Sam (not real name) is 63 years old. Sometime in June 2016, he had pain in his right arm. An X-ray was done and the doctor said it could be due to muscle problem. He was asked to go for physiotherapy. It did not help.

In January 2017, his right arm was swollen and his condition became more serious. He consulted an orthopedic doctor. There was nothing wrong!

Sam was admitted into a private hospital on 11 February 2017 for further examination.

MRI on 12 February 2017 showed a 3.1 x 2.3 cm mass at the distal humerus (bone in the upper arm) involving the triceps muscle. Incidentally, the doctor also found a suspicious 4.4 x 5.2 cm lesion in the lower zone of his right lung.

A CT scan done the next day, 13 February 2017, confirmed the presence of an irregular 4.3 x 4.38 x 3.96 cm mass in his lung. There were also multiple enlarged lymph nodes in the pretracheal and carina. The largest being 2.69 x 1.77 x 1.9 cm and 3.48 x 2.91 x 1.61 cm respectively.

In short, the cancer had spread. But the question is: Spread from the lung to the bone, or from the bone to the lung? A biopsy of the bone showed negative for malignancy. A biopsy of the lung showed positive for cancer.

The total cost of the 4-day-stay in the hospital for the above procedures cost RM 12,595.90.

So what comes next? What to do. The doctor suggested the following options:

1. Chemotherapy.
2. Immunotherapy.
3. Target therapy — taking of oral chemo-drug if it is positive for EGFR.
4. Bisphosphonate, a drug that slows down or prevent bone damage. Depending on the type of drug given, this is to be taken either once a day, once a week (on the same day of the week), or once a month (on the same day of the month).

Listen to our conversation this morning!

Gist of our conversation.

Daughter: My father has lung cancer. It is positive for EGFR. The doctor suggested taking the oral targeted therapy, Tarceva. One box, lasting one month, cost about RM8,000. After we take Tarceva for 10 months, and if the medicine works, for the rest of his life the medicine will be free. But must complete the ten boxes first. That’s the deal!

Chris: You mean after spending RM80,000 they will give you Tarceva for free for life? But what happen if your father dies before the ten months?

D: I was thinking. May be my father cannot last that long. Maybe before the ten boxes, sure die one.

C: I have one patient who came and see me. She was asked to take Nevaxar (for liver cancer). The deal was buy one, free one. But must pay RM20,000 first (for the first month’s supply) and next month she will get one month’s supply of Nexavar for free! But after she took the drug for a week, her health deteriorated, had to be hopitalised and she died. Already paid RM20,000, cannot claim back.

So back to you, Tarceva is a good deal. Why don’t you want to take the drug? Can take the drug for life and no need to pay.

D: (Shaking her head) No, don’t want.

C: Did you ask if Tarceva can cure or not?

D: It will control the cancer cells, so that they never spread.

C: But cannot cure?

D: That’s what I asked him (doctor). The tumour is going to be there.

C: That means, cannot cure la because the tumour is still there.

D:  In about 5 percent of patients, the tumour shrink.
C: What happen to the 95 percent, tumour never shrink?

D; Under control.

C: I tell you. For some people the tumour was totally gone after taking the drug. But a few months later, the tumour came back again. And this time it was twice the size.

Did the doctor tell you about the side effects of Tarceva?

D: Ya, I asked. Diarrhoea, only that.

C: Only that?

D: Ya, mild one only.

C: You believe him or not?

D: May be not.

C: I tell you. Don’t just listen to me only. I can bluff you. Go back and read more. Read what others say.

D: I prefer natural medicine.

C: I shall do my best to help you. I shall give you herbal teas for his lung, lymph nodes and bone. The herbs are bitter — awful taste. Can or not?

Know that I cannot cure your cancer. But take herbs and see if they can help you or not. If you take the herbs for a month, I am going to ask you if you feel better or not. If you don’t feel better, then no need to come and see me anymore. If you feel better, continue taking the herbs.

When can you stop taking the herbs? I really don’t know. But if you are feeling better, why stop it? Because I know there is no cure for cancer.

In America, most people with stage 4 lung cancer die within a year. But, I am not saying you are going to die soon. Go home and read the stories (in the website).

Of course, all of us have to die. So don’t worry about death. What is important is, don’t die suffering. Want to die also cannot, want to live also cannot. That’s terrible.

So, I shall try to help you. If it’s good, continue. If no good, don’t continue. Go home, take care of yourself and take care of your diet.

Comments

They say knowledge is power. This is true! To me, with cancer, ignorance kills!

I am glad that Sam’s daughter is smart! She asked questions. And she “processed” the answers given!

In this world today, we read about “fake news”, “fake information”, “cybertrooper”, etc.. So please be on guard and beware.

As I was writing this story, one lady came to ask for help. She was also given Tarceva for her lung cancer. For about one month plus, Tarceva seemed good for her. Then she started to suffer side effects. After seven months the side effects were unbearable and she gave up Tarceva totally. No, she did not hit the 10-month-mark! The irony is, this lady is a medical staff of a hospital. She should know better!

Listen to her story.

Google “side effects of Tarceva” and you get this. No, it is more than just mild diarrhoea!

Side effects of Tarceva include:

• Acid or sour stomach
• belching
• blemishes on the skin
• bloated or full feeling
• bone pain
• burning, dry, or itching eyes
• diarrhea (mild)
• difficulty with moving
• dizziness
• dry eyes
• dry skin
• excess air or gas in the stomach or intestines
• excessive tearing
• fear
• feeling sad or empty
• feeling unusually cold
• hair loss
• headache
• heartburn
• indigestion
• irritability
• itching skin
• joint pain
• loss of interest or pleasure
• nervousness
• passing gas
• pimples
• rash, mild
• redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
• shivering
• stomach discomfort, upset, or pain
• swelling
• swelling or inflammation of the mouth
• swollen joints
• thinning of the hair
• tiredness
• trouble or inability to sleep
• trouble with concentrating
• weight loss
• loosening of the fingernails
• redness or soreness around the fingernails.

Source: https://www.drugs.com/sfx/tarceva-side-effects.html

More about the side effects of Tarceva:

Meaningless Shrinking of Tumor While on Tarceva https://cancercaremalaysia.com/2012/04/26/meaningless-shrinking-of-tumor-while-on-tarceva-treatment/ 

Meaningless Decline of CA 15.3 and Tumour Shrinkage Following Treatment With Iressa and Tarceva https://cancercaremalaysia.com/2012/04/26/meaningless-decline-of-ca-15-3-and-tumour-shrinkage-following-treatment-with-iressa-and-tarceva/ 

 

Update: Daughter wrote to say father died on 7 October 2017