We felt sorry for SF, her hope crushed. After 12 cycles of chemo and spending RM 150,000, she was told the tumors had shrunk and she was cured! (Or did she misunderstood her doctor’s message?). But after one month at home, she had bleeding and came back to her doctor again. Her tumour had grown back to its original size. It was a failure. Her doctor did not have time for her and hurriedly told her to for surgery.
With wounded feelings she and her husband left the hospital and sought the help of another oncologist in another hospital. She was started on radiotherapy to be followed by chemotherapy. We felt SF should just continue with her medical treatment and not take our herbs yet. We sent set her away without any herbs.
SF and her husband came back to see us again after a few days. We spent almost 2 hours talking. It was a “heart-breaking” morning for me. I laid out my advice as clearly, honestly and bluntly as possible. But I was mindful not to cause panic or to instill fear in her. Many times during our conversation, I asked her and her husband to think clearly and deeply the implications of what she wanted to do. She should then make her own decision based on what her heart wanted, after considering various points I raised.
What did you get out of your failed RM150,000 treatment?
- Diarrhea after radiotherapy
Patient: I had diarrhea after the radiation.
C: Did you have any diarrhea before you went for radiation?
P: No, the diarrhoea started 2 days after the radiation (note: it continued as of this writing — already 3 weeks).
C: I really cannot tell you what else can happen after this. Did you ever ask the doctor if these treatments — radiation and chemotherapy — are going to cure you?
P: No, we never ask.
C: You should ask before you undergo all these!
- Tumor shrunk after the first round of chemotherapy!
P: After 6 cycles of chemo, I was told the tumour had shrunk. And I needed another 6 more cycles. The doctor said I was cured. I requested the doctor to do a CT scan for me to confirm the result. The doctor said, No need, you are already cured. Go home.
C: What? He said chemo cured you?
P: He asked me to come back after 2 months for review. But one month at home, I had bleeding and we brought forward our travel and came back to see the doctor again.
Husband: The tumour had grown bigger (back to its original size, see table below).
C: Did you ask the doctor why? Only last month he said you were already cured. Now, what happened.
P The doctor was angry.
H: We were confused. We returned to see the doctor one day before he was to go on leave. It seemed he was “uncomfortable” and told us crudely — You just go for the operation! We then went to see another oncoloogist in another hospital.
- Elevated liver function parameters
C: Let’s look at your liver function results (table below).
On 8 June 2016, after finishing 6 cycles of chemo, your liver function was still okay. But you see what happened after you did 12 cycles of chemo. All the liver enzymes values were elevated. Your liver was going downhill. Okay, some people may want to rationalize that it is normal after chemotherapy. The liver function enzymes will go back to normal again after you stop chemo. Well, I don’t know if you want to believe that or not.
You are going to be given more chemo. I cannot tell you what is going to happen to your liver after this. I don’t know how many more cycles of chemo they are going to give you, and what drugs they want to use. If they give you the more toxic or aggressive drugs, what is going to happen to your liver?
They want to give you more chemo because they hope to shrink the tumour before they proceed with surgery. You have already done 12 cycles of chemo in Hospital A before. The tumour shrunk and grew back after a month. Think carefully, what do you hope to achieve this time with chemotherapy? Shrink the tumour again?
- Lung nodules disappeared
P: The doctor told me that the nodules in my lungs were all gone after the chemotherapy. At least, my lungs are free of cancer.
C: Wrong Ibu (mama)! Yes, the lung nodules were completely gone after the chemo but in the October 2016 scan, there was again a 0.6cm nodule in your lung. So the impression you had was wrong.
P: I did not know this. I did not understand all this. Only now that you have told me this.
- Chemotherapy means sufferings
C: Two days ago, a lady came to see me on behalf of her elderly father who had lung cancer. She consulted the same oncologist (the second oncologist, not the first oncologist in Hospital A) that you went to. This oncologist told the lady that her father needs chemo but chemo is going to cause many side effects and he would suffer. The oncologist also said that the father could go for oral drug. But oral chemo-drug can also cause sufferings.
On hearing this, the daughter “ran away” and would not want any more medical treatment for her father! At least we should be glad that this oncologist was honest to tell us this.
Patients are an ignorant lot!
C: This episode really make me sad. For years I have been trying to “educate” patients. I wonder if I have failed miserably? I understand all that you have said and gone through. You put your full trust in your doctors — they are your gods — and the gods failed you!
Also, unfortunately some of these gods are not honest. They don’t tell you the whole truth that you need to know.
P: Indeed I don’t understand all these.
C: You came to see me twice. I have explained to you what I know and I ask you to think carefully what you want to do.
H: Before this I believed that after the surgery — the tumour gone — all problems would be solved! That was what I thought. I did not know all these before your explanation. Now, I understand and realise the implications.
P: I was hoping that after the chemo, I would be cured. I did not want to go for surgery!