did he receive and he died because of his cancer or his treatment?  We can never know, one day we may get an e-mail from another angel ?

1st April 2013:  Dear Dr Chris Teo,

I am writing this in response to your post (16 March 2013).

It was indeed a shock for me to read in The Star news that Dr Albert Lim Kok Hooi passed away from cancer at age sixty.

Many questions ran through my mind.

  • What cancer did he die from?
  • When did he find out that he had cancer?
  • How did he treat his own cancer?
  • Why did he discover his cancer at such a late stage? 

I surfed the Internet to try to find more details. When I could not find any information, I contacted friends who knew him and his family.

I was informed that Dr Albert Lim had prostate cancer which spread to the bone and liver. Apparently his cancer was diagnosed a year ago. However he kept it from the public. No one in the hospital was allowed talk about it.

If The Star did not publish the cause of his death, we would not have known that Dr Albert Lim passed away from cancer.

Recently, I came across an online article and confirmed that Dr Albert Lim learnt he had cancer a year ago. http://thestar.com.my/health/story.asp?file=/2013/3/17/health/12844733&sec=health

To quote from the article

He also kept his cancer a secret from acquaintances and friends.

He was a private person in many ways. His cancer was something to be dealt with within the family

Now this brings up some interesting issues.

Why did Dr Albert Lim choose to keep his disease a secret?

As a prolific writer in the papers, he shared his knowledge, medical training and experience to raise the level of public awareness on how to prevent cancer, treat cancer and how to cope with cancer.

Was he doing a social service or was he merely writing to boost his image after his six months suspension from the Malaysian Medical Council?

http://thestar.com.my/news/story.asp?file=/2007/2/23/nation/16951173&sec=nation

What had he hoped to achieve by keeping his cancer a secret?

Normally it is the patient’s prerogative whether to keep the disease secret or make it public. However Dr Albert Lim is no ordinary patient. He is a leading oncologist and a respectable authority on cancer locally and internationally. He was actively running a thriving oncology practice. He had cancer patients who made decisions based on trust and confidence in his prescriptions. Had he disclosed his condition, would some of the patients choose different courses of treatment?

It would seem that there is some implied moral duty or fiduciary duty to disclose his cancer as he is an involved party. Steve Jobs was chided for trying to conceal his pancreatic cancer from the Apple Board and investors. Under stock exchange rules, it was material disclosure as the information would have caused some investors to make their decisions differently.

Here, how do you think his patients would feel? Having faith in a doctor and having spent thousands of ringgit on chemo and other treatments, he read in the newspapers that his oncologist passed away from cancer! And the patient had no inkling that his oncologist had cancer!

It would not be unreasonable to conclude that Dr Albert Lim kept his cancer a secret as it is sheer bad publicity for the medical industry. If the Physician Heal Thyself  maxim, does not work, what faith can the patient have in the doctor? Was Dr Albert Lim worried that his business would be affected?

I am not saying that doctors are not human and that they are immune from diseases. Of course an oncologist can also be afflicted by cancer like anyone else. However, when an oncologist dispenses How To advice, we would expect that the probability of him diagnosing himself at an early treatable stage is higher than anyone else. And if he did get cancer, share the journey with others so as to benefit all.

I read a New Straits Time article dated 26 November 2012 that Dr Albert Lim gave media statements endorsing a new chemo drug which offered hope for late stage prostate cancer patients.

http://www.nst.com.my/latest/hope-for-prostate-cancer-patients-1.176963

It would now seem ironical that four months later, Dr Albert Lim died from prostate cancer. At the launch of the new drug, he knew that he was suffering from late stage prostate cancer. Unless he had tested it himself and it worked, it would seem so inappropriate to endorse a highly toxic drug. Chemo drugs are very expensive. It is unfair to sell hope to poor patients, while not proving its efficacy on oneself. Would the drug company have asked him to endorse the launch of the drug had they known the facts?

