Kanker Lambung Bagian 2: Dia memilih kemoterapi. Setelah dua siklus dia menyerah dan kembali minum herbal CA Care. Mengapa?

DK adalah dari Indonesia. Dia didiagnosis mengidap kanker lambung oleh seorang dokter di Penang.

Dari Penang, dia pergi ke Singapura mencari pendapat kedua. Dia mendapat saran yang sama. Setelah operasi, ia membutuhkan kemoterapi. Tidak ada dua cara untuk hal itu.

Di Singapura, operasi akan menelan biaya SGD60.000 sementara kemoterapi biaya SGD40.000. Totalnya sekitar SGD100.000.

Pada awal Agustus 2017, DK kembali ke satu lagi rumah sakit swasta di Penang dan memutuskan untuk menjalani operasi di sini. Seluruh lambungnya diangkat (gambar di bawah). Biaya operasi adalah RM50.000. Dia tinggal di rumah sakit selama sekitar sepuluh hari.

Laporan histopatologi menunjukkan adenokarsinoma usus berdiferensiasi. T3N1Mx, setidaknya Stadium 3A.

Setelah operasi, DK dirujuk ke ahli onkologi yang mengatakan DK membutuh delapan siklus kemoterapi. Obat yang digunakan adalah: infus Oxaliplatin dan obat minum TS-One. Total biaya perawatan adalah sekitar RM50.000 (ambil perhatian: total biaya operasi dan kemoterapi di Penang tiga kali lebih murah daripada Singapura).

Ahli onkologi di Penang memberitahunya, Tidak masalah. Kemo bisa menyembuhkan. Tetapi jika Anda tidak melakukan kemo, kanker bisa kambuh.

DK datang menemui kami dan mulai minum herbal selama sekitar dua minggu.

Selepas itu ia tidak datang kembali lagi ke CA Care.

Setelah beberapa bulan, pada Januari 2018, DK kembali menemui kami lagi. Apa yang terjadi?

Kami diberitahu bahwa DK berhenti minum ramuan kami. Dia kembali kedapa dokternya untuk kemoterapi. Ini adalah pada bulan November hingga Desember 2017. Setelah dua siklus, DK memutuskan untuk menghentikan kemoterapi dan beralih ke herbal kami lagi.

Kasus DK keluar dari radar saya untuk sementara sampai September / November 2018 ketika istri dan putrinya datang untuk melaporkan kemajuan DK.

Saya tidak tahu mengapa dia memutuskan untuk beralih pengobatan setengah jalan seperti itu. Apakah kamu ingin tahu? Dengarkan penjelasan istrinya.

 

 

Setelah minum herbal selama sekitar dua minggu, ia memilih kemoterapi. Mengapa? Itu bukan karena rasa pahit atau bau herbal yang mengerikan. Sebab yang benar adalah tentang makanan. Mengikuti terapi kami berarti dia harus mengurus dietnya.  Dia tidak bisa makan apa yang dia suka. Ini pembatasan yang tidak cocok dengannya. Jika dia memilih kemoterapi, dokter mengatakan dia bisa makan apa yang dia suka. Bravo!

Setelah dua siklus kemoterapi, DK memutuskan untuk beralih ke herbal kami sekali lagi. Mengapa? Seperti kebanyakan orang tahu, kemoterapi memiliki terlalu banyak efek samping yang parah. DK tidak bisa menerimanya. Jadi dia harus kuai-kuai (dengan baik hati) kembali ke herbal kami.

Setelah minum herbal kami selama sekitar satu tahun, dia baik-baik saja? Sejauh ini baik.

Sementara minum herbal kami, apakah DK menjaga dietnya? Ini adalah pertanyaan juta dolar. Putrinya hanya tersenyum ketika saya bertanya pertanyaan ini. Ya, di rumah, istrinya memastikan dia makan dengan benar. Tapi dia pergi keluar dengan teman-teman sehari-hari. Apa yang ia lakukan tidak ada yang tahu.

Menurut Anda apa yang akan terjadi pada DK? Dugaan Anda sama baiknya dengan saya.

Berikut adalah satu kasus yang mungkin bisa menjadi satu teladan kepada kita semua

Mari kita namakan pasien ini sebagai Jim. Dia juga menderita kanker lambung. Saya sarankan ia mengangkat total lambungnya. Setelah operasi Jim memutuskan untuk tidak menjalani kemoterapi. Ia mau minum herbal kami.

Jim adalah orang yang baik dan ramah. Setiap kali dia datang ke pusat kami, kami selalu mengobrol panjang seperti teman lama. Kami berbicara tentang segalanya.

Pada suatu waktu dia mengatakan ingin menulis buku tentang kisah hidupnya. Saya mendorongnya untuk melakukannya dan menawarkan untuk membantunya mengedit naskah. Kami memulai proyek itu … ya, bab satu selesai!

Selama satu tahun, Jim minum herbal kami. Kesehatannya baik-baik saja.  Dia tampak hebat dan dia merasa hebat.

Jim memberitahu saya bahwa nafsu makannya telah meningkat dua kali lipat dibandingkan dengan waktu sebelum dia menderita kanker. Tapi ingat, dia tidak punya lambung lagi!

Lalu suatu hari, Jim mengalami sakit perut. Saya sarankannya untuk kembali ke dokter bedahnya (yang juga temannya) dan mencari tahu apa yang terjadi. Ususnya penuh dengan makanan yang tidak dicerna. Jim butuh operasi segera.

Setelah operasi, Jim kembali ke pusat kami lagi. Dia tampak kurus dan capek. Sayangnya, beberapa bulan kemudian dia meninggal. Saya telah kehilangan seorang teman dan pasien dengan begitu cepat.

Beberapa minggu kemudian, putri Jim datang ke pusat kami. Kami duduk dan berbagi kesedihan kami. Pertanyaan saya – apakah Jim benar-benar jaga makanannya? Dengan air mata di matanya, anak perempuan Jim menjawab, TIDAK. Saya bisa merasakan frustrasi dalam putrinya.

Biarkan kebenaran ini diberitahunkan kepada semua pasien. Tidak, Jim tidak mepatuhi pantangan tentang makanannya sejak hari pertama!

Setelah dia pulih dari operasi pertamanya, dia keluar dengan teman-temannya (ya, seorang yang riang  memang  memiliki banyak teman!). Dan mereka akan pergi keluar untuk makan apa yang mereka sukai. Tidak heran usus kecilnya berubah menjadi “sosis yang dikemas dan padat” yang perlu dibuang.

Kemudian putri Jim menambahkan bahwa bahkan setelah operasi kedua, ayahnya tidak belajar dari kesalahan ini. Setelah ia sembuh dari operasi kedua itu, lagi ia pergi keluar dengan teman-teman ke berbagai tempat di Penang mana ada makanan yang enak.

Saya merasa sedih mendengar cerita ini. Tapi itulah caranya. Itulah kebanyakan pasien mau.

Jadi jika Anda bertanya lagi, apa yang bisa terjadi pada DK. Saya akan mengatakan, saya berharap DK tidak akan menjadi seperti Jim. Tapi benar-benar dihati saya, kemungkinan besar cerita DK  pun seperti cerita Jim, kalau ia tidak jaga makanannya.

