Breast Lump: Two Experts, Two Different Opinions – you like that?

Pet (not real name, H621) is a 42-year-old female. Sometime in early 2011 she felt a lump in her right breast. She did not see a doctor until May 2011. An ultrasound on 24 May 2011 showed:

  • An irregular hypoechoic mass at 12 o’clock position of her right breast. The size is 4.4 x 3.0 cm. The margin is irregular.
  • Another  three hypoechoic nodules noted at 8 and 10 o’clock position of right breast and behind the nipple (0.5 x 0.7 cm, 0.5 x 0.5 cm and 1.7 x 1.8 cm)
  • A right axillary node is also seen, 0.9 x 0.8 cm.

Impression: Findings in keeping with Ca breast.

Trucut biopsy was performed. The histopathology report indicated: Invasive ductal carcinoma, NOS; grade 3.

Pet met a surgeon of a private hospital who told her that she needed a mastectomy. However, before surgery, she has to undergo chemotherapy first. This is to shrink the tumour. She may need 2 cycles of chemo or more, depending on the outcome.

Not satisfied, Pet went to see a breast surgeon at a government hospital. She was told there is no need for chemo. The surgery can be done right away.  Confused?

Pet came to see us on 3 June 2011. Watch this video and listen to our interesting conversation.

Comments

It is hard enough to be told that you have cancer – that applies to everybody! Then, you have the high hope that the experts know how to cure you. You met the surgeon. Oh, he said, the lump was too big. Go for chemo first. So there you are having to shuttle to the oncologist. The oncologist said you might need two cycles of chemo to shrink the lump. But you may need more. It all depends.

You wondered aloud, even if you had surgery or chemo, the cancer may come back again?  You make known this concern to your oncologist, hoping to get some reassurance. Imagine the answer he gave you – Do you have any disease that medicine can cure you?  Then he equated that with diseases like diabetes or hypertension. See, there is no cure. Instead you will get hooked to the drugs until you die! But you may wonder, is the analogy correct or logical? Is it logical to believe that you will need to depend on chemo all your life? Chemo drugs are toxic – they night just kill you after a while unlike the diabetes or hypertension pills.

Not satisfied with the first surgeon and the oncologist, you decided to seek a second opinion. Indeed a correct thing to do, so they say. So you went to see a breast surgeon – after all, a breast specialist is supposed to know more than other experts about the breast. Furthermore he is from a government hospital. In your mind, you tend to trust doctors in government hospitals than those in the private hospitals. You know la, these days.  At least those in the government  are there not for money – rather, as a national service to the country.

To your surprise, this breast expert said there is no need to do chemo first. Go straight for surgery! Now, you are at the cross road – another confusion in your mind.  How is that, two experts tell you two different stories. Who is right? Who is a better expert then? Whom to listen to now? They say, medicine is based on scientific fact – but in this case, one expert must have got his fact mixed up! Both experts cannot be right in trying to solve your “simple” problem. Or is it truly simple?

Since both doctors say different things, why not turn to a “quack” – the non-medical doctor and let’s see if he can pull out another trick. So, there it is – you went to CA Care and met with a Dr. Chris, a Ph.D. not a M.D. You had a chat with him. You were confident and hoping that he would say – No surgery, just take herbs and you shall be well. But you were disappointed. He wanted you to have your breast cut off as well – like those two doctors. The only consolation is that after surgery, you could see him again if you decided not to undergo chemotherapy or radiotherapy.

In your discussion with him you also learned that doctors are basically disease- and drug-orientated. The job of the surgeon is to cut. The job of the oncologist is to chemo. They have nothing else to offer more than that. You will be left on your own to fend for yourself after you leave the hospital.  This is like what Barry Boyd, M.D., wrote in his book, The cancer recovery plan, “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.”

Of course, you are told: “There is nothing else to do. Go home and do what you want to do. Eat what you want to eat.” You just did exactly that – followed what the experts told you. And if the cancer comes back again, there is nothing to worry. Go back to the hospital again. You can go through the entire procedures again – the devastating regimen you did before. There is still hope –  that’s the saving grace!

Perhaps that is why you don’t get well? Do they ever teach you how to get well? Do they teach you how to increase your odds against recurrence of the cancer? No, only the “quacks” in the alternative medicine do that.  You may now wonder – are those in the alternatives really “quacks”? Who are the real quacks in this case?

In this video, Pet was trying to understand or defend her doctor – to be fair, we cannot blame the doctors if they are not sure if they can cure your cancer or not, in spite of the chemo.  After all everything depends on the patients themselves. Yes, exactly, that is true but such thinking is not scientific! When experimenting with the chemo drug to see how effective it is, factors like diet, lifestyle, personality, lifestyle, etc., do not count. They are not supposed to exist. You get cured by that drug – nothing else count. So to say that it all depends on the patients whether you get cured or not is “scientifically flawed” thinking. And in CA Care,  it is this flawed thinking that is important and must not be ignored!

Two questions are always in the minds of most cancer patients. One, is the chemo doing going to be effective? Two, will the cancer come back again after the surgery, chemo or radiation? Every cancer patient is seeking for a cure. Unfortunately, scientific medicine cannot give you any definitive answer to these all-important questions. One renowned oncologist of Singapore put it this way: “Oncology is not like other medical specialties where doing well is the norm. In oncology, even prolong a patient’s life for three months to a year is considered an achievement. Achieving a cure is like striking a jackpot. Not all cancers can be cured.”

We wonder, how many newly diagnosed cancer patients have gone through such a dilemma. If that is the situation you are in, take comfort, you are not the only one feeling lost, disappointed, frustrated or helpless. Many are just like you too.

Penelope Williams, a Canadian breast cancer survivor, was diagnosed with breast cancer in late 1988. She had surgery, chemotherapy and radiation – a treatment referred to as “slash, poison and burn”.  In her book, New Cancer Therapies – the patient’s dilemma, she wrote in detail the issues facing a cancer patient after being diagnosed with cancer.

She reasoned, “There had to be a better way. Why, in these days of modern medicine, was the treatment for cancer almost as bad as the disease?”

In spite of all these treatments which they claim to be scientific, “there is no certainty of a cure for cancer, the specter of recurrence is always lurking.”

Surgery “is invasive, disfiguring, often unnecessary, and rarely gets all the cancer despite the frequent claim by the surgeon that “we got it all”; according to some, surgery actually encourages the proliferation of cancer cells.”

Chemotherapy “ Is the cornerstone of modern cancer therapy… it kills  more patients than it cures, is useless for many cancers, causes secondary cancers, and is so toxic it destroys the immune system, leaving  the body susceptible to other diseases, including new cancers. To find a chemical that will make cancer disappear and leave normal tissues unharmed would be like finding a drug that you can take by mouth that will make one ear disappear and not the other.”

“Radiation therapy was at best an inexact science, at worst, highly dangerous to patients. Fifty years later, this observation still applies. Even in low doses, it can cause cancer and is highly invasive, painful and disfiguring. It can only be successful in curing cancer in dosages so high as to kill the patient. It damages body organs and tissues and actually increases death rates when used as adjuvant treatment for such diseases as breast cancer.”

“For many people, the anguished struggle to sort out treatment options comes down to a decision whether to go with the heart or the mind.  Ultimately, it must be your call because it is your body and your mind that are in danger of becoming the casualties, not of cancer, but of the cancer wars. So what to do? How to choose? “

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