Month: October 2016

Brain Cancer – Glioblastoma

mountain-and-see

Z is a 16 plus years old girl. For the past 10 years or so, she had been having sinus problems and had been on doctor’s medication. About two months ago, August 2016, she became dizzy and had pain when moving her head. She also vomited a lot. A CT scan and MRI done showed a 35 x 30 x 30 mm enhancing mass in the region of third ventricle, at or near the left foramen of Monro.

brain-zetty-compsite

A biopsy done the next day confirmed left thalamus tumour, features consistent with a glioblastoma, WHO grade 4.

The doctor implanted a VP shunt to drain out the fluid from her brain.

According to the doctor in P Hospital, surgery is not an option. The only way out is radiotherapy. The parents were told that the treatment cannot cure her brain cancer. It may slow down the growth of the cancer but she will suffer a relapse within two years. This was not what her parent wanted. They wanted a cure.

I received a request from her family friend (who is a pharmacist) for consultation. At first Z’s father and the pharmacist came. The next day, Z’s mother and the pharmacist came. On both mornings, we discuss how to help Z. The following are my advice to them.

  1. There is no sensible way out of this situation. I don’t see anyone on earth being able to cure brain cancer.
  2. Perhaps, the family can try another doctor in another hospital. Perhaps, the surgeon there might want to suggest surgery. But this could be just a futile effort.
  3. Z’s mother said the family decided not to let Z undergo radiotherapy. They are afraid of the side effects. And they don’t see any purpose of radiation since it does offer any chance of a cure.
  4. The family wanted to try the herbs. But I made it clear to Z’s mother that herbs cannot cure her daughter’s brain cancer. Based on my experience, herbs may be able to help, and to what extend I really cannot tell or guarantee. To know more about what herbs did to our patients, click this link: https://cancercaremalaysia.com/category/brain-cancer/

I also made it clear that they should not blame us if the herbs do not help Z. Take the herbs for a week or two and at the same time take care of the diet. Let’s see what happens. If the herbs do not provide any benefit then they should consider finding other people to help.

Basic Anatomy of the Brain

The brain is divided into 3 parts:

  1. The hindbrain – which is the base of the skull consisting of brain stem and cerebellum.
  2. The midbrain – which is the small part of the brain stem that joins the hindbrain to the forebrain.
  3. The forebrain or cerebrum – which is the largest and most highly developed part of the brain and consists of two hemispheres which look like walnut kernel. In general, the left hemisphere controls the right side of the body and vice versa.

3rd-ventricle-1

3rd-ventricle-2

In a normal brain there are four ventricles (ventricle means small cavity or chamber):

  1. Two large right and left lateral ventricles, located on either side of the brain.
  2. The third and fourth ventricles are placed along the midline.

Within each ventricle is a network or blood vessels knows the choroid plexus. This is where the cerebrospinal fluid (CSF) is produced. The CSF is a clear, colourless fluid. Any change in this can indicate disease.

The CSF fills the ventricles and the surrounding space of the brain and spinal cord where it acts as a protective buffer from injury. and transports nutrients and waste.

The ventricles produce approximately glassful of CSF every day, continuously replacing it as it’s absorbed. Under normal conditions, a delicate balance exists between the amount of CSF produced and the rate at which it is absorbed.

The fluid flows from the ventricles as it bathes and cushions the brain and spinal cord.

The third ventricle is a narrow cavity that is located between the two halves of the brain. CSF flows into the third ventricle through openings in its roof called the foramen of Monroe. The two foramen of Monroe are connected to the left and right lateral ventricles above. The third ventricle is connected to the fourth ventricle below by the cerebral aqueduct (canal) of Sylvius, which passes through the midbrain.

If the channel through which this fluid flows is blocked then fluid accumulates in the brain. Hydrocephalus is a medical term that refers to an abnormal accumulation of CSF within cavities inside the brain called ventricles.