Semoga beruntung, DK.

 

 

 

 

 

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Cancer of the Oesophagus: Surgery, chemo and radiation failed. RM 200K gone!

PK is a 61-year-old Malaysian. In April 2017 he had difficulty swallowing. He consulted a doctor in Ipoh.

A CT scan on 14 April 2017 indicated:

  • Long segmental circumferential wall thickening of the mid-oesophagus with luminal narrowing.
  • No evidence of local infiltrations or mediastinal lymphadeopathy.

PK was referred to a private hospital in Kuala Lumpur for further management.

PET scan on 10 August 2017 indicated:

  • FDG avid primary at the mid oesophagus.
  • Intense FDG uptake in the left upper lobe lung nodule — suspicious of metastasis.
  • Small focal FDG avid lesion at L3 vertebra — suspicious of small volume metastasis.
  • No conclusive FDG avid lesion demonstrated elsewhere.

PK was told to proceed with one cycle of chemotherapy immediately. Five days later he had surgery. The total length of the tissue removed is 20.05 cm (picture below). This is made up of 10.04 cm oesophagus and 5.0 cm stomach tissue.

Histopathology report confirmed a moderately differentiated squamous cell carcinoma, ypT2ypN2.

Four of the 26 lymph nodes examined were positive for tumour metastases.

Following the standard procedure, PK underwent six cycles of chemotherapy and 25 sessions of radiotherapy.

A repeat PET scan was done seven months later. Is the cancer gone or is he getting worse?

Study the three pictures below and compare them with the PET scan done on 10 August 2017 (above).  You don’t need to be a doctor to know that PK is not getter better. He is getting worse and the cancer has spread more widely.

The PET scan report of 11 April 2018 stated the following:

  • New development of large reticulonodular changes at the left upper lobe, probably related to post-radiation inflammation.
  • New FDG avid mediastinal nodes, probably reactive nodes from inflammation.
  • Metabolic increment in the left level IV cervical node.
  • Mixed metabolic changes in the retroperitoneal and pelvic nodes.
  • New development seen at thoracic stomach wall nodule and peri-bowel node at celiac axis, and celiac trunk nodes.

His blood test results are as follows:

30 July 18 27 Sept 18
 CEA 25.7 H 33.8 H
 CA 19.9 132.1 H 164.2 H

All told, PK had spent about RM200,000 for this failed medical treatment. He was asked to undergo more chemotherapy. PK refused and came to seek our help.

Below is excerpts of our conversation that morning.

Part 1: Surgery, chemo and radiation failed

 

Part 2: My advice

Comments 

Generally most patients who come to us are those who have undergone all medical treatments and failed, like PK’s case. They probably have nowhere else to go. Then suddenly through words of a friend or the internet, they discovered CA Care. That is okay — after all this is what CA Care is about — to help those who are lost and in need of help.

Unfortunately, some patients are rather unrealistic. Even at this point of failure, they come with the hope that we can offer them a cure! That is impossible. We do NOT promise any cure. We only promise to do our best to help.

There is also another disappointing group of patients. They come seeking our help on their own terms and some even at their own time. They want to do things their way. They only want capsules and don’t want to drink the bitter teas — too much work having to brew them! What if I go for a holiday? They want to eat anything they like. For such patients, I generally send them home without any herbs. It is better for such patients to find someone else to help them.

Our core belief is that YOUR health is YOUR RESPONSIBILITY. We teach you how to get well but it is you who need to take charge of your own healing.

One of the things I often look for when talking to patients is their attitude and commitment. Do they believe in what we are doing — taking herbs and changing of diet, etc.?  If you do not trust us or believe in what we do there is no reason why you should come to CA Care in the first place.

When PK was first diagnosed with oesophagus cancer he put his total trust in the doctors.

He underwent surgery, chemotherapy and radiotherapy and along the way spent RM200,000. Did he ever thought or believe in an alternative healing method? No. Did he know about alternative healing? I believe it is a big YES.

PK came to CA Care with his sister who is our patient. His sister had breast cancer. She underwent an operation to remove her breast and was treated with chemotherapy. After one shot of chemo, she suffered badly — difficulty breathing and the colour of her skin turned dark. She gave up chemo and started to take our herbs. That was in June 2005. Now, it is October 2018 — thirteen years — and she is doing well and has no problems all these years despite forgoing her schedule to do six cycles of chemo.

From my conversation with PK and his family, I sensed that he has zero knowledge about cancer. To him doctors know best. And he is wealthy enough to be able to pay the medical bills.

Whatever it is, after seven months of medical treatments, we know the reality of what modern medicine has done for him. There is no need to find a scapegoat. What is done is done. For those who wish to learn, take note of what had happened to PK. Since the past two decades I got to learn new things everyday! So I am sharing with you both the good and bad news so that we can all learn from these experiences.

I prescribed PK some herbs and told him to take care of his diet. I hope to see him again in the next two or four weeks, that is if he ever comes back again for more herbs! (Update: Yes, he did come back after two/four weeks, but I told him: If you find the herbs difficult to take or if they don’t help you, please stop taking them. Find other person to help you).

About this same time, I also have another case of oesophagus cancer. Let’s call him Alex, a 58-year-old man from Melaka. Like PK, Alex too had problems swallowing food. Alex was subsequently diagnosed with cancer of the oesophagus. Unfortunately the cancer had spread to the stomach and bones. Alex refused surgery or chemotherapy and came to seek our help instead.

How did Alex know us? Through a friend in Melaka who had stomach cancer. This friend underwent surgery but refused chemo. Through the recommendation of the surgeon who removed his stomach, this patient came to seek our help. It has been three years now, and this friend is doing well. Perhaps because of this friend’s experience that Alex came to us with high hope that we could help him.

After studying his medical reports, I suggested to Alex to go for surgery — at least to have the tumour removed so that he can swallow his food. No, Alex would not want to go for surgery. I impressed on Alex that

surgery is probably a good option to solve his swallowing problem. He was adamant — he would not go for any surgery.

I have to respect his decision. I also know that surgery would not cure him because the cancer had already spread to the stomach, many lymph nodes and bones.

I struck a compromise with Alex. Okay, take the herbs for about a month and see what happens. If there is no improvement, he should go for the operation. If the herbs do not help and he still refuses surgery then he should go and find someone else who can help him. I cannot help him anymore.

Alex came back after two months! He has no more problem with his swallowing. He seems to be able to carry on with his life like any normal person, except of the pains in the backbone because of the cancer. Is he cured? Definitely not.

So what is next? I really don’t know. But for now we can see that his outcome is better than PK. There is no drama and no suffering. On top of it, there no need to spend RM200K in seven months!

 

 

 

Kanker Lambung Bagian 1: Saran saya

DK adalah orang Indonesia berusia 58 tahun. Masalahnya muncul pada Juni 2017. Ia berak berdarah.

Dia pergi ke rumah sakit untuk pemeriksaan. Darahnya rendah dan dia membutuhkan transfusi darah.

Dia kemudian datang ke rumah sakit swasta di Penang untuk konsultasi.

