Kok, 64-year-old retired accountant, was a heavy smoker. He started smoking since young. His father was a cigarette manufacturer. Sometime in June 2004, he started to cough, had chest pains and shortness of breath. His weight decreased from 53.5 kg to 48.9 kg. The doctor in the government hospital suspected he had tuberculosis (TB) and Kok was referred to the Respiratory Institute. Upon further investigation it was not a TB case.
A CT scan indicated a mass in the right upper lobe of the lung. There were also several smaller satellite lesions adjuvant to the mass. No calcification or cavitation was noted within the mass. There was no mediastinal lymphadenopathy. Two rounded hypodense lesions were noted in Segment 4 and 7 of his liver. The larger was in Segment 4 which was 1 cm in diameter. A cortical cyst was noted in the left kidney. Impression: cancer of the lung. The hypodense lesions in the liver could represent either cysts or metastases.
A radiologic-guided FNA of the lung mass, performed on 18 August 2004, confirmed diagnosis of non-small cell carcinoma of the lung. Accordingly to his medical record, Kok was subsequently treated as a lung patient with liver metastasis. The doctor told him and his son that it was a serious disease. He could go home, eat and do whatever he liked.
Kok was asked to undergo chemotherapy but he declined. He immediately sought our help on 16 October 2004, and was prescribed Capsule A + B, Liver-P, Lung Tea and LL-tea.
The following are comments noted in our record regarding his progress.
30 October 2004: Until this point in time patient is still puzzled about his diagnosis. He feels good and does not believe that he has lung cancer. So, why must he go for chemotherapy? He is not going for chemotherapy and prefers to take herbs.
1 November 2004: Patient and daughter came to replenish his herbal supply. He goes for qi gongevery morning. Friends advised him to undergo chemotherapy saying that he was lucky that the doctor gave him this chance to undergo this treatment. They argued: Why turn it down?
18 November 2004: Patient made his final decision not to undergo chemotherapy. This decision was made after a discussion with his children.
12 January 2005: Patient feels normal. He can eat and sleep well. He has less cough.
28 October 2005: Patient feels alright. Doing qi gong daily. He drops off to sleep very easily.
19 November 2005: Good appetite but not putting on weight.
4 August 2007: Patient has been coughing for the past one week. He started to have productive coughs with thick, dark yellowish phlegm, after eating oranges. Patient feels a bit breathless after slight exercise.
22 August 2007: Less coughs after taking Cough No: 3. Occasionally, patient still has cough with blood stained phlegm. Patient complained of difficulty in passing urine. The doctor had prescribed drugs for BHP (Benign Prostatic Hyperplasia or enlarged prostate) . We suggested that he takes Prostate A and B teas instead of the drugs. Patient and his daughter decided to take doctor’s medication because he felt he is taking enough herbs for his lung and liver.
28 November 2007: Patient occasionally had breathing difficulties. Doctor said his problem is serious and prescribed more medication: (1) Liquid morphine (2) Tramal (3) Ventolin (4) Benadyl syrup (5) Voltran.
11 December 2007: Patient was coughing out blood for the past one month but he was alright after the doctor’s medication. However, patient still has shortness of breath when he exerts himself. For example when climbing the stairs. We suggest that he use oxygen to help in his breathing.
15 January 2008: We visited Kok in his home. The main reason for this visit was to find out what had actually gone wrong. We wanted to find out what had triggered the downturn of his health. The following are excerpts of our hour-long conversation.
Question: How old are you now?
Q: How long have you been smoking?
A: Forty or fifty years. I smoked a lot, nearly two packets a day. My father was a cigarette manufacturer.
Q: Did your father smoke?
A: He smoked a pipe, the bamboo type – with water inside. He did not have any lung problems. He died of heart problems.
Q: When were you diagnosed with lung cancer?
A: In 2004.
Q: What were the symptoms?
A: I had chest pain, coughs but no blood. I was referred to the TB centre. After checking, it was confirmed that it was not TB. Then we went to the GH. The X-ray showed lung cancer. They asked me to go for chemo.
Q: Did you go for the chemo?
Q: Why not?
A: I came home and discussed with my children. Considering my age, I may not be able to withstand the chemo. My daughter’s friend had some problems with her arm. After taking your herbs, she got better. So, my children (five of them) decided that I should take your herbs. I myself also do not want to go for chemo.
Q: Why? Why don’t you want to go for chemo? Do you know anything about chemo?
A: I know. I was afraid I cannot withstand it. I had friends who went for chemo. After that . . . . pfoooh! (waving hand to show flying away!). When I was first diagnosed with lung cancer, it was a very bad case. The doctor told my son to let me eat whatever I like and go where ever I want to go. Let me enjoy life. I was not going to last. When he told my son, I was also there. I heard what he said. My son was very angry.
Q: How did you feel after such a comment?
A: I told my son, Forget about it! My son was very angry with the doctor. How can the doctor say things like that? I was also angry.
Q: Did the anger last very long? Could you sleep when you come home?
A: Caaannnnn. I know this – there is no cure for cancer. Everybody knows that.
Q: When the doctor asked you to do chemo, did he say you will be cured?
A: I asked him that. He said no guarantee. So, what for I go for chemo?
Q: When did you start taking the herbs?
A: October 2004, immediately after the diagnosis. I believe in your herbs. That is why I take them for so many years now.
Q: When you first came, you had pain and were coughing. Did these problems go away after taking the herbs?
