Lucy (not her real name) was 58 years old when she noticed redness on her left breast. She also felt a lump in her left breast. Lucy went to a government hospital for consultation. An ultrasound confirmed the presence of an irregular, 2.6 x 3.6 x 3.2 cm lesion at 10 to 11 o’clock of her left breast. There were few enlarged axillary nodes. Subsequently a biopsy confirmed it was an invasive carcinoma – no special type.

On 13 July 2019, Lucy underwent a mastectomy of her left breast at a private hospital. Some lymph nodes were also removed.

Histopathology confirmed an infiltrating ductal carcinoma, grade 3 with ductal carcinoma in situ – high nuclear grade. Fifteen of the 17 lymph nodes showed malignancy. The cancer is staged as pT2N3Mx and is ER positive, PR negative and e-ERB-2 = 2+.

X-ray of the chest showed normal mediastinum and the rest of the lung fields were clear. No rib lesion was seen.

The total cost of the mastectomy at this private hospital was RM14,999.70

Let Lucy tell the remaining part of her story in her own words.

1. Initially I refused to go for chemotherapy.

1. On 23 July 2019, on the recommendation of my Dharma teacher, I consulted Dr. N, a naturopath.

• Dr. N did mention about me doing 3 cycles of chemotherapy. He also advised me:
• To take baking soda with brown sugar.
• To take tumeric powder and whey protein.
• To avoid soya, egg yolk, fresh mushroom, almond.
• To take chia seed, nuts, buckwheat, millet, steamed beetroot, green veggies, 1 part brown rice + 3 parts white rice, marmite, beans, lentils.

2. On 8 August 2019, I consulted an oncologist at a private hospital in Kuala Lumpur. A PET scan was done. The results indicated:

• Low grade FDG uptake seen at the post-operative inflammatory changes at left anterior chest wall. No hypermetabolic nodal or distant metastasis.

The oncologist advised me to do 6 cycles of chemotherapy. I told the oncologist that I wanted to seek a second opinion. The oncologist said: You will die if you do not proceed with chemo!

3. On 9 August 2019, I went back to Dr. N,  the naturopathic doctor to discuss the PET scan results. I told Dr. N I was not keen to do chemotherapy. My late mum died after radiotherapy for her lung cancer. Dr. N advised me to continue taking baking soda and tumeric.

4. On 21 August 2019. An ultrasound of breast showed normal results – no solid nodule, no cyst, no calcifications and no lymph nodes infection.

5. On 29 August 2019. I went to consult the doctor at the private hospital where I had my surgery. The doctor in charge of my case refused to see me after I told him that I am not keen to do chemotherapy.

2. I was started on an oral drug – tamoxifen.

6.  On 20 February 2020. a doctor at the cancer hospital started me on tamoxifen.

7. On 21 February 2020. I went to my naturopath doctor to seek his advice.

Dr. N advised me:

• To take tamoxifen for only 1 year.
• To take supplements: super leutin, izumia, fish oil, vit D3, calcium.

8. On 15 December 2020, I found a lump on my neck. I consulted my naturopath doctor again.

9. In February 2021, I stopped going to the cancer hospital and stopped taking tamoxifen due to Covid-19 lockdown.

10. In May 2021. After consulting a dietian, I started taking supplements such as: Bio Rex, Nona, organic spirulina, curcumix, Biovision, Bio organmix, probiotics, Vit. C.

3. Problems – muscle ache and swollen arm.

11. On 30 August 2021. I had 1st dose of Pfizer Covid-19 vaccination.

12. In September 2021.

• I had muscle pain and swelling of the left arm and shoulder.
• I had a fall in the bathroom. X-ray showed no fracture.
• I was advised to go for physiotherapy.

13. On 20 September 2021, I had the 2nd Covid-19 vaccination.

14. On 29 September 2021, I consulted my naturopath doctor (Dr. N) regarding:

• The swelling of my arm. I was advised to take water chestnut for water retention.
• For the difficulty lifting up my arm and nagging pain on the shoulder blade, I was told to wear a tight band.
• My breathing was a bit difficult.