I got to know Dr Albert Lim nineteen years ago. He was Head Oncologist at KLGH. He treated my father for terminal lung cancer for six months. During that time I got to know him fairly well on a social basis.

Well, when one meets with an oncologist in a social setting and he is not wearing his professional mask, one gets some interesting insight into the medical industry.

Perhaps in those days, chemo drugs were not as advanced as today.

In the course of conversations, I found that oncologists viewed cancer patients, especially late staged ones as quite hopeless cases. The majority of cancer patients who came to seek treatment would die anyway. Whatever the oncologists do will not make much of a difference. It is a matter of time but the cancer will spread. However since patients came with hope and expect the oncologist to do something, he has to administer the prescribed industry treatment protocols whether he believed in them or not, whether he would practice the same treatment on himself or not!

Maybe the chemo drugs today are more powerful in combating cancer and Dr Albert Lim has changed his views after starting private practice. I do not know. After my father passed away I did not keep in touch. I hear of him on and off from some patients and through reading his articles.

Over the years, I had two close friends and my step mother who succumbed to cancer. They had their share of stories when dealing with oncologists.

Dr Albert Lim and most other oncologists are averse to alternative therapies, labeling anything that is not from Western medicine as quackery. I am not denying that there are some cases where cancer patients have benefitted from oncology treatment. My aunt now in her eighties survived breast cancer for forty years. She could only afford minimal cancer treatments from the hospital and nothing else. Another friend now in his fifties has against all odds battled cancer over twenty years with chemotherapy, stem cell replacement, consuming birds nest daily and mainly a strong willed mind.

However in many other cancer cases, the treatments prescribed by the oncologists did more harm than good. Unfortunately many specialists in private practice run their clinics like running a business. They have high overheads and of course, there is always the thrill of making money like any other business. In private practice, everything revolves around money.

I strongly believe in the mind-body model, the intelligence of the body to heal itself and that diet and herbs are Nature’s gifts to mankind. I do not know you but I have been following your work on and off since the publication of your first book.

At that time, my old classmate and dear friend, suffered from Stage 3 NPC. She went to a famous oncologist and was prescribed a course of radiotherapy. At the end of the sessions, he asked her to say AHHH… looked at her tongue and throat and declared her free from cancer. No other tests were done. I asked her to go to your clinic as additional treatment but she refused.

She was jubilant and went round testifying in the churches that God healed her. Six months later, the cancer came back with a vengeance. She sought treatment from a UH oncologist who gave her chemotherapy but it was too late. I saw her two weeks before she died. She held my hand and said the saddest words I ever heard “I was a fool to believe Dr T ” (the first oncologist who declared her cured). Faith is invaluable but we must be realistic.

Last year, my close friend who is a well known corporate figure, died from Stage 4 stomach cancer which spread to bones, pancreas and abdomen. Initially he was given six months to live. He was treated by the best oncologists in Singapore and locally as his company paid the medical bills. After the first six months of chemo treatment and breathing meditation which we encouraged him to learn, the PET scan showed that the cancer had disappeared. The Singapore oncologist said to him, ‘Whatever you are doing, continue with it’!

At that time, I asked him to go to your clinic to get additionally therapy. However he refused saying that he would follow the doctor’s advice. He too was jubilant and immersed himself fully in his hectic work and had no time for his breathing and meditation. Six months later, the cancer came back. He spent the next twelve months with massive chemo treatments, switching from one drug to another when the cocktail did not work. It was sad to see his health and body getting worse with each treatment. He passed away 2 ½ years after he was diagnosed. The company spent nearly RM2 million for the treatments. How many patients can afford to pay such massive sums for cancer treatment?

When friends tell me so-and-so is diagnosed with cancer, I always recommend that they explore your alternative therapy with an open mind. It is up to each to follow his inner guide as to what treatment they should sought. Living and dying are not in our hands. We do what we can to help by telling patients that there are alternatives besides chemotherapy.

I hope this fills up the gap in your blog as to how Dr Albert Lim died.

