Dissecting Chemotherapy Part 1: Knowledge Empowers

Patients face one well known hazard (but some call that treatment) after being diagnosed with cancer. More often than not they are asked to undergo chemotherapy. The drugs used are cytotoxic. Everyone knows that and that fact cannot be denied – chemo-drugs are toxic to both the good and bad cells.

In fact, chemotherapy has earned a bad reputation among patients. Those who know what chemo is would think a “million times” before they go for chemo (see: Why patients refused to undergo chemotherapy).

Over the years working with cancer patients, I came across many ways how chemo is being “sold” to patients. They are told either one of the following:

a)     You do chemo to kill all the cancer cells. What is not being told is that chemo also kills good healthy cells in the body. Chemo may even damage the vital organs of the body. Even worse, some chemo drugs themselves are carcinogenic, that is to say it causes cancer. Similarly, radiation causes cancer. In short, if patients get to live long enough, they may get a new cancer and this time it could be due to the treatment.

b)   You do chemo to stop the cancer cells from spreading. This is good sales pitch and very attractive indeed. Many patients “buy” this naïve idea. However, after chemo, the body’s immune system is almost wiped out. Your body is so weak that it cannot even ward off germs attacking you. Generally cancer has already spread after it being in your body for a while – before you even know it or it being diagnosed by the doctors. True some cancer cells can be killed but some will remain in the blood stream unharmed – they are the “dormant” or “stem”cells. These survivors will one day wake up and cause problems.

Indeed, it is encouraging to see the lump shrinks after chemotherapy – but this does not mean the cancer is cured! Often shrinkage is only temporary. The tumour often grows back again and this time more aggressively. One lady wrote that she did not get any cure from chemotherapy, she just moved from treatment to treatment! So where is the control of spreading?

c)     You do chemo as an “assurance.” Since cancer cells may be floating around in the blood stream – it is good to get them early! Kill them before they multiply.  Well, don’t we know that some chemo drugs and radiation can cause cancer? Don’t we know that these treatments can weaken the immune system and make the body much more vulnerable to enemy invasion? Is “assurance” not achieved by making the body system stronger and not weaker? Is it not better to boost up the immune system through healthy diet and lifestyle? Oh, NO – that is not proven or scientific, so they say!

Knowledge Is Empowering!

Julian Whitaker, a medical doctor, wrote: I am convinced that the best protection against the evil that lurks among us – and make no mistake that it lurks among us – is information.

There is no doubt at all that having access to knowledge is most empowering indeed. I always like to tell patients over and over again – please read and read, if you can, that is if you are not buta huruf  (in Malay for blind to printed words). Know that this is the only way to protect yourself from danger!

The problem is most people still don’t want to do anything with the knowledge that’s available to them. Either they are too busy and have no time for themselves or they would rather accept “canned” answers from the experts – yes, they trust the experts.

Unfortunately they never realize that some of the answers given by experts could be just “empty platitude” and some may even be self-serving. Dr. Chesnut called that “lying with authority” (the title of his book).

I cannot blame the uneducated patients – forgive them for their ignorance – because they can’t read. But if you are able to read this message, then there is no excuse for you to be ignorant. I would say – serve you right if you still fall in the hazardous trap. From the tone of this sentence, you perhaps know that I am very upset with lazy people who just want information to be served on a silver platter.

Let’s Get Serious

According to the World Health Organization, 7.1 million people died of cancer each year. That works out to 591,666 deaths each month or 19,722 deaths a day due to cancer. Every minute of the day, about 14 people die of cancer in this world. I always tell patients this: We all have to die – irrespective of whether we have cancer or not. I too, even without cancer, can die any time. The important thing is: how we die. Let us pray that while we are alive, we live a happy, pain-free life. When the time for us to go, let’s pray that we go peacefully.

Think hard – in cancer, do we die because there are not enough oncologists around, not enough hospital to go to, and not enough chemo-drugs to treat us? To fight cancer and win, do you think we need to build more hospitals, to have more oncologists, to make chemo-drugs more easily and readily available to patients? Is this the way to help cancer patients find their “cure”?

I have written these words before (and more than once), and I am writing this again.  In the name of fairness, I feel that anyone who is to undergo any invasive treatment procedures MUST be provided with sufficient and honest information so that he would be able to decide for himself what is best for him. Unfortunately, many people who came to see us were ignorant or very much unaware of what they were going in for – the cards were not laid out for them. Sometimes they were even misinformed.

Without any disrespect to any person or profession, I have to point out that one much needed step that has to be taken is to seek the truth about the current treatments of cancer. Let us study all the records available and let us ask these questions and find honest, unbiased answers. For all the surgery, chemotherapy, radiotherapy (and other drugs) that have been administered to patients:

1   How many patients have been cured?

2   How many have benefited from the treatments?

3   What are the benefits and at what cost?

4   How many died?

5   How many survived after one, two, three, five or ten years after the treatments?

6   How many had metastases of the liver, bone, lungs, etc.?

7    Is there any correlation between the treatments they received and the metastases that occurred?

Unfortunately, such answers remain elusive and not forthcoming. Know that the strategy to remain in this lucrative business is to be as non-committal with the real facts. Be as vague and ambiguous as possible in addition to putting up a false front of “I-know-all” image. You patients, don’t ask too many questions. I am the one who know best and you just follow my orders.

Ask your doctors these questions:

  1. What is the contribution of chemotherapy to my cancer cure? Can the chemo you want to give me cure me or not?
  2. What is the chance of me getting a cure?
  3. If it does not cure, what is the chemo supposed to do? Give you a better quality of life? Stop it from spreading?
  4. If it is quality of life – is it not true that chemo makes life “miserable” with all those side effects? Ask what these side effects are.
  5. If chemo is to stop cancer from spreading – is it not true that cancer has already spread before you are even diagnosed with it? Is it not true that by the time you know you get cancer, the cells have already moved out of the tumour and spilled into the blood stream? If the cancer cells are already in your blood stream, can chemo-drug kill ALL of them without killing you too?
  6. If you get these kind of answers:
  • Oh, you have a 50:50 chance! Ask what do you mean by chance? Chance of what – curing or dying?
  • If you don’t go for chemotherapy you get three months, with chemo it is two years. What is the basis of this predication? It is written anywhere in medical journals or text books?

Don’t be afraid to ask even if this is done at the risk that you may get chased out of your doctor’s office (some patients told me that happened to them). It is better to get chased out of his office then to get chased out of this world!

If you seek an easy, ready-made canned-answer, you get an easy and lousy answer. If you are the kind who is seeking for the “instant-noodle” type of answer then you will be disappointed.

In life, I always believe that anything good never come easy. Do you want to know what is the contribution or exact role of chemotherapy to your cancer cure? If you want to know the truth, let me take you on a journey to find that answer. I shall be writing a series of articles under this heading:  Dissecting Chemotherapy. It you take time to follow all the articles I shall be writing, I believe you can learn something substantial and come out more enlightened.

By writing these articles, let me say this clearly and plainly: I am not anti-chemo or anti-doctor. The reason I do this is to empower patients so that you know some facts that can help you make informed (hopefully also wise) decision.  I wish to say too that at times, I did (and do, and will) urge patients to go for chemotherapy if the situation warrants it. But I am skeptical about a cook-book-style of package deal or one-size-fit-all approach.