Blockage of cerebrospinal fluid (CSF)

A ventriculoperitoneal (VP) shunt is a medical device that relieves pressure on the brain caused by fluid accumulation. Patients with hydrocephalus need to undergo a surgical procedure called VP shunting. Doctors surgically place VP shunts inside one of the brain’s ventricles to divert fluid away from the brain and restore normal flow and absorption of CSF.

Cysts, tumors, or inflammation in the brain can impede the normal flow of CSF and create an unsafe accumulation.

Risks of VP Shunting

Placement of a shunt is a very safe procedure. However, complications can occur during or after the procedure. Risks associated with any surgical procedure include excessive bleeding and infection. You might also experience adverse reactions to anesthesia, such as breathing difficulties, changes in heart rate, or changes in blood pressure levels.

There are rare risks specific to VP shunting that can be serious and potentially life-threatening if left untreated, including:

  • infection in the shunt or brain.
  • blood clots
  • bleeding in the brain
  • damage to brain tissue
  • swelling of the brain
  • Fever, headache, abdominal pain, fatigue, and a spike in blood pressure levels can indicate an infection or a malfunction of the shunt.

Symptoms of brain tumour 

  1. An epileptic seizure.
  2. Muscle weakness or lack of co-ordination.
  3. Increasing drowsiness.
  4. Loss of balance.
  5. Loss of certain vision field.
  6. Headache and vomiting.

Sources:

http://www.yoursurgery.com/ProcedureDetails.cfm?Proc=44

http://www.hydroassoc.org/brain-physiology-relevant-to-hydrocephalus/

http://www.healthline.com/human-body-maps/third-ventricle

http://www.upright-health.com/third-ventricle.html

http://www.healthline.com/health/ventriculoperitoneal-shunt#Recovery4

 

 

 

Question Time: CanSurvive Workshop – 17 September 2016

qt

  1. Belief & Commitment

 

  1. His kidney function improved. Her blood pressure back to normal

3 Health is your responsibility

  1. Sharing
  1. Diet and no durian
  1. Cost of CA Care Therapy
  1. Bringing herbs overseas
  1. He married his doctor
  1. Would you go for surgery and chemotherapy again?
  1. Our experience with kidney tumour
  1. Flow with life
  1. Genetic or are you creating your own cancer?
  1. Should I go for surgery?
  1. Healing crisis
  1. Kidney failure — Go see your doctor

 

 

 

 

 

CanSurvive Workshop 17 September 2016: Sharing Our Experiences

sharing-2

The second part of the workshop was about sharing experiences. We were glad to have six panelists to come on stage to share their experiences. Here are what they said:

  1. Truth from different perspectives

 

  1. My first patient (prostate spread to bone) did well on herbs

 3. I am glad that I am still alive (NPC spread to bone)

4. I outlived my two doctors (cancer of the tonsil)

 

5. Twelve years – I am still healthy and full of energy (colon-liver cancer)

 

  1. Let me make my own decision: No chemo for me! (ovarian cancer)

 

  1. I want to be beautiful when I die. But with herbs and good diet I am still alive and healthy (breast cancer)

 

Thank you for sharing and praise God for this blessing!

 

 

 

Brain Tumour: No to Surgery

tea

Jenny (not real name) is a 35-year-old Indonesian lady from one of the islands of Riau. For about six months she had been having headache and dizziness. Om 23 May 2016, she went to a hospital in Tanjung Pinang (Indonesia) and did a CT scan. There was a tumour in her brain.

brain-tumour-yeni-singkep

The doctor suggested surgery to remove the tumour. Jenny’s family refused surgery. Jenny was sent home with the following medications:

  1. Kalium diklofenak
  2. Citicoline
  3. Lansoprazole
  4. Ramtidin
  5. Beta histinemesilate
  6. Pheytonin sodium
  7. Methylpredinsolone

Jenny’s husband came to know about CA Care and came to seek our help.