When I read Dr Albert Lim’s obituary, I wondered how he felt the instant he was diagnosed. It would have been truly useful if Dr Lim had documented his own journey. That would have been ultimate service to humanity.

Did Dr Albert Lim administer the same toxic treatments he recommended to others for himself? Do chemotherapy and other oncology therapies work? Well, it would seem not but we shall never know.  It is very easy to preach but not easy to walk in the patient’s shoes. Anyway, may the good he has done live on.

In closing, since we did not get to hear Dr Albert Lim’s experience, it may be interesting to read how other oncologists wrote about their own cancer journey.

http://www.npr.org/2010/12/14/131760656/a-breast-oncologist-diagnosed-with-the-disease

http://www.nytimes.com/2005/05/24/health/policy/24docs.html?pagewanted=all&_r=2&

http://www.kevinmd.com/blog/2012/02/diagnosis-stomach-cancer-profoundly-oncologist.html

The following article had gone viral but it is a very touching account from Dr Richard Teo (not an oncologist but a plastic surgeon) from Singapore who documented his cancer experience before he passed on. Irrespective of one’s religious beliefs it will be worthwhile to read with an open mind.

http://www.heavenaddress.com/Dr-Richard-Teo-Keng-Siang/424153/379719/content

Wishing you all the best always.

Yim,

Petaling Jaya

My Comment:

Thanks dear writer for giving us your precious time to share your thoughts. You have done your part! Let me conclude with these quotations:

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Comment added: 23 May 2013

“Another question left unanswered. What medical treatments did he receive and he died because of his cancer or his treatment? “

I have some further information.

Last week, I met a family friend of Dr Albert Lim. She informed me that she only got to know Dr Lim had cancer two months before he passed away.

I asked if Dr Lim administered any treatment on himself. She said that when he was diagnosed with Stage 4 prostate cancer, he started chemotherapy. However after a few treatments, the cancer got worse and he opted to end the chemo treatment. He preferred to let the cancer advance faster. He knew there was nothing more he could do.

I asked why Dr Lim could not diagnose his own cancer earlier. Apparently, he did not have any symptoms and the cancer markers did not pick up the prostrate cancer. His oncologist friend from Europe who visited him while he was ill, commented that he too, has come across a few cases in Europe where the prostate cancer did not show up in cancer markers.

I heard from one of Dr Lim’s patients that Dr Lim was administering chemotherapy to the patient up to a week before he died. She noticed that he looked very tired and old, but he was very very nice to the patient. Of course it came as a shock to the patient to read that her oncologist died of cancer as no one knew that he was suffering from the disease.

The purpose of my writing is not to run down the Doctor or the treatments. What I learnt from this whole episode is.

1) Cancer is not always detectable at an early stage.

2) When diagnosed with cancer, a patient should educate himself on all options of treatment available and make an informed decision himself.

It is not prudent to rely on medical opinion alone.

All doctors are trained and sponsored in some way by Big Pharma. At the end of the day, they will push drugs which may not yield the desired results but because it is standard protocol, they have to recommend the regime to the patient.

The patient end up spending  and suffering unnecessarily.

Over the last four years when I accompanied my step mum for her cancer treatments at UH, I came across patients who spent all their money at private hospitals. With no money left, they came to UH to seek subsidised  treatments. It was so pitiful to talk to them, some mortgaged or sold their homes, some borrowed money and others took loans to find the elusive care.

I hope the day will come when there will be oncologists with conscience, oncologists who will honestly tell patients when all hope is gone, to stop wasting their money and find some other means of natural treatment and palliative care.

Kind regards.

Yim, Petaling Jaya

 

Breast Cancer: Surgery and Hormonal Therapy Did Not Cure Her

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SH (H785) is a 67-year-old lady. She was diagnosed with breast cancer in January 1998. A left mastectomy was performed. The histopathology report of 13 January 1998 indicated two malignant nodes. No residual tumour in her breast. Axillary fat and lymph nodes were free of tumour.

No chemotherapy or radiotherapy was indicated. But SH was put on Tamoxifen. She took this drug for 6 years.