CT scan pada 16 Juni 2017 menunjukkan lesi mukosa fokal di persimpangan gastroesofageal, sesuai dengan tumor awal.

Endoskopi mengindikasikan tumor persimpangan cardio-oesophageal.

Biopsi menunjukkan jaringan villoglandular abnormal dengan displasia derajat tinggi.

Berdasarkan hal di atas, dokter mengatakan DK harus menjalani operasi dan mungkin membutuh radioterapi.

DK memutuskan untuk menunda perawatan lebih lanjut karena dia telah menjalani operasi by-pass jantung hanya enam minggu yang lalu.

DK dan keluarganya datang untuk meminta saran kami.

Kami memiliki percakapan yang panjang dan tenang pagi itu.

 

 

Berikut ini adalah beberapa hal penting yang kita bincang.

  1. Kami berada dalam situasi yang sangat sulit. Minum herbal CA Care tidak bisa mehilangkan tumor itu. Biarkan kebenaran ini diketahui semua. Orang lain mungkin menjamin yang obat mereka bisa menyembuhkan kanker. Tapi bukan diCA CAre. Saya tidak ingin menyesatkan Anda.
  1. Pilihan terbaik adalah operasi. Tetapi operasi juga tidak bisa jamin kesembuhan. Masalah ini bahkan lebih rumit dalam kasus Anda. Enam minggu yang lalu Anda menjalani operasi by-pass jantung – dan sekarang Anda diminta untuk menjalani operasi satu lagi diikuti dengan kemoterapi atau mungkin radioterapi. Jadi kita harus lebih berhati-hati.
  1. Kekhawatiran lain adalah apakah Anda sudah pergi ke dokter yang tepat atau bagus.

Menurut putra DK, dokter itu mengakui bahwa ia adalah pakar kanker usus  dan karena itu ia butuh dokter spesialis lambung untuk membantunya dalam operasi itu.

Oleh itu, saya menyarankan agar Anda mendapat pendapat kedua dari dokter lain.

  1. Ke mana Anda bisa pergi untuk operasi semacam itu?

Salah satu pilihan adalah mencoba SGH / NCC (Singapore General Hospital / National Cancer Centre) di Singapura.

Ketika berbicara dengan dokter, tanyakan dua pertanyaan ini.

Satu, bisakah operasinya bisa menyembuhkan Anda?

Dua, berapa total biaya perawatannya?

  1. Anda harus tahu bahwa operasi mungkin tidak dapat selesaikan semua masalah Anda. Operasi mungkin tidak menyembuhkan Anda. Tidak ada yang tahu. Tapi jalan ini adalah satu-satunya pilihan yang Anda miliki.
  1. Setelah operasi, jika Anda tidak ingin menjalani kemoterapi, Anda dapat minum herbal kami. Ada pasien saya sebelum Anda yang melakukan hal itu. Setelah operasi, dia menolak kemoterapi dan menjalani terapi CA Care. Dia masih baik-baik saja selama bertahun-tahun sekarang. Ada satu lagi pasien lain yang menolak kemoterapi. Dokter bedahnya sarankan ia datang ke CA Care. Ia minum herbal kami. Sudah tiga tahun sekarang dan dia baik-baik saja.
  1. Bagaimana jika saya menolak operasi, saya hanya minum herbal Anda?

Biarkan saya beritahu dengan jelas. Herbal saya tidak bisa menyembuhkan Anda. Herbal dapat membantu Anda, memperpanjang hidup Anda – mungkin. Tapi tak mungkin menyembuhkan secara total.

  1. Saya sadar ini adalah satu tanggung jawab yang berat untuk ditanggung. Jika Anda mengkonsumsi herbal kami dan Anda berakhir dengan lebih banyak masalah, Anda mungkin menyalahkan kami. Saya mederita karena herbal Anda! Dokter Anda mungkin juga menyalahkan kami. Jadi itu sulit.

Bahkan saya lebih suka pasien-pasien TIDAK datang menemui saya — kalau bisa, jangan datang jumpa saya!

Di CA Care kami memberikan saran gratis – tanpa biaya konsultasi. Dan kita harus memikul tanggung jawab yang berat. Itu memang susah.

  1. Tidak apa-apa, saya ingin minum herbal Anda!

Biarkan saya jelas sekali lagi. Tolong jangan salahkan kami jika Anda berakhir dengan masalah. Saya akan coba yang terbaik untuk membantu Anda.

  1. Sekarang Anda tidak harus terburu-buru. Pulanglah dan pikirkan baik-baik. Anda bisa berkonsultasi dengan dokter lain. Coba selesaikan hal ini dalam waktu satu bulan. Jangan abaikan perkara ini terlalu lama.
  1. Saya telah memberi Anda pendapat saya yang tulus. Jika saya berada dalam situasi Anda, saya akan melakukan apa yang baru saja saya katakan kepada Anda. Pergilah untuk operasi. Mungkin saya pergi ke Singapura.

Apakah Anda ingin menerima saran saya atau tidak, itu adalah keputusan Anda. Jadi pulanglah dan pikirkan baik-baik.

  1. Tidak, dok. Saya ingin mencoba herbal Anda!

Apa kata alhi keluarga Anda? Putra dan istri Anda?

Biarkan saya mengingatkan Anda lagi, herbal tidak dapat menyembuhkan Anda!

  1. Oke, sementara itu Anda bisa mengikuti terapi kami – minum herbal untuk mempastikan apakah Anda sanggup minum teh yang pahit ini. Anda harus juga jaga diet / makanan Anda.

Diet ini juga mungkin dapat membantu masalah jantung Anda.

 

 

 

 

Stomach Cancer Part 1: My advice

DK is a 58-year-old Indonesian. His problem showed up in June 2017, when he passed out blood in his stools. He went to the hospital for check up. His blood was low and he needed a blood transfusion. He then came to a private hospital in Penang for consultation.

CT scan on 16 June 2017 indicated a focal mucosal lesion in the gastroesophageal junction, in keeping with early tumour. A small perigastric node noted suggestive of reactive node.

An endoscopy indicated a cardio-oesophageal junction tumour.

Biopsy indicated abnormal villoglandular tissue with high grade dysplasia.

Based on the above, the doctor said DK has to go for surgery after which need radiotherapy.

DK decided to defer further treatment because he had undergone a heart by-pass operation just six weeks ago.

DK and his family came to seek our advice. We had a long, sober conversation that morning.

 

 

The following are some important points we discussed.

  1. We are in a very difficult situation. Taking our herbs cannot make the tumour go away. Let this truth be told. Others may promise you a cure. But not here. I don’t want to mislead you.
  1. The best option is surgery. But even operation does not guarantee you a cure. No one can tell. This problem is even more complicated in your case. Six weeks ago you had a heart surgery — and you are asked to go for another surgery followed by chemotherapy or even radiotherapy. So we have to be a bit more careful.
  1. Another concern is whether you have gone to the right doctor.

According to DK’s son the doctor had admitted that he deals mostly with colon cancer and therefore he needed another doctor (a stomach specialist) to assist him in the operation. In view of this, I suggested that DK go for a second opinion.