 

Our Advice

  1. It was indeed a “hard” morning, having to face such a case.
  2. From what I could guess from the pictures, the tumour in the brain is really big. And I really don’t know what to say. If you come and see me hoping to find a cure, then I must say right away that I cannot cure your wife. But if come here to find help, maybe we can help.
  3. You turned down the doctor’s suggestion of an operation. Surgery may not cure her and she may end up with more problems later. Over the years I have seen many of such pathetic results of surgery. So I would not push you to go for surgery.
  4. But on the other hand, to tell you not to go for surgery does not sound right. Anyway, you have decided not to go for surgery and I think you have made a wise decision.
  5. However, if you decide to change your mind and want to go for operation, then go to Singapore. Perhaps your chances of getting better results is higher a bit. But I know this could mean having to spend a lot of money. Husband replied: Yes, we cannot afford such treatment in Singapore.
  6. Now, we have no choice. I would take on this case with the understanding that you know beforehand that herbs cannot cure your wife’s brain cancer. Herbs may be able to help her — yes, that may be possible.
  7. I am not “plucking this kind of hope” from thin air. Over the years, I have seen that our herbs and our therapy did help brain cancer patients.

For those interested to know more, click this link: https://cancercaremalaysia.com/category/brain-cancer/

To know who brain cancer patients wrote to us, click this link. https://adaywithchristeo.wordpress.com/category/brain-cancer/

  1. So what is your decision? Husband: Please help us. We want to try your herbs.

 

Jenny was prescribed Capsule A, C, D and M besides taking Brain 1 and Brain 2 teas.

About three months later, we received an email from Jenny’s husband. This is what he wrote:

Nyeri kepala sudah mulai berkurang walaupun masih ada sedikit sedikit
Tidak muntah muntah lagi
Sudah masuk kerja walaupun tidak setiap hari
Badan sudah mulai berisi dan ada tenaga
Bicara sudah mulai lancar

Keluhan sekarang penglihatan masih agak kurang terang, masih kabur.

Jenny’s condition had improved, in spite of not undergoing the brain surgery. What is most encouraging is that her health did not deteriorate — this perhaps is the most important point to note. She is not getting worse. After taking the herbs, the frequent day long headache had subsided, she did not vomit anymore. She was able to go back and work on and off (not everyday yet). She had more energy and started to gain weight (which I think is not important! But to the Indonesians, it is important). Before the herbs Jenny had difficulty talking, fumbling to form words. And now, according to her husband, her speech is now going back to normal. Unfortunately, her blurred / double vision still persist.

In an earlier posting, https://cancercaremalaysia.com/2016/10/09/brain-cancer-operation-radiation-blind-after-two-weeks/, thirty-two-year-old Amar underwent an operation and radiotherapy for his brain cancer. Two weeks after the treatment, Amar was blind.

Jenny did not do anything invasive. She only took the bitter herbs and took care of her diet. Now she is still doing fine. Praise God for this blessing, We pray that she continues to improve with time. We cannot ask for more.

 

 

 

Brain Cancer: Operation, Radiation, Blind After Two Weeks

rice-field

Amar (not real name) is a 32-year-old Indonesia male. In April 2016, he had a seizure and vomited. He was immediately sent to the hospital in Batam. After performing an X-ray, he was given some medication and sent home. He was able to go back work.

One week later, Amar went into a coma and was sent back to the hospital again. The doctor told the family Amar had stage 4 brain cancer. He was asked to immediately undergo a brain surgery. The doctor said that was the only option left. The risk of surgery would be: Amar could suffer memory loss or he could go blind.

The operation was carried out in Batam and Amar regained consciousness. The operation cost IDR 170 million. Unfortunately the surgeon was only able to remove 70 percent of the tumour. Amar was asked to undergo chemotherapy which the family rejected.

This is what Amar’s brain looked like after the surgery.

brain-augus-batam

Amar was brought to consult two doctors in Johor Baru. One surgeon suggested that Amar should undergo another surgery to removed more of the tumour in his brain. An oncologist suggested radiotherapy. The family opted for the latter and he had 30 sessions of radiation. Radiotherapy cost the family RM 12,000.

