Fen (not real name) was 44-years old. In July 2015, she found a small lump at 2 o’clock position of her left breast. An USG confirmed the presence of a 1.5 x 10 x 1.3 cm irregular mass in left breast.

FNAC (biopsy) confirmed a ductal carcinoma.

Fen underwent a left mastectomy. Histopathology indicated the tumour was positive for ER, PR and c-ERB-2 receptors.

After surgery, Fen was asked to undergo chemotherapy and hormonal therapy. No radiation was indicated. According to her surgeon, the benefit of these treatments are as follows:

1. If no treatment was done, the 5-year-survial rate would be 57%.
2. If Fen was to take Tamoxifen (oral drug) the 5-year-survival rate would be 68%, meaning Tamoxifen would give a 11% benefit.
3. If Fen was to take Tamoxifen and Chemotherapy, the 5-year-survial rate would be 81%. This means, chemotherapy would provide an additional 13% benefit.
4. If Fen was to take Tamoxifen + Chemotherapy + Herceptin, the 5-year-surival would be 88%. This means, additional treatment with Herceptin would add another 7% benefit.

Heceptin is expensive. That drug alone would cost more than RM100,000.

But what can happen if Fen opted not to do any more medical treatments? Will she die soon? According to the doctor’s statistics, Fen has a 57% chance of surviving 5 years. Take note, she was to do everything what the doctor said, her chance of survival would be 88%. So medical treatments would provide 31% more chances of survival.

Perhaps, what is not told are:

• What if the patient dies during or after the chemo?
• The medical treatments would not give a 100 percent chance of cure. Some patients get worse with chemo. Some died while others suffered severe side effects.
• How to know if Fen is in the “fortunate” or the “unfortunate” group of patients? Nobody can tell for sure.

Fen and her husband came to seek our help. My caution to the couple.

Chris: I don’t want you to go home and quarrel with your husband. So, go home and discuss with him first.

For whatever you want to do, everyone around you should all support you.

(To the husband) Give her all your support.

Fen: We have already decided. I don’t want to go for chemo. I am afraid my body cannot take it. I have a friend. She also had breast cancer, all three negative. She had chemo and suffered badly. After three cycles of chemo she gave up. Took some Chinese herbs and it is already four and a half years and she is doing fine. So I don’t want to go for chemo.

One and a half years later!

Chris: Your blood test results are all good. There is nothing wrong there!

Fen: I take care of my diet!

C: Good, and you don’t curi makan? Bluff, bluff a bit. There are patients who said, Yes I take care of my diet. But when I dig and dig further — no they did not keep to their diet. Why are they cheating themselves? When I said that, they got angry because they said I am blaming them. I don’t know what to say!

F: I understand your problem.

C: Do you get angry with me because I told you not to eat what you like?

F: Why should I get angry with you? I googled and learned that many other people also say the same thing.

C: Do you exercise?

F: I walk, four times a week. Each time about one hour.

C: You think too much?

F: No.

C: You were on the herbs for one and a half years now. How is your health compared to the time when you were not on the herbs?

F: I feel much better now.

C: Do you want to go back for chemotherapy?

F: NO!