  1. Where do you go for such an operation?

One option is to try SGH/NCC (Singapore General Hospital / National Cancer Centre) in Singapore.

When talking to the doctor, ask these two questions. One, can the surgery cure me? Two, what would be the total cost of the treatment?

  1. Also take note that surgery may not be able to solve all your problem. It may not even cure you. No one can tell. But that is the only option you have.
  1. After the surgery, if you don’t want to go for chemotherapy, you can opt for our herbs. I have patients before you who did exactly that. After surgery he refused chemo and took the herbs. He is still doing well for years now. There is another patient who refused chemo. His surgeon sent him to see us. It has been three years now and he is doing fine.
  1. What if don’t go for the operation, I only take your herbs?

Let me be very clear. Herbs cannot cure you. Herbs can help you, extend your life — may be. We cannot talk about cure.

  1. I am aware this is a heavy responsibility to bear. If you take our herbs and you ended up with more problems you may want to blame us. It is because of your herbs! Your doctors may also blame us. So it is difficult.

In fact I would rather people NOT come and see me, if possible.

At CA Care we provide free advice — no consultation fee. And we have to bear a heavy responsibility. It is hard.

  1. It is okay, I want to take your herbs!

Let me be clear. Please don’t blame us if you end up with problems. I shall try my best to help and that is all I can do.

  1. There is need to rush. Go home and think carefully. You can go and seek the help of another doctors. Get this sorted out within a month. Unnecessary delay is also not advisable.
  1. I have given you my sincere opinion. If I were in your situation, I would have done what I have just told you. Go for the operation. May be I go to Singapore. Whether you want to accept my advice or not, it is your decision. So go home and think carefully.
  1. No, doc. I want to try your herbs!

What do your son and wife say? Let me remind you again, the herbs cannot cure you!

  1. Okay, in the meantime you can follow our therapy — take the herbs to see if you like it or not. Then you have to take care of your diet. In fact taking care of your diet may also help with your heart problems.

 

 

 

BALT lymphoma of the lung: Chemotherapy failed. Herbs helped him.

AST is from Tanjung Balai, a town on one of the islands in Riau, Indonesia.

In April 2018, this 48-year-old man — a smoker of some 30 years standing — went for a routine medical checkup in Johor Baru, Malaysia. He had no symptom whatsoever.

An X-ray during the checkup showed something in his lung. A trucut biopsy of the right lung mass was done immediately. Histomorphology and immunoprofile pointed to a low grade lymphoma of BALT.

Bone Marrow Aspirate and Bone Marrow Trephine showed normocellular marrow (meaning, in contains a normal number of cells; neither hypocellular nor hypercellular).

(Bone Marrow Aspiration and Biopsy: The procedure known as trepanning, or trephination, of bone is the oldest surgical practice that continues to have clinical relevance in modern times. There are 2 main types of bone marrow test: 1) bone marrow aspiration — doctor sucks some liquid bone marrow cells up into a syringe. 2) bone marrow trephine biopsy — the doctor removes1 or 2cm core of bone marrow in one piece. Usually both of these tests are done at the same time. These tests are often done to find the reason for many blood disorders and may be used to find out if cancer or infection has spread to the bone marrow).

AST was referred to an oncologist of the same hospital for follow up treatment. He was sent to another hospital for PET/CT scan. The results of the scan done on 23 April 2018 indicated:

  • FDG avid mass right lung, 8.4 x 5.9 x 8.1 cm.
  • FDG avid nodule apicoposterior segment lower upper lobe, 1.0 x 0.8 cm.
  • Bronchieactatic changes seen in both lungs.
  • No mediastinal mass lesion or lymphadenopathy.

AST underwent chemotherapy. The drug regime used was: R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin (hydroxydaunomycin), Vincristine (Oncovin) and Prednisolone (a steriod).

Each cycle cost RM11,000. He received a total of three cycles at three-weekly interval. The treatment completed on 14 June 2018.

After this initial treatment, AST’s father died (due to old age) and as a result he took a break from chemotherapy.

A repeat PET/CT scan was done on 15 August 2018. The result showed:

  • Previous FDG avid mass right lung has reduced intensity and was smaller 6.5 x 4.9 x 5.5 cm.
  • Previous FDG avid nodule apicoposterior segment lower upper lobe disappear.
  • New two FDG avid nodules at posterior lower left lobe, 1.5 x 1.0 cm and 1.1 x 0.9 cm.
  • New right paravertebral mass lesion, 0.8 x 0.6 cm.
  • Multiple cysts both lung fields unchanged.

Impression: progression of lesions with new lung metastases left lower lobe and small right paravertebral mass.

AST received ten times of radiation on the chest. This cost him RM 5,000.

He was told to go for more chemo. He refused. His daughter found CA Care in the internet and decided to seek our help. 

Comments 

You may wonder why I document this case. Here is the answer. For more than two decades of helping cancer patients, lung cancer is one of the most common that I get to see. And these are carcinoma type of lung cancer. During these years I did come across a few cases of lung cancer of the sarcoma (not carcinoma) type.

Primary lung sarcoma is very rare, accounting for less than 0.5% of all lung tumors. Then this week, I encountered a pulmonary BALT lymphoma, a first case in over twenty years.

I came home and started to learn what this BALT lymphoma is. Here are some information about this type of really rare lung cancer.

  • BALT means Bronchus Associated Lymphoid Tissue. It is a lymphoma found in the lung. Actually there are two types of lung lymphoma — BALT and MALT lymphoma. MALT stands for Mucosa Associated Lymphoid Tissue. The most common type of primary pulmonary lymphoma is MALT lymphoma.
  • Most pulmonary lymphomas are low-grade B-cell lymphoma.
  • Primary pulmonary lymphoma is rare, accounting for 0.5% of all lung tumors and less than 1% of all lymphomas.
  • They are generally indolent (causing little or no pain) with good prognosis.
  • Patients with BALT lymphoma have an excellent prognosis. Interestingly, surgical treatment, radiotherapy, chemotherapy, or combinations of these strategies all seem to achieve good results.
  • The most frequent reported symptoms in patients with BALT lymphoma include dry cough and difficult breathing.
  • Patients may also present with fever, night sweats and weight loss.
  • Since many patients are asymptomatic or present with vague symptoms, there is often a delay in diagnosis. It is believed that, in approximately one-third to one-half of the patients, the disease is discovered incidentally on X-ray.
  • About 14% of patients may have bone marrow involvement.
  • Since this is a slow-growing disease, it has excellent response to surgery, chemotherapy or combined treatment. Treatment provides excellent prognosis, with extremely low mortality rates. There is a report that pulmonary BALT lymphoma was successfully treated with eight cycles weekly Rituximab.

AST and his daughter came to consult us in October 2018. He looked “healthy” except for a bit of cough and difficulty in breathing. After hearing his story, I told AST that his lifestyle is reckless. While still on chemotherapy, AST told me that he was riding motorcycle up the rugged hills in the rain. This resulted in infection. I emphasized to AST that he needs to adopt a more “healthy and restrained” lifestyle if he wants to live without problems.

