Cervical cancer is one of the most common cancers that affect the female reproductive organs. It occurs at the cervix – the lower part of the uterus that opens into the vagina. About 11,000 women in the United States are diagnosed with cervical cancer each year and nearly 4,000 (or 36.4%) die from it. Worldwide it is estimated that there are 473,000 cases of cervical cancer each year and 253,500 women (or 53.6%) die from the disease. This makes cervical cancer the number-one cause of cancer-related deaths among women in the developing countries of the world.
In order to detect this type of cancer early, women are asked to take a Pap test regularly. The rationale is that cervical cancer can often be cured if found and treated at its early stage. How true is this statement?
An Tee (not real name) was fifty-five years old when she was diagnosed with cervical cancer. This was in 1996. Fortunately for her, the cancer was at its early stage. Her doctor felt surgery and radiotherapy were adequate to deal with her problem. An Tee underwent to remove the cancer and this was followed by twelve external-radiation treatments. In addition, she received internal-radiation treatment. The latter involved an exposure of radiation-tube implanted in the vagina. An Tee was kept isolated in the hospital for two days while receiving this treatment.
An Tee was asked to visit her doctor every six months for routine check up. Everything was alright. And life went on as usual. Ten years after this “apparent cure” An Tee started to cough since 2005 (i.e., about three years before this relapse). However, her doctor did not consider anything amiss and she was told everything was alright.
In August 2006, i.e., twelve years after her diagnosis, An Tee was told that her kidney was not functioning well. A MAG-3 Lasix Renogram was performed. The results showed that An Tee’s left kidney had normal function but her right kidney was hydronephrotic with reduced size and function and was significantly obstructed. Essentially there was only minimal (ten percent) right renal function.
A CT scan of the chest indicated both lungs were studded with numerous nodular lesions of varying sizes measuring 5 mm to 25 mm. A dominant 3 cm nodule was seen in the right lower lobe. There were also multiple small mediastinal lymphadenopathies in the aorto-pulmonary window and pre-aortic region. In short, the CT scan revealed An Tee had extensive lung nodules in both her lungs that had also spread to the adjacent lymph nodes.
A biopsy was performed resulting in bleeding and An Tee’s stay in the hospital had to be extended. The histology results showed the lung parenchyma was infiltrated by malignant cells. The pathologist concluded that it was a moderately differentiated adenocarcinoma – representing perhaps a metastasis or TB.
An Tee was asked to undergo chemotherapy. She and her entire family refused and opted for herbs instead.
- From the internet, I learned that lung metastasis due to cervical cancer occur in less than five percent of patients at presentation, 20 to 30 percent at autopsy. This metastatic cancer is staged as 4B – a serious condition indeed.
- It is also said that women who survive cervical cancer face a higher risk for developing other cancers in the days ahead. This is even more so in survivors who had been treated with radiotherapy. In this case, besides serious lung metastasis, An Tee’s right kidney had failed – a side effect of radiotherapy done many years ago.
- This case once again demonstrated what we at CA Care have been telling patients: Don’t be complacent. Cancer may recur anytime. Always be on the watch. Listen carefully to what your body is telling you.
- In this case, An Tee had been having chronic coughs for the past three years before a CT scan was done. In spite of consulting her doctors every now and then, none of her doctors ever had the “fore sight” to examine her chest! Perhaps many around her were “blinded”, believing that since she had survived five years, she was “cured” of her cancer. There is no scientific basis for this erred perception. The number “five” is an arbitrary figure. So being able to live past five years does not mean the cancer is gone forever. Patients must not be misled by this untruth.
- Dr. David Johnson, deputy director of Vanderbilt-Ingram Cancer Center thinks that: “The five-year benchmark becomes a balm for doctors or patients who find the unpredictability of their situation intolerable. Physicians are reluctant to say cancer might recur, so they would rather us these terms like – OK, in five years you’ll be cure.”
- This case highlighted another inadequacy of cancer medical treatment, as articulated by Dr. Barry Boyd, director of Integrative Oncology program, Greenwich Hospital, Yale Cancer Center:“Many doctors don’t bother to counsel their patients after treatment. Once cancer treatment is completed, most patients are left on their own to cope with the rest of their lives. This is what I call falling off the cliff. Patients are left in free fall.” Dr. Boyd went on to say that: “In addition to the best medical care possible, nutrition, exercise and stress reductions are absolutely necessary to make your cancer treatment more effective and prevent cancer’s return.”
- An Tee had been on the herbs for the past 9 months. Then at about 7.30 a.m., 15 June 2009, our phone rang. We were told An Tee had just expired. The only daughter in my grandfather’s family was lost to cancer. In spite of this loss, we were glad that at the end, An Tee did not suffer any pains. At the later stage of her illness, An Tee became breathless and she had to use oxygen mask to help her breathe better. That was about the only discomfort she had.
- I flew home to be with An Tee’s family during this time of grief. Her face looked sweet and natural. This image remained imprinted in my mind. Above all, everyone in the family remained grateful that she died without any pain or suffering, that is so typical of many cancer deaths. When her time came, she took two deep intake of air that morning and she passed off.