Two week after the completion of the radiation treatment, Amar became blind. As a follow up the oncologist put Amar on oral chemotherapy. Amar had three round of chemotherapy. Then his brother decided to come to Penang to seek our help.

 

Chris: When you were asked to undergo the operation, did you ask the surgeon if he was going to be able to cure your brother?

Brother: We did not ask. We did not know else to do.

C: Actually, surgery would not cure anything! Then you went for radiotherapy. Did you ask if this was going to cure him?

B: We asked about the benefit of radiation. The doctor said radiation cannot cure, but we need to try. We want the radiation to kill the cancer cells!

C: Then the oral chemo-drug. What good will that do to your brother? Let me be very outright with you. No one can cure your brother’s cancer. For all that you have done, your brother ended up blind. You now come and see me. What do you expect me to do?

B: I want to find a cure for my brother.

C: That is impossible. There is really nothing much I can do. You may just waste your money and efforts. So go home and discuss with the family — what they really want to do.

B: The family do not know what to do. I want to try your herbs.

What if you do nothing?

do-nothing

The son and daughter of this patient came to our centre. Yes, they felt compelled to do the utmost for their father. But sometimes, it is wiser and braver not to do a thing. In this case, it would be a bad joke to believe that 5 times radiation and a biopsy would make sense. What do you hope to achieve? To say that radiation is going to kill the cancer cells or to stop the cancer from spreading is only a good selling point, nothing than that. Let’s not be naive.

Let us recall two well documented brain cancer cases in the US. Let’s see if we can learn anything from these.

  1. Senator Kennedy and glioma

Senator Kennedy was diagnosed with a malignant glioma in May 2008, after being hospitalized following a seizure. A month later, he underwent what was described as “successful” surgery at Duke University Medical Center, Durham, North Carolina, and then received both chemotherapy and radiation after returning home to Massachusetts.

Six months after the diagnosis, Senator Kennedy had returned to the Capitol and was working part-time while still continuing with treatment. However, in January 2009, he collapsed during the inaugural luncheon for the new president Barack Obama. Senator Kennedy died in August 2009 — barely one year after his diagnosis.

Source:  http://www.medscape.com/viewarticle/708105

  1. Beau Biden, US vice president’s son, died at 46 of brain cancer.

The son of Vice President Biden and former state attorney general of Delaware, died after battling brain cancer. In 2010, Beau Biden had suffered what officials described as a mild stroke. Three years later, 2013,  he was admitted to the University of Texas M. D. Anderson Cancer Center in Houston. Doctors removed a small lesion from his brain and then followed a normal course of radiation and chemotherapy. By November 2013, he had been given a clean bill of health, but after a recurrence in 2015, Biden began an aggressive treatment and was admitted to Walter Reed.  He died in May 2015.

Source:  https://www.washingtonpost.com/politics/2015/05/30/e1ac5a2a-0731-11e5-a428-c984eb077d4e_story.html

The above are outstanding “sons” of America where the best of medical treatments can be found and are available. Senator Kennedy or AG Biden would have access to the best of medical technology to combat their brain cancer. Yet, they died. What chance do we — common folks — have? Or are we  being misled and sold false hope?

Read what Dr. Tobias has got to say about surgery for brain cancer ….

6-surgery-tobias-brain-ca

See our next posting: Brain Tumour – No to Surgery.

 

 

 

After Tamoxifen, there was endometrial -endocervical polyp

recon-lady-breast

 

Laura (not real name) is a 35-year-old Indonesian lady. In May 2014, she found lumps in her right breast and armpit. She consulted a doctor in Jakarta who told her not to worry. It was not dangerous! Not satisfied, Laura went to Singapore for a second opinion.

Laura was told that she had breast cancer. In Singapore she underwent an operation to remove both her breasts, followed by breast reconstruction. The total cost of these procedures came to about SGD 50,000.