I cannot say what is going to happen next but after reading what pulmonary BALT lymphoma is, I want to “believe” that the herbs and a change of lifestyle  can help him. But ultimately, it all depends on AST, whether he is willing to help himself or not.

Update: AST came back to see us again after a month. He took the herbs and keep to the diet without any problem. He did not suffer any healing crisis. Did his health deteriorate this one month after defaulting on chemotherapy? No. Did he feel better after taking the herbs? Yes.

AST said he has more energy after taking the herbs. His cough is also resolved. He can now take a deep breath. Before the herbs, his breathing was swallow. AST said he would NOT go for anymore chemo. He is happy following our therapy.

Watch this video.

 

P/S:  As I am writing this story, a lady came to your centre. She was diagnosed with MALT lymphoma.This is also my first encounter with this type of cancer. In this case, the MALT lymphoma “attacked” the inner lining of her eye lid. How could that be? I wonder what has become of our world today. I hope to be able to write about this story in the near future.

 

 

Lymphoma of Nasal Cavity: No chemo or radiation. Ten years on, doing just fine.

 

 KC was 53 year old when he was diagnosed with T-cell lymphoma of the nasal cavity. His problem started with a runny nose in 2007. His nose had a swelling.

In 2008 he had difficulty breathing and production of blood-stained phlegm. He consulted a GP who said he had an infection. Antibiotics did not help him.

KC consulted an ENT at a private hospital. CT scan showed soft tissue lesion seen occupying the left nasal cavity.

A biopsy was performed. The histology report dated 24 March 2008 indicted: Left nasal blocked for long time. Left nasal mass –  atypical lymphoid proliferation found suggestive of low grade non-Hodgkin’s lymphoma. The diagnosis was later confirmed by University of Malaya as Nasal type: T-cell lymphoma.

The doctor suggested 30 sessions of radiotherapy and six cycles of chemotherapy. The doctor warned KC that without treatment his nose will be blocked, his vision will be affected and he may go deaf.

KC refused further medical treatment. He came to CA Care on 4 April 2008. He told us that he has many friends who had undergone chemotherapy and radiotherapy and they all died. He would not want to go through such treatments.

KC was started on herbs: NPC 1 and NPC2, Lymphoma 1 and 2, NPC Phlegm, Capsule A and detox Tea. He was also told to take care of his diet.

One day on the herbs, KC had more bleeding from the nose. The second day, his phlegm was yellowish.

Seven weeks on the herbs KC felt his nose was better.  There was less bleeding and production of phlegm. He could sleep better. He was happy with the progress. KC said he spend time jogging from 3 to 5 pm each day.

About five months later, on 19 September 2008, KC went back to see the doctor who examined him earlier. A nasal endoscopy was done. The doctor told him it was good and there was nothing inside his nose anymore. KC came to our center on 28 September 2008 to inform us of this good news.

I asked him: Did you go and see the same doctor who examined earlier? KC confirmed that it was same ENT who did the biopsy for him.

Since then KC is well and fine.

KC does not understand much English and Hokkien. I need an interpreter to communicate with him. My question to him: How are you doing? Are you okay? He would reply: Ok, ok. No problem. I can eat, can sleep well and can go anywhere I like. 

Fast forward to November 2018 — ten years later. KC came to our centre. He is doing okay. No problem.

A few years ago, KC’s brother was also diagnosed with nose cancer. KC brought his brother to see us. Unfortunately his brother did not believe in herbs. He opted for chemotherapy and radiotherapy. He died some months later.  

Questions to Ponder

  • What could have happen if KC were to undergo chemotherapy and radiotherapy as suggested by the doctor?
  • It has been TEN years now, and KC is doing extremely well. Is the taking of herbs and changing of diet not a proven healing method?
  • KC’s brother also had nose cancer but opted for chemo and radiation. He knew first hand that KC was doing well on our therapy. Why did he not follow KC? Is it because following our therapy means he cannot eat anything he likes?

 

 

 

Limfoma Hidung: Tak mau kemoterapi atau radiasi. Sepuluh tahun kemudian, baik-baik saja.

 

KC berusia 53 tahun ketika dia didiagnosis dengan limfoma sel T dari rongga hidung. Masalahnya dimulai dengan hidung berair pada tahun 2007. Hidungnya bengkak.

Pada tahun 2008 ia mengalami kesulitan bernapas dan produksi dahak bernoda darah.

Dia berkonsultasi dengan dokter umum yang mengatakan dia mengalami infeksi. Antibiotik tidak membantunya.

KC berkonsultasi dengan THT di rumah sakit swasta. CT scan menunjukkan lesi jaringan lunak terlihat menempati rongga hidung kiri.

Biopsi dilakukan. Laporan histologi pada 24 Maret 2008 mengesahkan: Hidung kiri diblokir untuk waktu yang lama. Massa nasal kiri – proliferasi limfoid atipikal ditemukan menunjukkan limfoma non-Hodgkin derajat rendah.

Diagnosis kemudian dikonfirmasi oleh University of Malaya sebagai tipe Nasal: limfoma sel-T.

Dokter menyarankan 30 sesi radioterapi dan enam siklus kemoterapi.

Dokter memperingatkan KC bahwa tanpa perawatan hidungnya akan diblokir, penglihatannya akan terpengaruh dan dia mungkin menjadi tuli.

KC menolak perawatan medis lebih lanjut. Dia datang ke CA Care pada 4 April 2008.

Dia memberi tahu kami bahwa dia memiliki banyak teman yang telah menjalani kemoterapi dan radioterapi dan mereka semua meninggal. Dia tidak mau menjalani perawatan seperti itu.

KC diresepkan herbal: NPC 1 dan NPC2, Limfoma 1 dan 2, NPC Phlegm, Capsule A dan Teh detoks. Dia juga diberitahu untuk menjaga pola makannya — harus pantang.

Satu hari setelah minum herbal: KC mengalami pendarahan lebih dari hidung. Hari kedua, dahaknya kekuningan.

Tujuh minggu setelah minum herbal: KC merasa hidungnya lebih baik. Ada kurang perdarahan dan produksi dahak. Dia bisa tidur lebih baik. Dia senang dengan kemajuan.

KC mengatakan dia pergi joging dari jam 3 sampai jam 5 sore setiap hari.

Sekitar lima bulan kemudian, pada 19 September 2008.

KC kembali menemui dokter yang memeriksanya sebelumnya. Endoskopi nasal dilakukan. Dokter mengatakan bahwa itu baik dan tidak ada massa di dalam hidungnya lagi.

KC datang ke pusat kami pada 28 September 2008 untuk menginformasikan kepada kami kabar baik ini. Saya bertanya: Apakah Anda pergi ke dokter yang sama yang memeriksa sebelumnya? KC menegaskan bahwa itu adalah THT yang sama yang melakukan biopsi untuknya.

Sejak itu KC baik-baik saja.

KC tidak mengerti banyak bahasa Inggris dan Hokkien. Saya membutuhkan seorang juru bahasa untuk berkomunikasi dengannya. Pertanyaan saya padanya: Bagaimana kabarmu? Apakah kamu baik-baik saja? Dia akan menjawab: Ok, oke. Tidak masalah. Saya bisa makan, bisa tidur dengan baik dan bisa pergi kemanapun saya suka. 