SH said she was well all these years and her progress was monitored by her doctor. About 10 years later, in early 2009, SH developed shortness of breath. She could not lift her left arm. She was tired and lost her appetite.  A chest X-ray indicated large left pleural effusion. SH had the fluid in her lung tapped out. A CT scan on 7 January 2009 indicated several subcentimeter nodules in her left lung. The lymph nodes in the left axilla and aortopulmonary window were enlarged. Impression: left pulmonary and pleural metastasis.

SH sought a second opinion from another oncologist at a university hospital. Another CT scan was performed and it also confirmed a metastatic breast cancer with left pleural effusion with small benign liver cysts.

A bone scan done on 29 January 2009 indicated multiple skeletal metastases in the sternum and two ribs on the left side.

SH was prescribed Arimidex – another oral chemo-drug for breast cancer. She was on this drug for 2 years.

In August 2011 SH developed shortness of breath again.  A CT scan on 4 August 2011 confirmed presence of mild left pleural effusion. Fluid was tapped out of her lung again.

The doctor told SH that Arimidex did not work for her. She was prescribed yet another oral drug – Aromasin. SH was on this drug for about 3 months now. At the same time SH received Zometa injection (for her bone) every 6 weeks. Each Zometa injection cost RM 1,200.

A bone scan done on 18 March 2011 indicated “sclerotic bone metastases in manubrium showing activity.” SH was told that if Aromasin did not work for her, she would have to undergo intravenous chemotherapy.

The following are her CA 15.3 readings throughout the years.

Date CA 15.3
17 January 2009 149.0
4 March 2009 230.0
8 July 2009  30.0

Year 2010 fluctuating values under 30.0
26 April 2011 51.0
22 June 2011 66.0
4 August 2011 67.4
27 October 2011 164.5
24 November 2011 227.0
23 December 2011 231.7
31 January 2012 477.0

SH and her family came to seek our help on 5 February 2012.

Below is her AcuGraph reading on 5 February 2012 which indicated a rather unbalanced internal energy.

Comments

Why did you take tamoxifen? To prevent recurrence, so you are told. Some patients are also often told this – if you survive 5 years, you are cured of your cancer! What a great lie. Did tamoxifen cure cancer in this case? It must have since his patient had survived for 5 years. That, “medically” is defined as a cure. But, you never ask – what if she does not take tamoxifen? She may also survive 5 years! Anyway the cancer came back after 10 years. This time it struck the lungs and the bones. Where then is the so called cure?

Reflect on the quotations below:

Second-Line Treatment: Arimidex

Arimidex (anastrozole) is indicated for the treatment of advanced breast cancer with disease progression following tamoxifen therapy.

Side Effects:  Patients receiving Arimidex had a mean decrease in both lumbar spine and total hip bone mineral density. Patients should be informed that Arimidex lowers the level of estrogen. This may lead to a loss of the mineral content of bones, which might decrease bone strength. A possible consequence of decreased mineral content of bones is an increase in the risk of fractures. Arimidex may also cause heart disease.

Effectiveness:

 Pooled Efficacy Results of Second-line Treatment

Source: http://www.rxlist.com/arimidex-drug/clinical-pharmacology.htm

Final results of the Arimidex, tamoxifen, alone or in combination (ATAC) trial, presented at  the San Antonio Breast Cancer Symposium and published simultaneously in The Lancet, found that, compared with tamoxifen, anastrozole (Arimidex) improved disease-free survival by 13% and increased time to recurrence by 21% ,however, there was no statistically significant improvement in breast cancer survival or overall survival. (Note: be skeptical when reading figures like such percentages – they could be manipulated to bring out only the positive message.)

Some researchers questioned whether use of Arimidex was justified in light of its higher cost ($6.56 per day for Arimidex versus $1.33 per day for generic tamoxifen) and lack of a demonstrated survival benefit (Source: Journal  National Cancer Inst (2005)97 (2): 86-87)

There are 197 comments by women taking Arimidix (as of 27 February 2012) in the website below: http://www.webmd.com/drugs/drugreview-4511-arimidex+oral.aspx?drugid=4511&drugname=arimidex+oral

Below are some examples.

