Rectal Cancer: What to do next? Oncologist said he has not come across any research report that links diet to cancer.

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WL is  35 year old Malaysia male. On 25 September 2015, he sent us an e-mail as below:

Hi Dr Chris,
My name is WL. I have worked in Penang for the past 12 years. Recently I have took  up a job in China and I have been there for about a month. Last week I went back to Malaysia and I went to see doctor in Ipoh because I found blood in my stool. Also it’s not easy for me to pass motion.

Initially, I thought it could be my piles which I’m having for more than 10 years back. During that time the doc asked me to leave it since it was not serious. When I got back to see the same doctor last week, he felt something was not right. He asked me to do an endoscopy.

Unfortunately, the report said, “moderately differentiated adenocarcinoma”.

I am going back to Penang next Wednesday (9/28) to get more opinions from different doctors. I’m thinking if I can meet you, I can find more from you about the alternative way of using herbs. Can I know if you will be available next week or the following week? If yes, should i come to see you after or before the tumor surgery? Kindly advice. Thanks.

Reply: Go and get the cancer removed. Either do it in KL or Penang. There are many doctors who can cut you up but be careful where you go to.

Hi Dr Chris,
Thanks for the reply. Attached files of medical report. I understand your point. Do you have any recommendations for a doctor in Penang? It will be easier for me and my family because my wife is just 4 months pregnant.
CT scan, 19 September 2016: Slight irregular and eccentric wall thickening at lower rectum n keeping with lower rectal tumour/lesion as noted clinically.

Histopathology report: Rectal tumour biopsy – moderately differentiated adenocarcinoma.

WL came to seek our opinion. This was what I told WL.

  1. There is no other option. The tumour has to be removed.
  2. The main concern is whether WL has to use a colostomy bag after that, because this a rectal cancer. According to WL the doctor he consulted said that might be the case. It would indeed be a great disadvantage if WL, being a 35-year-old, has to deal with such a bag throughout his life. Stressful and messy indeed. The idea is try to avoid having to use a colostomy bag if possible.
  3. I suggested that WL take time to “shop” around for a better surgeon. One surgeon I had in mind was in Kuala Lumpur. It would be worth that extra effort for WL to consult him and let him do the operation if there is not necessary to use a colostomy bag after that.
  4. I also informed WL that there is a surgeon in Singapore (in private practice) who would be able to construct an “artificial rectum” should there is a need for one. In this way, WL would not have to use a colostomy bag. It would be worth spending some money to go to Singapore to consult him. But perhaps, before seeing someone in private practice, it would be a good idea to start seeing someone in Singapore General Hospital and take it from there.

About three weeks later, WL came back to see us again.  He had his rectal tumour removed by the surgeon in Kuala Lumpur, as suggested. The total cost of the treatment was RM 40,000. WL was hospitalised for a week.  After the surgery, WL had to use a temporary colostomy bag for a few weeks. After that he needs another surgery to rejoin the rectum.

Before the surgery,  as suggested, WL went to Singapore General Hospital for consultation. The total cost of the surgery would be SGD 50,000 — almost four times more expensive than the cost in KL hospital.

Chemotherapy

An oncologist came to visit WL while he was still in the ward. According to the oncologist WL needs to undergo chemotherapy, using Xelox regimen (Xeloda + Oxaliplatin). WL needs 8 cycles and each cycle would cost about RM 4,000. Chemotherapy would start 2 to 6 weeks from the operation date.

The oncologist told WL the following:

  1. You are still young.
  2. Your situation is very critical.
  3. If you don’t do chemo, you will lose the battle.
  4. Within two years the cancer will spread all over.
  5. If you don’t do chemo, you have a 65 percent chance of recurrence, i.e. the cancer would come back.
  6. If you do chemo, you have a 65 chance that the cancer will not come back.
  7. You can eat anything you like. According to the oncologist he has not come across any research report that links diet to cancer.
  8. While warded in the hospital, WL had diarrhoea. The oncologist suggested that WL take fried food to stop the diarrhoae!

Chris: Do you believe what the oncologist told you about the diet — that your husband can eat anything he likes?

Wife: No, I never believe him.

There are three lessons we can learn from this case.

One, chose you surgeon wisely. If you go to the “wrong” surgeon, you may end up having to wear the colostomy bag the rest of your life!

Of course, it is logical to expect that it is more expensive to undergo medical treatment in Singapore than in Kuala Lumpur or Penang. No one to blame here — it is the exchange rate! It cost almost the same on a dollar-to-dollar basis.

Two,  when told to do chemo, always ask if this treatment is going to cure you? What is your chance of obtaining a hundred percent cure — after all this is what you want anyway.  When you get the answer from your oncologist, evaluate his answer critically.

WL was told: If you don’t do chemo, you have a 65 percent chance of recurrence, i.e. the cancer would come back. What does this mean? In  simple language, it means that even without chemo there is a 35 chance that you will survive! Not ALL those  who do not do chemo ended up dead. Right?

WL was told: If you do chemo, you have a 65 chance that the cancer does not come back. It means that even if you undergo chemo as suggested,  there is 35 percent chance that the cancer can come back — meaning chemo does not guarantee you a cure! Right?

Therefore, it is up to YOU — the patient — to decide which path to take! Make your own decision because no one can help you  in this dilemma.

Third,  even WL’s wife — an ordinary housewife, could see the fallacy of the oncologist’s advice about diet. But if you need to read to believe, there are hundreds and hundreds of books written about diet and cancer. In my library at home I have no less than a hundred books on food and cancer! For those who prefer not to buy books, then go to the internet for free information. Click this link: http://www.wcrf.org/,  http://www.aicr.org/cancer-research/.  In 1982, American Institute for Cancer Research (AICR) was founded to advance the simple but then-radical idea that cancer could be prevented. AICR focused on the link between diet and cancer, and immediately began supporting cutting-edge research in this area and educating the public about the results. It has published three global expert reports:

  1. Food, Nutrition and the Prevention of Cancer: a global perspective, published in 1997
  2. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, published in 2007; and
  3. Policy and Action for Cancer Prevention, published in 2009.

For those caregivers, be forewarned though, that teaching patients to become healthy makes no money! Asking them to change to good diet and lifestyle means you cannot prescribe any more drugs or herbs for their ailments. And when patients become healthy they don’t need to come back and see you again! So, from all angles, it appears that suppressing the truth and letting the status quo prevails is better?

For busy people out there, let me help you a bit on this connection between diet and cancer. Read what these outstanding doctors said:

1-devita

3-oncologist-dont-know-nutrit

8-diet-must-be-integral-par

 

6-pig-knows-better-nutrtion

Ho, ho, I believe we all want to be just as smart (or even smarter) than a pig, right?

 

 

 

 

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