Maju cepat hingga November 2018 – sepuluh tahun kemudian.

KC datang ke pusat kami. Dia baik-baik saja. Tidak masalah.

Beberapa tahun yang lalu, KC membawa saudaranya yang menderita kanker hidung ke CA Care. Sayangnya saudaranya tidak percaya pada herbal. Ia memilih kemoterapi dan radioterapi. Dia meninggal beberapa bulan kemudian.

Pertanyaan Untuk Renungan

  • Apa yang bisa terjadi jika KC menjalani kemoterapi dan radioterapi seperti yang disarankan oleh dokter?
  • Sudah SEPULUH tahun sekarang dan KC baik-baik saja. Apakah menjalani terapi herbal dan perubahan diet bukan metode penyembuhan yang terbukti?
  • Saudara KC juga menderita kanker hidung tetapi memilih kemoterapi dan radiasi. Dia tahu secara langsung bahwa KC baik-baik saja dengan mejalani terapi kami. Mengapa dia tidak mengikuti KC? Apakah karena mengikuti terapi kami berarti dia harus pantang dan tidak dapat makan apapun yang dia suka?

 

 

 

From TB to Nose Cancer. After chemotherapy and radiotherapy, extensive bony metastases. What has gone wrong?

FR is a 40-yer-old male, private school teacher from Indonesia. In November 2017, he had a swelling in the left side of his neck. A biopsy was done by a doctor in his hometown. FR was told he had tuberculosis (TB). He was prescribed Rifastar — a TB drug. FR took Rifastar for about two months. Another lump appeared on his neck.

FR went to see another doctor. He was again told he had TB. This time he was prescribed more drugs: Rofamtibi, Lovesco (antibiotic) and Lesichol (for liver).  After one month on these drugs the swelling in his neck became smaller. But after the second month, the drugs were not effective anymore.

FR went to a hospital in Melaka for further management.

A trucut biopsy of left cervical lymph node on 28 March 2018, suggested a metastatic undifferentiated or poorly differentiated carcinoma, highly suggestive of undifferentiated nasopharyngeal carcinoma (NPC – nose cancer).

CT scan report stated: Tiny right middle lobe lung nodule and aorto-pulmonary lymphadenopathy (1.1 cm). Infection or metastasis ? No suspicious bony lesion.

MRI showed multiple enlarged left jugular nodes as large as 4 cm. There is no obvious tumour in the postnasal space.

FR was referred to the oncologist in the same Melaka hospital. He was told to undergo chemotherapy and radiotherapy immediately because this was a Stage 4B cancer.

FR came to Penang and consulted us. He was prescribed some herbs for his NPC, lung, lymph nodes and liver. However, FR’s father asked FR to undergo medical treatments instead of just relying on our herbs.

So FR went to a private hospital in Kuala Lumpur and had six cycles of chemotherapy with cisplatin — one cycle every week. He also received 33 sessions of radiotherapy.

In all, the cost of the treatments was about IDR 200 million (approximately RM58,000).

PET scan results below showed amazing results after the medical treatments. The swelling were all gone!

But there is no time to celebrate yet.

Unfortunately, the PET scan also showed (below) that the cancer had spread extensively to the bones — the skull (white arrow), T4, T5, T6, T7, T8, T9, T10, T11, T12, L1, L2, L3, L4, L5, and sacral vertebrae, head of humerus, left scapula, sternum, right 3rd and left 6th rib, pelvic and femoral bones.

FR was told to undergo more chemotherapy, this time using carboplatin + Gemcitabine. Six cycles of this treatment is going to cost RM42,000.

FR refused further medical treatment and came back to seek our help for the second time!

Comments

This is indeed a sad morning for me to see how “lost and fearful” FR and his wife were. Why the extensive spread to the bones? And this happened so fast. Barely five months ago — the PET scan in May 2018, before chemotherapy and radiotherapy — showed no traces of bony metastasis. What has gone wrong?

Most patients, after being diagnosed with cancer, generally opt for the so called “scientific, proven” medical treatment. Yes, they believe medical treatments can cure their cancer. I have no problem with that. By all means, go and see your doctors and do whatever they want you to do. I also tell patients that if or when these treatments fail, they can come to us. No hard feelings. We do NOT promise we can cure you. But we shall try our best to help the way we know how.

Dr. Laura Nasi, an integrative oncologist, in her book, Cancer as a wake-up call explained clearly what medical treatments for cancer can offer patients. Let me quote what she wrote:

page114: Fifty percent of those who receive a cancer diagnosis — and up to 90 percent with some kinds of cancer — are cured with conventional medicine. 

page 115: Eastern medicine, e.g. Chinese and Ayurvedic medicine, are excellent for preserving health, but they are not always fast enough when cancer is already established in the body. When the situation is urgent, Western medicine’s surgery, radiation and chemo take effect immediately. 

page 117: When cancer is detected during its early stages, conventional medicine considers that there is a cure … the treatment is usually aggressive. In these cases, it’s considered more acceptable to tolerate serious adverse effects, since a cure is the intended outcome.

page 117: When cancer is more advanced or has spread to other organs, conventional medicine generally doesn’t have the tools to cure it. A long-term treatment can help control the cancer, reduce pain, relieve symptoms, avoid complications and sometimes extend a person’s life. 

I am sure many oncologists everywhere in the world would say the same thing as Dr. Nasi. I guess most patients are also on the same page and believe their oncologists fully.

Perhaps that could be the reason why FR’s father told his son to go for medical treatments instead of just relying on our herbs!

But look at what happened to FR. Barely five months later, FR ended up with more metastases than anyone could ever imagine. Why? Is this the first time such a thing ever happen? My answer is NO. I have seen similar cases.

I have been helping thousands of cancer patients over the past two decades. Most of them who came to us had already undergone medical treatments. These treatments failed. These patients came to us as a last resort. So it is hard for me to fully agree with what Dr. Nasi wrote above.

For one, I have come to believe from my long years of observation that there is no such thing as a cure for cancer! Remission yes, but not cure. I have seen cancer patients suffered recurrence even after six, 12, 14 or even 20 years! I am skeptical when doctors tell patients about cure!

The idea of “whacking” the cancer real hard with toxic drugs or radiation trying to get rid of the cancer quickly seems a sensible proposition. Good logic but take note also that such aggressive treatment can not only weaken the immune system but also kill the patient!

Many patients who came to seek our help refused to undergo chemotherapy as suggested by their oncologists. Why? Because they have seen how their loved ones or friends suffered or died during or after the treatment. I wonder why people don’t realize that! If this doesn’t happen to you, it does not mean it is not true! Read more to know what others have gone through.

I also find it odd that people can sell the idea that chemo or radiation treatments can “control the cancer, reduce pain, relieve symptoms, avoid complications and sometimes extend a person’s life.” What about the short-term and long-term side effects?

Some of our patients have outlived their doctors prognosis many times over. Because they live long enough, we started to see the long-term side effects from their previous medical treatments. Of course if they die soon after their treatments, no one will know what these long-term side effects are!