Comment 1: Have not had bothersome side effects from this med so far, but am experiencing hair thinning. Some aches in a hip and knee, lack of sex drive, minor hot flashes …So far this med has not bothered me.

Comment 2: I am 63 and found I had breast cancer at 60. Had lumpectomy, 6 chemos over 7 months (carboplatin, docetaxol, nausea med, Herceptin IV’s, and a Neurlasta shot), followed by 8 more IV’s of Herceptin over 8 months, along with 31 radiation treatments, at last one 1miligram Arimidex  I’m to take for 5 years daily. My complaint is that I was completely bald all over…I had started daily Arimidex  about June 2010. A month ago, I was looking at some old pics made in May2011, and it started to hit me that my hair was thicker with more coverage than NOW (Jan. 2012). It was heartbreaking, it was becoming thinner and patchier on top front where you want it the most. I accidentally happened on a site, read that 40 or more women sharing this experience, and most believed it was the Arimidex. I tried Femara for 2 mo. with no improvement. I have aches and pains and feel “aged from the inside out” … I might just drop the Arimidex, take no “cancer” pill, and pray it won’t come back.

Comment 3: Taking this med for approx. 2 months. Extreme lower back pain 2 weeks after started, brushed it off. At this point just using my arms is very painful. My shoulders are in extreme pain. Talked to oncologist nurse and am changing to another but as of today I just want to cry I am sick of all this pain. Did not have any of this before!! I am in no way a baby, and can handle pain but even I have reached my limits. Hope this helps someone else who is experiencing the same issues with this drug.

Comment 4: I used this drug for 3 years and 4 months thinking I was doing fine on it. Suddenly I felt like my crotch was on fire. It took another 2 months of doctor appointments and medical procedures before I had a doctor that made the connection. Vaginal dryness given as a side effect is a huge under-statement. I’ve been free of this drug for 10 weeks and on estrogen cream for 4 weeks and am still miserable.

Comment 5:  Constipation, depression, lack of motivation,  muscle weakness One plus sleeping 6 hours a night instead of 5.

Comment 6: I thought I had it made …no symptoms except a little weight gain… Now my thumb is locking up and I had no idea it was from the Rx until reading the other reviews. I am achy after sitting for a short time and have really sharp pain in the back of my hand sometimes when I pick something up, even a cup of coffee.

Second-Line Treatment: Aromasin

Aromasin (exemestane) is indicated for the treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy.

There are 99 comments from patients  taking Aromasin http://www.webmd.com/drugs/drugreview-17966-Aromasin+Oral.aspx?drugid=17966&drugname=Aromasin+Oral. The following are some examples:

Comment 1:  I have been on this medicine for 4 1/2 years. The past few months have been the worst. Every joint in my body hurts, night sweats and sleepless nights. It takes all I have to get out of bed in the morning.

Comment 2:  Shortly after starting the drug (04/2010), I developed a cough, which I still have. Had a dose of sinus infection, sore throat, worse coughing just before Christmas. Chose to let my immunity fight it off instead of antibiotics. Took 3-4 weeks to get over it, but I did it on my own. Still have the cough. Tried arimidex first-made my hands, feet and face swell. Satisfied with aromasin except for cough.

Comment 3:  I had a forced menopause after the 2nd cycle of chemo for my stage 2A BC. Never taking tamoxifen, was prescribed Femara for 2 months and then switched over to Aromasin following the chemo and radiation therapies. It has been 6 months since taking Femara and Aromasin. First experienced severe back and knee pains then had hand surgery for my Carpel Tunnel syndrome and now the pains has extended to all bones and joints, mostly in my hands and wrists. Memory loss and attention deficit is getting obvious. Hot flashes and insomnia is concerned. Without having daily walk and exercise and Melatonin Plus for sleep support, I would be miserable with all the side effects from the drugs.