The histopathology report showed that:

  1. Nine out of twenty seven lymph nodes showed metastatic tumour, both intra and extranodal.
  2. The tumours were positive for estrogen, progesterone and c-erb-B2.

Laura underwent six cycles of chemotherapy and this was done in Jakarta while 15 sessions of radiotherapy was done Singapore.  After these treatments, Laura was put on Tamoxifen and she had been taking it up to this day.

Everything seems to go on well and Laura asked to return to Singapore every four months for routine checkup.

Someone in the United States then told Laura about CA Care. So in May 2016, Laura and her husband came to seek our help. We prescribed her some breast herbs besides telling her to take care of her diet.

Laura and her husband came back to see us again five months later, October 2016. She showed us the results of her recent blood test (29 September2016). Every parameter was within normal range except her CA 125 which was elevated to 48.1 (normal below 35.1). According to her husband this elevated reading could be because Laura did a PET scan before performing the blood test. Well, a good explanation for now!

However, what is most disturbing was that, a few days earlier, on 24 September 2016, Laura underwent an operation to remove an endometrial-endocervical polyp.

Chris: Did you ask the doctor why you have that polyp?

Laura: The doctor said it is the side effect of Tamoxifen that I am taking.

C: And you are still taking the Tamoxifen? You do not stop the Tamoxifen?

L: I am still taking Tamoxifen.

Our Advice

We reminded Laura and her husband to be aware of what she is doing! Tamoxifen had probably reared its ugly head and they don’t even realise the danger. You just need to read to be better informed.

Read what Dr. Janey wrote:

Treating cancer with a carcinogen!! Yes, you read that right … Tamoxifen is a carcinogen! I bet your doctor didn’t mention that to you?

  • Australia’s National Health and Medical Research Council (NHMRC)  stated that no amount of Tamoxifen is safe with regards to its carcinogenic effect.
  • In California, the Carcinogenic Identification Committee voted unanimously in May 1995 to add Tamoxifen to their list.
  • Health Organisationfollowed in 1996 by officially designating Tamoxifen (along with 70 other chemicals) as a human carcinogen.
  • Even the pharmaceutical company, Zeneca, who promote and sell Tamoxifen, has had to confess that it is a liver carcinogen.
  • Tamoxifen is responsible for increasing the risks of cancer in the uterus and liver.
  • In addition, cancers of the 2ndbreast as well as cancer of the gastrointestinal tract have also been associated with Tamoxifen treatment. 

You need to ask yourself if you consider it acceptable to try and suppress one cancer with a drug that puts you at risk of developing other cancers.

Read more: https://blogdrjaney.com/2016/03/11/tamoxifen-the-other-side-of-the-story/

Read also an article by Dr. Sherrill Sellman, Tamoxifen: A Major Medical Mistake? http://all-natural.com/womens-health/tamox/

4-sellman-tamoxifen-danger

Ponder seriously the following quotations:

1-babara-tamoxifen-does-not-c

2-jane-plant-no-to-tamoxifen

3-john-lee-tamoxifen-more-har

 

No More Tamoxifen for Me

heading-lady-tamoxifen

2015: Rose (not real name) is a 39-year-old Malaysian lady. She and her family came to seek our advice. Unfortunately, Rose is the third person in the family who had breast cancer. Rose’s mother had breast cancer and underwent surgery, chemo and radiotherapy. The treatments were done in Australia. She died. Then, Rose’s sister had breast cancer. After surgery she opted to take herbs and not follow her mother’s footstep. She is doing fine.

In early 2015, Rose was also diagnosed with breast cancer. She underwent a lumpectomy. This procedure was done in Australia. After the surgery, her Australian doctor put her on Tamoxifen, which is generally to be taken for 5 to 10 years. Unfortunately  after some discussion, Rose’s husband (an Australian) decided that Rose should not to take herbs — go for the Tamoxifen instead. After all, this was what the medical doctor ordered anyway.