I am not being anti-doctor by telling you all these. I am just sharing the reality from my perspective. And I am not alone on this. Many doctors and oncologists themselves shared similar experiences.

Read what they said.

Dr. Nasi wrote: Fifty percent of those who receive a cancer diagnosis — and up to 90 percent with some kinds of cancer — are cured with conventional medicine. How do you reconcile such way off claim when some oncologists said the contribution of chemotherapy to 5-year-survival is only 2.3 or 2.1 percent!

 

 

 

Kanker pankreas: Tak mau opersai dan kemoterapi. Setelah tujuh tahu sehat-sehat saja. Sesungguhnya mukjizat.

Seorang pria berusia 35 tahun datang ke CA Care pada suatu pagi di bulan November 2018.

Kata-kata pertamanya adalah: Pak Baktia mengirimi Anda salamnya. Saya keponakannya.

Chris: Keponakannya! Bagaimana keadaan Baktiar sekarang?

Keponakan: Menang sangat sehat. Lebih sehat dari saya.

C: Luar biasa. Ketika pertama kali Pak Baktiar datang ke sini, kulitnya gelap, seluruh tubuhnya gatal. Dia benar-benar beruntung dan diberkati. Mungkin suatu hari saya akan pergi ke Aceh dan mengunjunginya.

Apa yang begitu istimewa dari pasien ini?

TUJUH TAHUN LALU BAKTIA DATANG KE CA CARE

Baktia, 56 tahun, didiagnosis menderita kanker kepala pankreas dan proses uncinate dengan penyumbatan saluran empedu.

Dia menolak operasi tetapi menjalani ERCP (Endoscopic Retrograde Cholangiopancreatography). Tiga stent (selang) plastik dipasang untuk membantu aliran empedu.

Setelah ERCP, Bak menolak kemoterapi. Dia datang ke CA Care pada 10 April 2011.

Berikut adalah masalahnya pada hari itu.

  • Gatal di seluruh tubuh
  • Kulitnya gelap
  • Tidak ada nafsu makan
  • Demam
  • Tidak bisa tidur
  • Diare
  • Air kecing kuning

Bak menjalani e-Terapi. Setelah satu sesi e-Terapi, gatal berkurang. Setelah dua sesi, rasa gatalnya berkurang hingga 50 persen. Setelah empat sesi, rasa gatalnya hilang.

Bak demam. Setelah minum segelas teh Appetite & Fever, demamnya lansung hilang!

Dia pulang ke Aceh.

Bak harus kembali ke dokter bedahnya setiap enam bulan untuk mengganti stent plastik itu.

Pada 5 Oktober 2011, Bak mengatakan sejak mengkonsumsi herbal pada April 2011, kesehatannya membaik.

Dia merasa lebih nyaman, tidurnya lebih baik dan dia merasa lebih bertenaga.

Sebelumnya dia harus bangun empat hingga lima kali semalam untuk buang air kecil. Setelah minum teh A-Kid-6, frekuensi buang air kecilnya berkurang menjadi hanya satu kali semalam.

Tes darah yang dilakukan pada 5 Oktober 2011 menunjukkan GGT, AST dan CA 19,9 semakin baik (Tabel, Kolom 3).

EMPAT TAHUN KEMUDIAN

Januari 2015: hampir empat tahun kemudian, istri Bak datang ke pusat kami. Pertanyaan pertama kami padanya adalah, Bagaimana kabar Bak? Apakah dia baik-baik saja?

Istri: Bersyukur. Sekarang bisa bawa mobil sendiri.

C: Sebelum jumpa saya, bisa bawa mobil?

I: Tidak, saya yang bawanya.

C: Jadi, dia sehat sekarang?

I: Ya, sehat.

C: Apakah dia kembali jumpa dokternya?

I: Tidak perlu mengganti selang itu lagi. Dulu setiap enam bulan, kita perlu tukar selang baru. Jadi kami melakukan ini dua kali setahun. 

Pada Agustus 2014, dokter mengatakan tidak perlu memasang stent baru lagi. Jika dia sakit kuning, segera kembali ke rumah sakit.

C: Selama bertahun-tahun, dokter pernah sarankan untuk melakukan kemoterapi?

I: Saya telah memberi tahu dokter bahwa suami saya sedang mengkonsumsi herbal. Saya bertanya kepada dokter apakah ini baik-baik saja. Dia menjawab, “Saya tidak tahu” dan dia hanya tersenyum. Dokter tahu bahwa suami saya mengkonsumsi obat herbal Anda.

Untuk lebih lanjut:

https://cancercaremalaysia.com/2011/11/04/pancreatic-cancer-severe-itch-disappeared-and-health-improved-after-herbs-and-the-e-therapy/

https://cancercaremalaysia.com/2015/02/05/pancreatic-cancer-no-chemo-only-on-herbs-still-fine-after-4-years/

 

 

 

 

Pancreatic cancer: Declined surgery and chemo. Seven years on and doing just great! Indeed a miracle.

A 35-year-old man came into our centre one morning in November 2018. His first words were: Pak Baktia sent you his salam (greetings). I am his nephew.

Chris: His nephew! How is Baktiar doing?

Nephew: He is doing very well. In fact he is much healthier me.

C: Amazing. When he first came here, his skin was dark, his whole body was itchy. He is really lucky and blessed. Perhaps one day I shall go to Aceh and visit him.

What is so special about this patient? 

Seven Years Ago Baktia came to CA Care for Help 

Baktia, 56 years old, was diagnosed with cancer of the pancreatic head and uncinate process with distal CBD (biliary duct) obstruction. 

He declined surgery but underwent ERCP (Endoscopic Retrograde Cholangiopancreatography). Three plastic stents (tube) were installed to help with the flow of the bile.

After the ERCP, Bak refused chemotherapy. He came to seek our help on 10 April 2011.

He presented with the following:

  • Severe itch throughout the whole body
  • His skin was dark
  • No appetite
  • Fever
  • Unable to sleep
  • Diarrhoea
  • Yellow urine

Bak was put on the e-Therapy. After one session of the e-Therapy, the itch was reduced. After two sessions, his itch was reduced by 50 percent. After four sessions his itch was totally gone.

Bak had fever. After taking a glass of Appetite & Fever tea, his fever was resolved.

He went home to Aceh.

Bak had to return to his surgeon every six months to change the plastic stent (tube).

On 5 October 2011, Bak said since taking the herbs in April 2011, his health had improved. He felt more comfortable, his sleep was better and he felt more energetic.

Previously he had to wake up four to five times a night to urinate. After taking the A-Kid-6 tea his urination frequency has reduced to only once a night.

A blood test done on 5 October 2011 showed improvements in his GGT, AST and CA 19.9 (Table, Column 3).

FOUR YEARS LATER

January 2015: almost four years later, Bak’s wife came to our centre. Our first question to her was, How is Bak doing now? Is he okay?

Wife: Thanks be to God. He can drive around, everywhere.

C: Before he came here, was he able to drive?

W: No, I was the one driving.

C: So, he is healthy now?

W: Yes, healthy.

C: Has he gone back to see his doctor?

