Johnny (not his real name) is 73 years old. This is his story.

February 2020.  His problem started with frequent (7 to 8 times) urination at night.  There was no blockage of urine flow. Then he had backache. He did nothing about the problem.

Vaccination history.

• Sinovac, first dose in August 2021. He felt weak after the vaccination.
• Sinovac, second dose in September 2021. Felt cold in the stomach and later had bloated stomach.

Admission to Hospital B in Kuala Lumpur.

Johnny  was eventually admitted into a private Hospital B in Kuala Lumpur on 19 September 2022. During the 8.5 days in the hospital he received the  following:

1. Blood test.

	19 September 2022	24 September 2022
Platelets	502   (High)	534   (H)
Alkaline phosphatase	208   (High)	190   (H)
PSA	7,652  (High)	7,292 (H)

2. PET scan – 20 September 2022.

There is a FDG-avid lesion at the left prostate lobe measuring 1.8 x 2.2 cm.

There are multiple small lung nodules scattered in both lungs,

largest measuring up  to 0.8 x 0.7 cm at the right lung base.

There are multiple FDG-avid bone lesions along: bilateral humeri, bilateral scapulae, bilateral clavicles, manubrium-sternum, multiple bilateral ribs, along the spine, pelvic bones (bilateral ilium, pubic bones) and along bilateral femur.

Some of the bone metastases have extraosseous soft-tissue components, particularly at thoracic vertebrae (T7, T8 and T 11 vertebrae) and left ilium.

Impression:

1. Lesion at left prostate lobe likely corresponding to primary prostate carcinoma.

2. Multiple bilateral lung nodules – suspicious for lung metastases.

3. Multiple bone metastases.

Treatment.

While in the hospital, Johnny  received oral chemotherapy and five times of radiation treatment.

The Total Medical Bill

Let us look at the medical bills critically.

1. Doctor Charges

Of the RM47,150.70 paid, about 25% (RM11,880) goes to the doctor.

• Doctor made 15 visits.

The first visit was RM230.

Subsequent 12 visits cost RM100 per visit.

Two other visits cost RM150 per visit.               

• Johnny had 2 short infusion and this cost RM500 per infusion.
• Johnny had 5 radiation treatment (VMAT). This cost RM9,150.

2.  Hospital Charges

The total hospital charges is RM35,279.70 and represents about 75% of the total cost of treatment.

1. Administration charges  $45

2. Chemo drug

• CASODEX, 500 mg tablet, 26 tablets taken while in the hospital, and
• 26 tablets on discharge. RM 980 x 2 = RM 1,960.

3. Equipment charges  RM395.00

4. General medical supplies RM 554.10

5. Imaging procedures

• CT scan RM1,350
• CT/PET scan package RM3,800

6. Laboratory  RM 802

7. Medical record RM18.00

8. Miscellaneous RM 110.00

9. Pharmacy  –  total cost RM5,667.10.

The drugs prescribed while in the hospital consist of antibiotic;  steroid (dexamethasone) – for swelling and inflammation;  nexium for gastrooesophageal reflux; senokot for costipation and Duodart.

Duodart cost RM132 while in the hospital and RM356.40 upon discharge (to bring home). Here is what it is used for (info from the internet):  benign prostatic hyperplasia (BPH).

10. Room charge for 8.5 days amount to RM1,360 (two-bedded at RM160 per day).

11. Treatment and Procedure Services – RM 19,818.50. This include:

• nursing services,
• injection charges,
• medical consumables,
• vac lock (RT) RM600.00 (Cushion create a rigid and secure support around the patient during radiotherapy).
• VMAT (radiotherapy) planning RM11,550.00
• VMAT treatments RM6,300

Lessons We Can Learn From This Case

1. Can the treatment be done on outpatient basis? Was he adequately treated while in the hospital?  Johnny needs to treat his prostate cancer that had spread to the bones. From the information in the medical bills above, do you think he was adequately treated? Do you think he really needs to be admitted into the hospital just to receive 5 times radiation and swallow some cancer pills? Could these treatment  be done or taken on an outpatient basis, to save cost?

During his 8.5 days in the hospital, Johnny received 5 radiation treatments. Then he was given Casodex. This is the medicine to treat prostate cancer. Then he was given Duodart. This is a drug to treat benign prostatic hyperplasia (BPH). But Johnny already had prostate cancer not BPH! Mind boggling indeed.

Even more mind boggling is, Johnny had extensive bones  metastases and many tiny nodules in the lungs. This is revealed by the PET/CT scan that he did. Did he not need treatment for his bones and lungs?  If that is the way it is, what is the whole idea of doing a PET scan? To just know if the cancer has spread and no treatment is needed?

