Tag Archives: stomach cancer

Stomach Cancer: Fainted and In ICU After One Chemo, Now Surgeon Said Go For More Chemo

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Lisa (not real name, M805) is a 35-year-old Indonesian lady. In October 2009 she passed out black stools. She came to Penang for a medical check-up. An upper endoscopy showed acute gastric ulcer but the rapid urease test was negative for H. pylori.  Her blood test showed low levels of haemoglobin (8.3), red blood cell (2.9) and high platelet count (431). She was prescribed medication for gastritis and was told to come back for further observation after a month.

On 3 December 2009, another endoscopy was performed. It showed an almost completely healed ulcer.  A repeat rapid urease test again was negative for H. pylori. A gastric biopsy was also performed and indicated an adenocarcinoma, diffuse type.  A CT scan on 11 January 2010 showed a thickening of the gastric antral wall consistent with the clinical finding of carcinoma. The diffuse hypodensity of the liver parenchyma was in keeping with fatty liver change. No mass lesion was seen in the liver. There was no evidence of any focal lung lesion or lymphadenopathy.

Lisa underwent an operation to remove her stomach. The histopathology dated 12 January 2010 confirmed a diffuse type adenocarcinoma of stomach, T3N1M1, Stage 4. Lisa was asked to go for chemotherapy.  She returned to Jakarta and received one cycle of chemotherapy. The treatment was a disaster.  She fainted and had to be admitted to the ICU. She was discharge after four days but could hardly remember many things. She only recovered after a month.

Lisa returned to Penang for a follow-up examination with her surgeon. A CT scan on 21 July 2010 showed no evidence of pancreatic, splenic or renal mass lesion. There was no evidence of any lymphadenopathy. There was no obvious recurrence in the surgical bed.

Lisa and her husband came to seek our help on 23 July 2010 as she was not prepared to go for any morechemotherapy. She was prescribed Capsule A, Stomach 1 and Stomach 2 teas and C-tea.

Sometime just around the Chinese New Year (end of January 2012) Lisa felt a small lump in her stomach. She returned to Penang on 20 February 2012. A CT scan showed the following:

  1.  Fatty liver change.
  2. Mild to moderately dilated intrahepatic ducts.
  3. Ill-defined enhancing soft tissue around the pancreas and common bile duct which extends inferiorly along the right retroperitoneum, right paracaval and ilio-psoas down to the right inguinal and upper anterior thigh region. This has infiltrated the right upper ureter. Features are suspicious of tumour/metastatic deposits.
  4. Moderate to gross hydronephrosis of the right kidney with diffuse cortical thinning.
  5. Mild ascites.

Blood test showed elevated liver function enzymes:

Alkaline phosphatase 188.74   H
GGT 102.44   H
ALT 48.1
AST 47.77     H
CEA 1.23
CA 19.9 36.2

Lisa and her husband met with the surgeon. The surgeon said it was not possible to undergo further surgery. She was told to go for chemotherapy. That was the only option left.

The following is the transcript of our video-taped conversation on 22 February 2012.

Wanting a cure, whatever it may cost

Husband: January 2011, she had the surgery.

Chris:  Her stomach was removed. Before the surgery, did you ask the surgeon if the operation could cure her?

H:  He told us after the removal of her stomach, she would be okay. Then we need to go for chemotherapy.

C: Did you explicitly ask if after the surgery, she will be cured?

H:  He did not answer that question. The surgeon explained that after the surgery, everything would be clean. The cancer would not spread anymore.  We believed whatever he said. The reason why we went to him was because we wanted to find a cure.

C:  Yes, I understand – all patients who come here (from Indonesia) are searching for a cure. So whatever answers you get or what the doctors said, you all would believe them. And also pay whatever it may cost. What you all want is a “cure.” I understand that. So, after the operation, how long was she in the hospital?

H:  About two weeks.

Health worsened after the surgery

C:   How was her health before and after the surgery?

H:  After the surgery she became weaker – she was worse off. Before the operation, she was okay- okay, normal and there was nothing wrong.

C:  Why did you go for the surgery then?

H:  She was okay, she could eat – there not nothing wrong with her. She was told that she had cancer and we were afraid that disease would spread.

C (to patient):  Can you tell me – before the operation, you were okay?

Patient: Nodding vigorously.

H:  Nothing wrong with her except she passed out black stools. Then they did a biopsy after a scan and said it was cancer.

C:  That was all?

H:   Nothing – no pain, nothing. If she had pains it would it would have been a different matter. But she was able to eat well.

C:  And when the doctor asked you to operate, you went ahead with the surgery? And after the surgery, she was not getting better?

H:  No, not better.

Surgery – a RM 20,000 adventure

C: How much did the surgery cost you?

H. About RM 20,000.

First Chemo – she fainted and four days in ICU

C:  After the surgery, she had chemo?