A: Slowly, slowly, I got better and better – after about a few months. My qi gong friends were also surprised. The doctors at the general hospital (GH) were also surprised. I went back to GH for check up every three or four months. The doctors asked me to continue taking your herbs.
Q: What happened to the chest pain?
A: No more. Everything went back to normal. My appetite was good. I could sleep well too. I also put on weight. I felt good.
Q: During the three years when you were okay, did you take care of your food?
A: Yes. I did not take banana, nor drink milk. I only took vegetables and fish. I followed the good diet. I also did qi gong – about two hours every morning. I think qi gong helped me a lot.
Current Health Condition
Q: Please tell us how you are feeling now.
A: I am not feeling good. Breathing is a problem. I’m short of breath. I cannot walk, even slowly. I cannot go upstairs. The problem is becoming worse.
Q: What about pain?
A: No, no pain.
Q: Did they say they want to do anything for you?
A: They asked me to go for chemotherapy again.
Q: Did they give you any medication?
A: Yes, medication for asthma. (Note: The patient is currently taking these medications – prescribed by the doctor – Cardura (Doxazosin mesylate), Ranitidine, Chondrotin sulphate, Glucosamine sulphate and Celebrex)
Q: When you take these medicines, do you feel better?
A: Not really better. A little bit okay. Before and after taking these, my breathing is almost the same. I have breathing difficulty throughout the day – unless I am sleeping. Actually my condition is bad now.
I started having this problem only around October, 2007. I cannot do qi gong now because I have difficulty breathing. Even walking is very difficult. I became breathless when I climb the stairs or walk a bit more. When I don’t move, I feel better. I am getting worse!
Drug Side Effects?
Q: For how long have you been having these breathing problems?
A: Already two months.
Q: Before that?
A: I was okay.
Q: (Baffled) Why? A few months before October, 2007, did you do anything different or not?
A: I had an operation in April, 2007 for my hernia problem. It was growing bigger.
Q: What did the doctor do?
A: The doctor did an operation, and put some kind of a net (?). The net is still there.
Q: On discharge, were you given any medication?
Q: Did you have breathing problems after your operation?
A: No. There were no problems.
Q: After the operation, were you okay?
A: Okay. But not too long after that, I could not urinate. Then they started to give me some medications.
Q: When you had difficulty urinating, they gave you these medicines?
A: Yes. (Cardura, Ranitidine, Chondrotin sulphate, Glucosamine sulphate and Celebrex).
Q: How long did you take these medications before you started having breathing difficulty?
A: Over a period of about three months, my breathing became worse.
Discontinuation of the Doctor’s Medication
Suspecting that Kok’s problems were due to the side effects of the drugs prescribed by the doctor the family decided to stop taking them. The following happened:
- e-mail 24 January 2008: My mother said ever since he stop taking the Cardura, his breathing is better.
- e-mail 14 February 2008: During Chinese New Year, I monitored him for two days. His breathlessness is better, but it seems once a while it will strike. And he cannot stand for too long, get tired easily. Cough is better. Yesterday I saw my Dad for about four hours, he did not cough. He has no complaints about the urination. Still having leg pain, especially at night.
Kok died in the early morning of 24 March 2008, three and a half years after being diagnosed with metastatic lung-liver cancer.
In spite of being told – Go home, do and eat what you like – because he had terminal lung-liver disease, Kok managed to live a good life without any chemotherapy or radiotherapy. He only relied on herbs. Did he die because the tumour in his lung grew bigger and kill him? The answer is No. Did he die because of his liver metastases? The answer is also No. He died because of breathlessness.
You do not have to be a doctor to know what has gone wrong. Just use your common sense and ask these questions:
1. Before Kok took the prescribed drugs, did he have any breathing problems?
2. After Kok was off the drugs, did the breathing problems improve?
Of course you cannot expect the side effects to go away immediately.
One lesson to learn from this episode. Check first with those who know or surf the internet, about the side effects of the drugs before swallowing them. For example in this case, I obtained the following information from the internet. With the information below, let me leave you to speculate the real cause of Kok’s breathlessness.
Documented Side Effects of Cardura
Cardura is a drug used to treat benign prostate enlargement or high blood pressure.
The more common side effects of Cardura may include: Dizziness or light-headedness, drowsiness or sleepiness, fatigue, headache, low blood pressure, lower blood counts. http://www.drugs.com/pdr/cardura.html
Seek emergency medical attention or notify your doctor immediately if you suffer the an allergic reaction such as difficulty breathing; shortness of breath or chest pain; weakness, fatigue, or feeling of not being well; an increased heartbeat; joint or muscle aches; etc.http://health.yahoo.com/bloodpressure-medications/doxazosin/healthwise–d00726a1.html
Caution should be used when administering CARDURA XL to patients with preexisting … mild or moderate hepatic dysfunction. Use in patients with severe hepatic impairment is not recommended. http://www.carduraxl.com/content/prof_Safety.jsp
Documented Side Effects of Ranitidine
Ranitidine is a histamine receptor antagonists. It is used to treat and prevent ulcers in the stomach and intestines and gastroesophageal reflux disease (GERD).
Among the side effects of Ranitidine are: chest pain, fever, feeling short of breath, coughing up green or yellow mucus; unusual weakness; joint and/or muscle pains, bronchospasm and pneumonia,etc.
Important information about ranitidine: Using ranitidine may increase your risk of developing pneumonia. Symptoms of pneumonia include chest pain, fever, feeling short of breath, and coughing up green or yellow mucus. http://www.drugs.com/ranitidine.html Stop using ranitidine if you have any of these signs like difficulty breathing.