Comment 4: After 20 days on arimidex I was suicidal, had severe bone pain, severe insomnia. I switched to aromasin and have found it easier to tolerate if I take meds for the side effects. I take ambien to sleep, percocet for pain, wellbutrin for depression. It’s either treat the side effects or I have a 70% chance of cancer recurrence. I will give it six months because sometimes the side effects do get better and I don’t want to die at age 63. But there does come a point when quality of life wins out – however short it may be.

Comment 5:  Have had major side affects with it. Tried Arimadex first, then was prescribed this one; a little more manageable, but still have trouble. Joint pain, sweats, muscle cramps and renaud’s syndrome.

Comment 6: I was prescribed aromasin by my doctor after the other 2 AIs had adverse side effects. I took it for 3 yrs and 3 months. I could not tolerate the lack of quality of life.

Breast Cancer: From Despair to Hope in Five Days

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1: Healing In Five Days

2: Her Tragic Story

Acknowledgment:  Permission to use these video clips without having to close the patient’s face is granted by the family.

The gist of our conversation:

1.  Breast lump, ten years ago and she did nothing about it.

She discovered a lump in her breast more than   ten years ago but did nothing about it. The lump grew bigger. In 2008, she went to Kuching, Malaysia for a full-body check up. At that time she did not experience any serious discomfort. However, the check up revealed a stage 4 breast cancer since it had probably spread to her bones.

Did she suffer any pains before the check up? Yes, she had pains around the shoulder blade. After a massage the pains disappeared.

2.  Trips to China to find the cure.

The doctor in Kuching suggested chemotherapy. She refused. The family decided to bring her to China for medical treatment. She received treatments such as chemotherapy, cryoablation and radioactive seeding  in the Chinese hospital.

She stayed about one to two weeks in China during each trip there.  She returned home feeling “alright” only to go back to China again for more treatment each year.

Did they teach you to take care of her diet? No, she was told to eat anything she likes. They did not teach her anything about the diet.

3. A Minor Fall

In January 2011, she had a minor fall. This cause one of her legs to become swollen. But even before the fall, she always had pains in her legs. She consulted a doctor in Kuching about this problem and was told that nothing was wrong with her leg but she probably had cancer in her colon.

4.  Leg Operation

Since February 2011, she was not unable to walk and remained immobilized at home. One of her leg was in pain and the other was swollen. She was unable to place her feet on the ground and stand up because of pains.

She went to Jakarta for further consultation.  Subsequently she underwent a surgery intervention for both of her legs.

Two months after the surgery she was able to walk. There were no more pains in the foot when she stepped on the ground. But the pains in the lower parts of her legs persisted.

 5.  Did no return to China anymore

 Did she go back to China again after this? No. We made a total of six trips to China.  In 2008, she went to China thrice, in 2009, twice and in 2010 once. No use – at every visit they asked us to do PET scan, chemo, etc. She became tired, vomited, etc.

6.  Hospitalization – September 2011

In late September 2011, she had pains in her abdomen and was unable to walk again. She had to be hospitalized. The oncologist suggested a PET scan to find out what was wrong with her. The family declined.  By this time she was taking a variety of medications prescribed by the oncologist, bone specialist and neurologist.

3.  CA Care Penang – 9 October 2011

She was wheel chair bound. She had to be carried up into the airplane. She was unable to stand up by herself.

She was unable to sleep and had pains in her legs throughout the day and night.  After listening to her story that 9 October night, we could only say this to her family, I really don’t know what I can do to help you. But I shall try my best. It was indeed a hopeless and helpless case.

After five days on the e-Therapy and herbs, her conditions improved.  The pains in her legs were almost gone. She was able to sleep and above all she was able to stand up by herself with minimal help.

Update: On 26 October 2011, her daughter-in-law called to say that patient (now at home in Jakarta) is able to walk by herself with the help of a walking stick. On the day when she returned home, she was able to slowly walk into the airplane – no need to be carried into the plane like the week before.