April 2016: Rose came to our centre again. This time alone. She told us that she had been taking the Tamoxifen for a year and had decided to stop that drug. Why? She suffered the following ill effects:

  1. Hot flashes a few times a month and each episode lasted a few days.
  2. Cramps of the legs and abdomen.
  3. Nausea which came with the cramps.
  4. Whitish vaginal discharge.
  5. Forgetfulness which stressed her.

Rose also said she cannot get pregnant and she has no children yet. Also from her readings, she and her husband learned that Tamoxifen can cause another cancer — probably uterine cancer.

Chris: Did you go back to your doctor and ask what to do with the ill effects of Tamoxifen?

Rose: The doctor prescribed anti-nausea medication.

This is our advice to Rose: You and your husband will have to make the final decision whether you want to continue taking Tamoxifen or not. We would not participate in your decision.

Comments

In our book, Breast Cancer: Perspectives of Medical Science and Holistic Healing, we wrote: 

Women on Tamoxifen may suffer from the following side effects: 

  1. Hot flashes as in menopause. About 50% of women may experience this.
  2. Nausea and/or vomiting.
  3. Vaginal dryness and/or discharge.
  4. Depression and mood swings. It is still uncertain if this is directly due to Tamoxifen or other factors.
  5. Loss of energy. This is similar to loss of energy in menopause.
  6. Memory loss. There is still no clear evidence to attribute this effect directly to Tamoxifen.
  7. Difficulty to concentrate.
  8. Menstrual irregularity in pre-menopausal women.
  9. Amenorrhea or absence of menstruation in pre-menopausal women.
  10. Skin rashes.
  11. Blood clotting problems. About 1% of women on Tamoxifen may experience blood-clotting problems. So women with thromboembolic diseases should not take Tamoxifen!
  12. Blurred vision and eye damage. Six percent of women on Tamoxifen have ocular toxicity causing cataracts, abnormalities of the cornea or retina, blurred vision and also eye damage.
  13. Triggers asthma attacks on some sensitive patients.

Perhaps the above side effects, although objectionable to many women, do not pose as a deep concern or fear as the possibility of inducing more cancers in other parts of the body after a prolonged intake of Tamoxifen.

Yes, Tamoxifen can cause new cancer in your body! Watch out for the next posting.

 

 

 

 

We need to change behaviours, not write more prescriptions!

From: Reimagining primary care in an era of chronic diseases — Jeremy Lim, October 4, 2016. http://www.themalaymailonline.com/what-you-think/article/reimagining-primary-care-in-an-era-of-chronic-diseases-jeremy-lim#sthash.StJwo84s.dpuf

Doctors’ clinics can often be sterile environments where patients occupy the waiting time reading old magazines, spend mere minutes with their physicians …. Not at Iora Health, a clinic with yoga, books and cooking classes, and where patients get as much as 90 minutes of consultation time each visit.

It is one of a small but growing number of clinics around the world that is trying to do primary care differently in an age of chronic diseases — by targeting behaviours.

Iora Health, a primary care group with 34 centres across the United States, and rapidly growing, eschews the traditional clinic set-up and physician-consult-based model, offering patients a homely environment that exudes warmth, security and perhaps even a sense of family.

…. Today’s patients tend to have diseases like diabetes, heart failure and chronic lung disease, explained founder Dr Rushika Fernandopulle, a Harvard-trained physician. So what matters are behaviours that are, in turn, influenced by attitudes and beliefs.

Medicines are only one part of the treatment plan.

“Managing a chronic condition is a time-consuming and costly endeavour,” Livongo says on its website, adding that it “reduces that burden” by adopting the latest technologies and behaviour sciences insights, combined into a mixture of behavioural nudges and human coaching delivered digitally. According to founder Glenn Tullman, patients want to know just enough to live full lives despite their illnesses. He compares Livongo with modern devices such as smartphones that the average person can use with minimal or no training.