15.  In October 2021:

• I went to seek the help of Traditional Chinese Medicine (TCM) sinseh and did acupuncture and cupping.
• I went to seek the help of another TCM sinseh.
• Then I went to seek the help of TCM sinseh in a private hospital in Kuala Lumpur.

16. On 25 November 2021, I went to seek the help of a physiotherapist and had massage.

17. On 9 December 2021, I consulted a medical doctor in a private hospital in my hometown. He then referred me to an oncologist of a private hospital in Kuala Lumpur.

4. The cancer had spread extensively.

18.  Results blood test and PET scan at the private hospital in Kuala Lumpur were:

• Blood test – CEA = 8.3 (above normal).
• PET scan showed local recurrence at left chest well, with metastases to regional and distinct lymph nodes, subcutaneous nodules, lung, peritoneum and bones. There is minimal pericardial effusion, metastases cannot be excluded.

Lessons We Can Learn From This Case

1. Have your cancerous lump in your breast removed!

Lucy did the right thing. She had a mastectomy to remove the cancerous lump in her left breast. Some ladies came to see me insisting not wanting to remove their cancerous breast. If the lump is not removed, most likely it will grow bigger and eventually burst.  This creates more problems. Some patients have the mistaken belief that herbs, vitamins or whatever supplements can make the cancer go away! That is wrong. In most cases, I would insist that they go for surgery first before following our therapy.

2. Surgery does not cure your breast cancer.

After surgery, histopathology confirmed no metastasis, but 15 of the 17 lymph nodes showed tumour involvement. This means the cancer had already spread to the lymph nodes.  Later a PET scan showed “inflammatory changes” in the chest wall but there was no metastasis. From the medical point of view, Lucy needs to undergo at least 6 cycles of chemotherapy. That’s  the standard protocol.

3. Chemo or alternative therapy – this is a gamble you need to take.

When Lucy refused to undergo chemo, the oncologist said: You will die if you do not proceed with chemo! Another oncologist refused to see Lucy after knowing that Lucy was not keen on chemotherapy.  I must say to a certain degree, these 2 doctors were right! Why?

• Don’t try to be too smart, the cancer was still there even if you had done surgery. If you don’t do chemo , you will die! Doctors believe that – don’t blame them. That is what they were taught in medical school.

• If you don’t want to do chemo, why did you go and ask the oncologist for advice in the first place?

On the other hand, I would say that Lucy needed to be better understood. She was in a dilemma. How could she reconcile the fact that her mother died while receiving treatment for her lung cancer? What if chemotherapy would kill her too? This is a reality which helpless patients face. Lucy is not alone, I have many patients who are like her. Let me give two examples.

• One lady refused to undergo chemotherapy after her mastectomy. I asked her why. Some years ago, her son died after receiving the 4th cycles of chemo for his lymphoma.

• Another lady also refused to do chemotherapy for her cancer because earlier on her husband died after receiving his  6th chemo treatment. As the needle was pulled out of his arm, his heart stopped beating.

If Lucy did not want chemo, then what other options are there for her?

Unfortunately, Lucy had to take a gamble with alternative therapies – some therapies could be beneficial while many others are outright dangerous.  So, to all patients, I say this:  If you wish to take this route, make sure that you know what you are doing. I know this is a hard call indeed. Don’t just believe anybody who claims that he/she can “cure” your cancer.

As demonstrated by the outcome of this case, Lucy had taken the wrong path. Twenty months after doing what she thought was the right things to do, Lucy’s cancer spread like wild fire. There were metastases to regional and distinct lymph nodes, subcutaneous nodules, lung, peritoneum and bones (see the pictures above).

 I may say I could not believe what I saw in the PET scan – it was a terrible disaster indeed. Lucy had committed  a tragic mistake.