Corinna is a 51-year-old Singaporean lady banker. On 5 May 2012 she was diagnosed with cancer of the pancreas. From the pancreatic tail the cancer has also spread to her liver and also the posterior aspect of her stomach. Her blood test results on 6 May 2012 are as below.
|Alkaline Phosphatase||168 H|
|CA 125||2172.7 H|
|CA 19.9||48660.7 H|
The surgeon who did the biopsy told Corinna that medical treatment would not be able to cure her. Nevertheless she was asked to seek further opinion from an oncologist.
Listen to what Corinna told us about her experience with her oncologist.
Acknowledgement: Thank you for your permission to share this story without having to hide your real identity.
Chris: You went to see the oncologist. What did he do?
Corinna: He said, “Oh, you stay in Sea View. What are you working as? I am a forex trader (in a bank). Do you buy health insurance? Yes, I did.
C: What has all these got to do …?
Husband: That is the Singapore way of thinking.
Sister: He talked nonsense. He called me and my (other) sister “ke-po” (busybody). Five of us went to see him. There were Corinna, husband and daughter. He said, “What about these two “ke-po.” He referred to me and my other sister as ke-pos. So angry!
C: You know, when you come and see me, I would want you to bring along all your whole family members. This is because I want to explain to everybody. You (the patient) will not be able to understand me – as far as your head is concerned it is all blank! Someone else around you is the one who will be able to pick up what I say. You (patient) listen to me but nothing gets into your head. So bringing others along is not “ke-po”.
Cor: He asked me to lie down. Checked here and checked there. He saw the scans. He put on his computer and showed four patients. One was a miracle case – he survived 6 years with no sign of cancer coming back. He said there are 3 types of people that he treated. The one type is completely cured. The second type is in remission and the third type is just wasting his time. He is suggesting that I am type that is wasting his time. He said, “I can’t cure you.” But he asked me to go back and think and decide. He then said, “I can start you on chemo. Chemo is every week, for 8 times. (My husband) asked about the side effects. He replied, “Nothing.”
H: He said to us, “If you go for chemo, you must eat a lot of meat. And we will be generous with the painkiller.
C: Why did he ask you to take a lot of meat?
S: Because to build up the strength.
Cor: I was a bit shocked.
C: Why were shocked?
Cor: Because he said there is no more cure of me. Second, they way he talked to me, more or less indicated that I am the one who is wasting his time.
C: Ya, there is no cure. It is fair to say that. You have been told this earlier (by the surgeon who did the biopsy). But the point is, the impression he gave to you was that …
Cor: I am wasting his time.
C: But he has already collected SGD700 from you anyway! You are wasting my time if you don’t pay me anything and I sit down the whole day talking to you! (Now, I know how much I have missed out every day! For whole day and whole night I talk for free!). So, all these took up 10 to15 minutes already and the results were that: He cannot cure you. Go eat a lot of meat, and I f you are in pain take a lot of painkiller. If you think that you want to do chemo – you can come back and the bank will pay for you.
C: Were you happy after seeing him?
Cor: No, I was totally lost. He said there is no cure for me. I know there is no cure but at least I may be able to extend my life a bit longer.
C: When you went to see him you were full of hope?
C: When you came out of his office, zero hope? Why in the first place did you go and see him?
Cor: My staff said he was good and told me that she knows his wife very well.
C: What difference does it make if she knows the wife very well?
Cor: I thought he was the best oncologist …
Si: If I can understand Corinna here. He is famous … bla, bla. So Corinna thought that it is better for her to go and see him first. She didn’t know what was going on. She was lost. At least she could find some hope.
C: You were full of hope but you end up with nothing after meeting him. Do you want to go and see another oncologist?
Cor: I am very confused.
C: Fair enough. You have seen an oncologist. You now know what he can do for you. Let me ask you – what is in your mind now? What is it that you want?
Cor: To be able to extend my life a bit longer.
If you only have 10 to 15 minutes with your oncologist – and have to pay SGD 700 for that – you probably need to be more organized before meeting him – so as to get the most of his valuable time. Unfortunately, what you want from your oncologist differ greatly from what your oncologist wants from you! In that precious 15 minutes that you have with him, I can see a clash of interest and concern!
As a desperate person, you go to your doctor to find “hope” and encouragement. You want to know what he is going to do to help you. These are questions you need to ask your oncologist: Can you cure me with your treatment? What are the chances of success (what ever that means!)? What are the side effects of the proposed treatment? How much would all these cost? You don’t have to ask the last question if you are loaded! See if he can answer these questions to your satisfaction. Take time to evaluate what he said – there is no rush into doing something that you may regret later. From the way I see it, it would take more than 15 minutes for a compassionate doctor to answer these important concerns that you have!
I believe it is important that the facts are stated clearly and truthfully. Call a spade a spade. If there is no cure, admit that there is no cure. But present this reality with compassion!
Patients go to their doctors wanting only to hear the good news – any else never get into their heads. It is therefore important that you bring along your friends or concerned family members who can help take note of what the oncologist is saying to you. Often as patients, you only hear what you want to hear! So, who tagged along with patients are not “busy bodies” – far from it doc! They go there out of love and concern for their loved one who is sick.
But the oncologist is not interested in your concerns. His initial queries are – where you live, where you work or do you have a health insurance to take care of his hefty bills. Some patients told me some really sad stories. One lady was told by her oncologist, “Ask your husband to go and rob the bank, if you don’t have the money to pay me.” A son of a patient was told, “Go home and sell your house and come back and pay me.” Sadly, these patients have been undergoing chemo after chemo without success. In spite of that they are asked to do more chemos.
Without hesitation most oncologists that you consult with tell you to go for chemo. But does that cure? That is not their main concern! Does it hurt? Not much – that is what most will tell you. And they assure you that lots of pain killer will be able to take care of that problem.
What is going to happen to you after the chemo? Well, do first and find out later! There is no need to downplay the side effects of chemotherapy. Undergoing chemo is not like going on a honeymoon trip. The devastating side effects are real and can even kill.
Diet is the most “frustrating” topic when it comes to cancer. Your oncologist tells you to eat anything you like – food has nothing to do with your cancer! You believe that? At CA Care we tell you to take care of your diet! Click this link to see the many articles that we are written of this subject: http://ejtcm.com/category/dietnutrition/ Decide for yourself what you want to do with yourself!
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