At home, Holmusk, a Singapore-incorporated health data analytics company with operations in Singapore and the US, estimates that only a third of chronic disease management success is decided by medicine. For the remaining two-thirds, success can be attributed to changes in behaviour. Using insights garnered from patient clinical and lifestyle data, Holmusk is rolling out programmes for mental health and diabetes.

In this era of chronic diseases, we need to change behaviours, not write more prescriptions.

What Iora, South Somerset, Livongo, Holmusk and other innovators are challenging us to do is to embrace a versatile, truly patient-centric health system that customises and adapts to what patients want and need to live long, healthy lives. — TODAY

* Dr Jeremy Lim is a partner in Oliver Wyman, the global consultancy and leads its Asian healthcare practice.

Breast Cancer: Go for a mastectomy!

heading-select-lady

Jane (not real name) is a 42-year-old Indonesian from Surabaya, Indonesia. About two months ago she felt a lump in her right breast. She went to consult a doctor in a private hospital in her hometown. An USG indicated a 32 x 30 x 18 mm solid mass at 10.30 o’clock of the right breast. The doctor suspected cancer which had probably spread to the lymph nodes of the arm pit. Her left breasts was normal.

A biopsy was done on 5 September 2016 and the results suggested:

  1. Infiltrating ductal carcinoma, right breast.
  2. Suspicious lymphadenopathy right axilla.

The doctor in Surabaya suggested that Jane remove her whole right breast. She decided to seek a second opinion and came to consult a doctor in one of Penang’s cancer hospital. A CT of the body was done.

Impression:

  1. There is a 5.7 x 3.2 cm enhancing lesion in right breast, suggestive of breast tumour.
  2. Right axillary lymph nodes.
  3. Uterine fibroids.

The doctor in Penang also suggested surgery to remove her breast. In early October 2016, Jane came to seek our advice.

These are what we told her this morning:

  1. The scan and the biopsy confirmed that this is malignant. The best option is to have the right breast removed.
  2. To avoid, unnecessary problems later, a mastectomy should be done — not a lumpectomy. The tumour is too big for a lumpectomy any way.
  3. In fact, Jane should not have gone to the “cancer hospital” when she first came to Penang. This cancer hospital only offers chemo or radiation to patients, besides scanning. So why incur unnecessary cost? Jane should have gone to a hospital that has doctors to do the surgery (which the “cancer hospital” does not offer).
  4. What hospital to go to and which surgeon should do the surgery? This is what Jane wanted to know. Based from the feedback of our patients, we suggested the following:
  5. Go and see Dr. Y at Z hospital. He is cheaper and can do a good job.
  6. If Jane prefer another doctor, then Dr. C from D hospital is another option. He is a breast specialist. But the cost of the procedure would be higher.
  7. Bring the USG, biopsy and CT scan to the surgeon and discuss with him what he can do to help. Make a request that the surgeon go ahead with the surgery. To save cost, ask not to undergo anymore scanning or biopsy again. Anyway, there is a lump in her breast — whether it is cancerous or not, Jane must have it removed.
  8. Based on the meeting with Jane and her doctor, she should decide which doctor or hospital is more suitable for her. If she is not happy with the doctor during the consultation, then our advice is go and find one who is more caring and compassionate. Don’t worry. There are many doctors in Penang! So make your right choice.
  9. It is better that Jane do the surgery in a hospital in Penang than in Surabaya. Costs of treatment in a Penang hospital is far cheaper than that of the hospitals in Indonesia. In addition, patients told us that Penang hospitals are cleaner and more organised.
  10. Our final advice — go and talk to the surgeon. Then make up your own mind, who and where you want to do the surgery. Even though we advised Jane to see Dr. Y and/or Dr. C we made it clear to Jane what we do not benefit from this advice. We don’t get any “referral fee” and we also do not know these doctors personally. We do this purely out of our desire to help another fellow being in need.
  11. Our “consultation fee” this morning for talking almost an hour is “zero”! God bless.

We shall give you an update if Jane comes back to see us again after her mastectomy.