AZ is a 45-year-old Indonesian lady. In early 2012, she had a swelling in her left breast. She went to a doctor in Palembang and did a biopsy. The result: not malignant! AZ did nothing after that.
In November 2012, AZ went to a private hospital in Melaka for a second opinion. She was told that she had cancer. A left mastectomy was immediately done on 21 November 2012. It was a Stage 3A cancer. Six out the 16 lymph nodes were found to be infected with cancer. The tumour was positive for estrogen, progesterone receptors and CerbB2 oncoprotein.
AZ underwent follow-up treatments: 6 cycles of chemotherapy, 25 sessions of radiation and was started on Tamoxifen. She had been taking Tamoxifen since 2012 until now.
AZ was well, but was not cured. About four years later, February 2016, AZ felt pain in her left chest. Her surgeon said there was nothing wrong with her! However, AZ consulted another doctor in the same hospital. A lump was found in her chest.
Impression: An active node, probably metastatic, is present in the left supraclavicular region. No other suspicious lesion is detected elsewhere.
AZ underwent another operation to remove the node in her chest. The histopathology report confirmed a recurrent invasive ductal carcinoma. AZ underwent another round of chemotherapy consisting of 6 cycles of oral Xeloda plus 6 cycles of Herceptin. In addition, she received another 25 sessions of radiation.
AZ was told that she had to monitor the progress of her cancer by doing PET scan every 5 months or twice a year!
A PET scan done on 24 October 2016, showed more tumours developed. In short, all the previous done failed.
- The hypermetabolic node in the left supraclavicular region is much less active.
- Two small hypermetabolic lesions have appeared in 2 ribs of the left side.
- In the hilar region, there are a few new hypermetabolic nodes of about 1.0 to 2.0 cm.
- In the lower mediastinum, there is a hypermetabolic nodules of less than 1.0 cm.
- Several small metastases have appeared in the lungs.
AZ was asked to see her oncologist. She refused to return to the hospital again.
Chris: Before the operation, did you ask if surgery was going to cure you?
Patient: The doctor said must operate. Then go for chemo and radiation. Only then can we know if I am going to be cure or not.
C: Did you ask the oncologist, if chemo was going to cure you?
P: The doctor said, “Tak pasti” (not sure!).
P: Doctor told me to come back for routine check-up and do a PET scan every 5 months.
C: What? Every 5 months? Do you know about radiation risks? If I ask you to go for a chest X-ray one time today, is that okay? Yes. But if I ask you to go for an X-ray 800 times a day, you will say I am mad, right? What if I say go 2,000 times of chest X-rays today. I must be real crazy.
Total cost of treatment
C: For all the treatments that you have undergone, how much did you have to spend?
Husband: About RM 200,000.
C: Wah, that is about the cost of a piece of land or a house?
H: Yes, the cost of a house.
Don’t want to see my oncologist anymore
C: What did the doctor want you to do now?
P: I don’t want to do anymore chemo — so far not effective at all. I don’t want to go back and see my doctor anymore. I suffered when I did the previous chemo.
C: I understand. And are you still taking the Tamoxifen?
P: Yes, until yesterday.
CA Care Therapy
C: Who ask you to come here?
H: A friend from Jambi. He had lung cancer and came to see you. Followed your therapy and he is now well — healthy.
C: You need to know that there is NO cure for cancer. I cannot cure your breast cancer. I don’t want to mislead my patients about this. But if I can help you to live a healthy life without problem, then that may be possible. You cannot ask for more. The doctor said you can eat anything you like. No, I am going to tell you that you have to take care of your diet. You cannot eat anything you like. Keep to a healthy diet and lifestyle. What I can do is to try and help you but you must learn how to help yourself. As to how long you live, God decides.