H:  Three months later, she had chemotherapy in Jakarta. There was no problem on the first day after the chemo. The night of the second day, she had a seizure and her hands were shaking vigorously and she fainted.  She was admitted into the ICU and was there for four days.

C (to patient):  Did you remember anything when you were in the ICU? Did you remember going off or flying away somewhere?

P: No (shaking her head).

H:  After coming out of the ICU she could not remember things – memory loss. She could only recognize me. But gradually her memory started to come back. It took about a month for her to become normal again.

C:  Did the doctor want you to continue with the chemo after this episode?

H:  At first he said she had to do 3 cycles of chemo, but after seeing what had happened, the doctor did not ask her to continue with her chemo anymore.

No more chemo for me

C (to patient):  If you were asked to go for more chemo – do you want to do it again?

P:  No, I don’t want any more chemo.

After extensive recurrence – the only solution is chemotherapy

H:  Now, the only solution is chemotherapy.

C:  You went to talk to the surgeon. He told you she should go for chemotherapy. Did he know what had happened to your wife after the first chemo?

H:  He knew. But he did not have any more words to say. He told us, there was nothing else he could do except chemotherapy. But how are we to go for chemo after such a bad experience? We are afraid. She is going to lose her hairs and what not.

C:  Loosing hair is not a problem at all – it will grow again. But what we need to worry is if she would “fly away.”

Next-bed-patient became blind after two chemo and died after three

C:  You told me earlier that there was another patient in the next bed. She also had chemo when your wife was having hers.

H:  After the chemo, she became blind. Her eyes could not see anymore.

C:  What? Before the chemo, were her eyes okay – could she see?

H:  Yes, her eyes were normal. After two chemos her eyes could not see anymore. She died after the third chemo.

C:  What? She died after the third chemo? After the second she became blind – why did she continue with the third chemo then?

H:  Her husband made that decision. Because of what I have seen, I would not want her to do any more chemo.

C:  Did you really talk to her husband?

H:  Yes, I talked to him.

C:  Even after becoming blind, the husband still wanted her to continue with the chemo?

H:  Yes, he wanted to continue with the treatment.

C:  Did he tell you why he wanted to do that?

H:  No and I did not ask.

Comments

1. Lisa passed out black stools, otherwise she was okay. What could have happened if she did nothing? Do no surgery or chemo? How bad could she be?

2. Lisa and her husband asked the surgeon if surgery would cure her. The answer was rather evasive – He told us after the removal of her stomach, she would be okay. Then we need to go for chemotherapy. We believed whatever he said. We would like to believe that whatever doctors say or do, it is always for the best interest of their patients. But let’s not be naïve. At time it is good to be reminded of what Dr. Mendelsohn  said:
3. Lisa had her first cycle of chemotherapy and she fainted and lost her memory.  Her next-bed fellow patient was blind after two chemos and was dead after the third. This clearly shows that chemo is not for everybody.
4. The story of Lisa clearly showed that surgery did not cure her cancer.  She expected a cure but she was short-changed. In fact she became weaker and was worse off.
5. As it is now, after two years, the cancer had metastatised extensively – could her cancer be worse than this if she did nothing?

Stomach Cancer: After Three Biopsies She Declined Medical Treatment: Where is the logic?

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DS-M906, is a 69-year-old female from Indonesia. Sometime in July 2009, DS had problems with her stomach. She consulted an internist at a private hospital in Medan. A biopsy was performed and the result indicated an adenocarcinoma, i.e. cancer of the stomach. After this examination, DS decided not to do anything. Her problem escalated and she suffered more pains.

In December 2010, DS went to see another doctor in another private hospital in Medan. A biopsy was again performed. The histopathology result indicated a moderately differentiated adenocarcinoma. Not satisfied, in January 2011, DS came to a private hospital in Penang for further consultation. A CT scan did not show any focal lung lesion. Her abdominal organs were normal. A colonoscopy showed simple haemorrhoids while the rest of the bowels were normal.  A biopsy of the pre-pyloric region was performed. The result indicated signet ring-type adenocarcinoma. There was also Helicobacter pylori associated chronic active gastritis. In short, for the third time, DS had been told that she had stomach cancer.


The doctor in Penang suggested two options – DS take medications or undergo an operation. DS declined further medical treatment and came to seek our help on 21 January 2011. Below is the video recording of our conversation.

Comments: Since DS and her children had already made the decision not to undergo any surgery, DS had no other choice but to take our herbal teas. We cautioned her to reconsider her decision to decline surgery. She was adamant that she did not want any medical treatment. One of her children said: “After surgery, she has to undergo chemotherapy. And we know that is not the thing we want to do.”

We posed this question to DS – and for that matter, to all patients. If she has already decided not to undergo surgery after a biopsy, why does she do one biopsy after another? It is understandable if only one biopsy is done – to determine what has gone wrong. But what does she expect to get by doing three biopsies?