2. Cancer treatment in the private hospital is not cheap! Johnny was treated in a private hospital for 8.5 days. This cost the family RM47,159.70. Many of us may want to ask – why so expensive?  Others may say it is already cheap because  there are many others who had to pay much more than that. 

Anyway, for the rich RM47K is just peanut but for those who are poor or in the middle income group, that sum is a big deal indeed. One week’s hospital treatment cost about RM50K. What would have happened if it was extended to a month’s stay? RM200K?  I know of many patients who had to spend that kind of money!

As I am writing this case, one patient told me he had colon cancer and underwent surgery and chemotherapy. He had already spent about RM200,000 ( I am not sure if this figure is corrrect or not. I did not see his medical bills). Many years ago, I knew of a medical doctor who spent about RM1.7 million for his wife’s cancer. In spite of that she died  in less than a year while on treatment.

3. What if you have no savings? If you have no money, there is no choice – go to the government hospital or the university hospital.  You may be able to receive similar treatments without having to pay through your nose!

4. Understand the reality. What could be the outcome after going to the expensive hospital? Can cure? Many people have the impression that expensive means better or the best!

I asked Johnny’s daughter. Can the treatment cure him?  She replied: According to the doctor there is a high chance of recovery, to lower his PSA. Wow, is that the answer you are looking for? Lower the PSA only?

For the bone metastasis this was what the doctor said: Can’t be helped. Just maintain and don’t let it get worse. Wonder how when no treatment was given!

Well, you can interpret what the doctor said anyway you like!

Johnny’s  PSA was 7,292 on 24 September 2022 (don’t be mistaken, it was 7.2 thousand plus not 7.2).  To be “free or cured” of  prostate cancer the PSA needs to come down to 6.50 ( yes, 6 point 5 for age 70 and above). When can that happen? Or can that ever happen?

5. Do you believe in alternative healling therapy?  Johnny’s wrote me before sending her father to the hospital for treatment. It was the family’s decision so. I did not give any comment. Go ahead and find out the truth for yourself!

I am aware that what we are doing is considered by most “educated” people as hocus pocus, not proven, not scientific, etc.  But let us see what happens now! Where can Johnny go after being discharged from the hosptial and after spending RM50K?  Go on spending more money chasing the cancer?

Johnny Came To Seek Our Help

When Johnny came to seek our help, he was on a wheelchair and was not able to walk  on his own (this is after being treated in the hospital).  

He was prescribed the following herbal teas for his:

• prostate cancer
• bone cancer and
• lung cancer.

. In addition he was given herbs for his:

• stomach gas and
• frequent urination.

Let me reproduce the whatsapp messages between me and Johnny’s daughter as we monitored the progress of Johnny’s healing.

Chris: Your pa took the herbs? Any problem drinking them? Did he find any changes to his condition?

Daughter:  Ya, he followed everything . He said the taste of the herbs is bad but he can take it. He feels fine so far. He told me he has less pain.  Only if going to lie down can feel a bit pain. So far others ok.

C: Your dad had taken the herbs for about one month already.  How is he progressing? Any improvement?

D:  I noticed he is doing well with your herbs. Ya, much better. Many thanks. During sleep pain only on the right side of  his back. When sitting no pain.  I noticed his leg feel stronger than before.

C: Still cannot walk?

D: This morning he tries to walk using the walker … around 15 steps, he felt legs were weak.

C: You need to keep trying because if you don’t use the legs, then you cannot use them anymore after too long.

D: We are just scared he falls unless we are there to help him. Will take your advice and let him keep trying .

C: Two more questions . Gastrovit — for his stomach gas — did he take it and did he get better?

D: That day he took but now no more pain, so he takes only when needed.

C:  I gave A-Kid-6 for his frequent urination (before he urinated 7 – 8 times at night), now what happen?

D:  Ya, already reduced to 3 to 4 times at night.

D: The other day, the hospital called to go for his appointment, but we rejected the appointment.

C: Your dad does not want to go to hospital again? Why?

D: He said, because he is already taking your herbs and feels better. So just concentrate on your treatment.

Up date: My Pa looks better. Leg stronger.

Think hard:

• In the US they call herbal treatment as snake oil therapy! And people like me are labeled as snake oil peddler! You buy that?
• 8.5 days in the hospital cost about RM47,150  and what do you get out of it?
• One month of herbs cost only RM1,500  – which do you prefer?
• Do you believe that cheap stuff does not work?
• Was the treatment in the hospital just only for his prostate cancer? Ignoring the metastases in the bone and lungs?
• Do you think by just taking Casodex his prostate cancer can be cured?
• Make your own choice – wisely!