This is one peculiarity we often notice among Indonesian patients. They come to Penang – bring all the money that they have. They spend their money on blood test, X-ray, CT scan, PET scan, biopsy, etc.  When they are told that they have cancer and need to medical treatments, some of them just pack off and go home the next day.  Is this not wasting money unnecessarily? Is there any logic in doing such thing?

This is our message to patient: Iif you don’t want to proceed with medical treatments recommended by your doctor, there is no need to do a biopsy. A biopsy is done to confirm if you have cancer, so that you can move to the next step – be it surgery, radiotherapy or chemotherapy. If you did not want to do any of these, why do a biopsy?

Again we say – before doing a biopsy, ask yourself first: If it is cancer, do I want to undergo surgery / chemotherapy / or radiotherapy? If you agree to such treatment, go ahead with the biopsy to be sure that it is really cancer. But if you do not wish to undergo further medical treatment as in the case of DS, why do you spend so much of your money doing the biopsy in the first place?

Granted – some patients say, the medical treatments are expensive and they cannot afford it. Or,  some may say they decline medical treatments because the doctors cannot guarantee a cure.  If these are your concerns, why don’t you ask the costs first or ask for a guarantee first before doing anything?

e-Therapy Helped With Her Severe Itchiness and Sleeplessness — Two Years After Stomach Surgery Without Chemotherapy

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LK (T905) is a 71-year-old female. Sometime in September 2007 she passed out blood. She consulted a doctor in a private hospital and was prescribed ulcer medication. She was on this medication for about a year. Then on 28 September 2008, LK was again admitted into the same private hospital for gastric bleeding. An OGDS (oesophago-gastric-duodeno-scopy) carried out on her on 30 September 2008 revealed a large ulcer at the pylorus of the stomach. A biopsy of the ulcer showed it to be a moderately differentiated adenocarcinoma, intestinal-type.

LK was again admitted into the same hospital on 7 October 2008. After necessary investigation and further blood transfusion, a Bilroth II partial gasterectomy was carried out on her the next day. The specimen was sent for histopathological analysis and it was reported as “moderately differentiated-type carcinoma of stomach, at least Stage 2.”

LK was referred to an oncologist for chemotherapy but she declined the treatment. On 24 October 2008, she and her family came to seek our help instead.

LK was prescribed Capsule A, Stomach1 & 2 teas, C-tea.

She was well up to this day. Since she did not come to see us personally, her case did not attract out attention. Nevertheless, her children regularly came to take herbs for her.

More than two years later, 5 December 2010, LK came to our centre again. For the past six months she had been staying with her daughter in Kuala Lumpur (KL). During her stay in KL  she developed severe itch and this deprived her of sleep every night. Her legs were weak and she had no strength to walk. This was further compounded by her long-standing backaches. She has to use a walking stick.

We immediately put LK on the e-Therapy.

Comments:

LK was asked to undergo chemotherapy after surgery of stomach cancer. She was then 71 years old. She declined the treatment.  What do you think would have happened to this elderly lady if she were to undergo the recommended chemotherapy? Would she have survived the treatment?

I searched the internet to find out about the effectiveness of chemotherapy for gastric (stomach) cancer.

First, ask this question: What is the purpose of chemotherapy after surgery? This is what one website said: This treatment may improve survival time by months and the quality of life. This statement implies that chemotherapy does not cure stomach cancer. It only improves survival time by months.

The statement also claims that it improves quality of life. Do you buy this claim? I really find it hard to swallow. This is because the same website said this: Chemotherapy given to treat stomach cancer may cause the following side effects: sunburn-like skin irritation, nausea, diarrhea, fatigue, nerve damage, low blood counts, hair loss and kidney damage. Another website had this list: skin rash, hearing problems, loss of balance, joint pain and swollen legs and feet.

According to the University of Pittsburgh Medical Centre, Pennsylvania: Chemotherapy given with radiation after surgery:

1. Increases the survival rate.

Patients undergoing 3- year survival rate
surgery + chemotherapy + radiotherapy 50%
Surgery only 41%
Benefit of chemotherapy + radiotherapy 9%

2. Increases the amount of time before recurrence.

Patients undergoing: Relapse /recurrence
surgery + chemotherapy + radiotherapy 43%
Surgery only 64%
Benefit of chemotherapy + radiotherapy 21%

Wang Qilu of the Cancer Institute & Hospital CAMS & PUMC, Beijing, China, said:  Chemotherapy has moderate efficacy for gastric cancer. Chemotherapy or combined therapy can reduce recurrence in the gastric cancer and improve patients’ survival.

Take note, no one claims that chemotherapy and / or radiotherapy after surgery can ever cure stomach cancer. In this respect, we are really glad to see LK doing fine even after two years.

For the past six months, LK developed itchiness of her skin. Besides she has difficulty moving around due to weakness of her legs. Even before her cancer she also had lumbar backache. We did not get to see LK often. In fact LK came to see us on 5 December 2010 on our request. We immediately put her on the e-therapy and within days, her conditions improved. As LK said the doctor’s medication could only helpe her temporarily – the problems recurred.