W: Yes. The stent had been removed and there was no need to replace it anymore.

C: How many times did he need to change the stent?

W: Every six months, we need to change a new stent. So we did this twice a year. In August 2014, the doctor said no need to put in a new stent anymore. If he is jaundiced, then come back to the hospital immediately.

C: All these years, didn’t  the doctor push him to do chemo?

W: I told the doctor that my husband was on herbs. I asked the doctor if this was okay. He replied, “I don’t know” and he just smiled. The doctor knew that my husband was taking your herbs. I told him.

 

For more: https://cancercaremalaysia.com/2011/11/04/pancreatic-cancer-severe-itch-disappeared-and-health-improved-after-herbs-and-the-e-therapy/

https://cancercaremalaysia.com/2015/02/05/pancreatic-cancer-no-chemo-only-on-herbs-still-fine-after-4-years/

 

Lung Cancer: Free “Tarceva-for-life” failed

FY is a 50-year-old Malaysian. His problem started with headache, poor appetite and weight loss. He consulted a doctor in a private Hospital A in his hometown. He was told there could be something in the brain. A CT scan was done and there was a lump in his lung. A biopsy confirmed a moderately differentiated adenocarcinoma.

FY was referred to a private Hospital B in Penang. The biopsy tissue was sent to Kuala Lumpur for further analysis. EGFR mutation was detected. In the meantime, FY underwent five times of radiation to the head (due to the headache). This treatment cost RM11,000. The oncologist suggested taking oral chemo.

FY decided to seek further treatment in another private Hospital C. The oncologist in Hospital C prescribed oral drug, Tarceva. This was the deal. Take Tarceva for ten months, thereafter it will be provided free of charge for life. Each month’s supply cost RM4,500, meaning FY will have to fork out a total of RM45,000 first before he could enjoy the free supply of Tarceva.

In all, FY took Tarceva for 11.5 months. So, he managed to enjoy free Tarceva for 1.5 months.

Medical Reports 

The progress of FY’s treatment was monitored by scanning and blood tests. 

CT scan thorax done in Hospital A, 29 August 2017.

  • a suspicious 3.4 x 2.8 x 3.3 cm lump in the lower lobe of his left lung.

CT scan of brain, neck, thorax, abdomen and pelvis done in Hospital C, 26 September 2017.

  • lesion at apical segment of left lower lobe of lung and small cavities due to primary carcinoma.
  • multiple small metastases in both lungs.
  • enhancing lesions at left parietal lobe, vermis and right cerebellum.
  • patchy sclerosis of body of T1 vertebrae suggestive of metastasis.
  • lymph node at level 4 of neck.

MRI thoraco-lumbar spine done in Hospital C, 3 October 2017.

  • abnormal signal intensity within C7,T1 and T2 vetebral bodies. Features suggestive of metastases.
  • L4/L5 disc bulge.
  • L5/S1 disc bulge. 

Whole body PET Scan done in Hospital C, 18 January 2018.

  • metabolic activity noted in the right (1.8 cm) and left sides of neck (1.9 cm) .
  • metabolic activity noted in the left base of the tongue.
  • metabolic activity left axillary lymph node (2 cm).
  • irregular metabolic active mass (3.2 cm) seen in the apical segment of the lower lobe of left lung.

Whole body PET Scan done in Hospital C, 21 August 2018.

  • metabolic activity node see in the left (1.3 cm) side of the neck.
  • metabolic activity left axillary lymph node (0.6 cm).
  • FGD-avid mass (4 cm) seen in the apical segment of the lower lobe of left lung. This is larger and has more metabolic activity compared to the previous PET CT on 18 Jan. 2018.
  • metabolic active nodule (1.9 cm) seen in the posterior segment of the upper lobe of right lung – not seen in the previous scan.
  • another metabolic active nodule (1.7 cm) seen in the posterior basal segment of the lower lobe of the left lung — not seen in the previous scan.
  • a few 2-5 mm, non metabolic active nodules seen in the right and left lungs. These are not seen in the previous scan.
  • increased metabolic activity seen in the left adrenal gland (1.4 cm).
  • metabolic active lesions seen in the spine of C7 and T1. These re larger and more metabolic active compared to the previous PET CT scan.
  • metabolic active bony lesions seen in the spine T12, left sacrum and medial wall of the left acetabulum. These are not metabolic active in the previous scan.

You don’t need to be a doctor to know that FY is getting worse, not better, after taking Tarceva.

Below is a table with values of CA125, CA15.3 and CA19.9 taken over a period of about a year while FY was taking Tarceva. The most telling results are the values of CA125. In September 2017, the value was 434. After taking Tarceva it gradually decreased to 48 and down to 15 in February. But in March 2018 (barely five months later) the CA125 started to increase and in August 2018 it was at 46.5.

Date CA 125 (0-35) CA 15.3 (0-31.3) C19.9 (0-37)
26 September 17 434 9.8 39.4
24 October 17 48 7.7 16.9
28 November 17 15 n/a n/a
27 December 17 15 n/a n/a
23 February 18 15 4.9 8.2
26 March 18 18 5.8 15.6
23 April 18 19 5.9 11.0
22 May 19 22 5.2 17.0
25 July 18 40.6 5.1 17.2
17 August 18 46.5 n/a n/a

The numbers above clearly showed that Tarceva was gradually losing its effective after five months!

In August 2018, the oncologist told FY that Tarceva was not effective anymore. He has to switch to i/v chemotherapy and radiotherapy. A cycle of chemo would cost RM12,000.

If FY does not want chemo, he can opt for another new, more expensive oral drug (probably Tagrisso which cost RM30,000 per month).

FY and his wife came to seek our help. They decided not to continue with further medical treatment – at least for the moment.

Chris: Can this new drug cure you?

FY: No, only control.

Comments

This my third case in which patients were asked to take Tarceva for ten months with the promise that at the 11th month onwards they get Tarceva without charge for life!

Do you ever wonder why patients are offered Tarceva for free, after being told to buy a ten-month- supply first?  Is it a noble, charitable intention or “smart” business deal?

Read this story: Lung Cancer: Spend RM80,000 and You Get Free Tarceva for Life

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 ten 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 Nexavar (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 hospitalised and she died. Already paid RM20,000, cannot claim back.

Another question that bugs me is, why free only after TEN months? Why not earlier? Why not buy one, free one like they offered for Nexavar?

Let’s study the blood test numbers critically.  Let’s look at the bigger picture. The CA125 was at 434 in September 2017. After taking Tarceva the value dropped to 15. Bravo! Tarveca seemed to do the magic. But this euphoria did not last long. A month later, in March 2018, the CA125 started to increase. By August 2018, it was at 46.5.

By offering patients free Tarceva after ten months, seems appealing and noble at the first look; but in reality does the drug company or doctor not know that by a few more months, patients don’t need Tarceva anymore because it is not effective?

From a business point of view, it also does not make “sense” why the drug company would give Tarceva for free. Business is to make money. Just imagine what could happen if all patients get free Tarceva for life — will that not make  the drug company go bankrupt?

Let me share with you what my favourite Jewish rabbi, Harold Kushner said:

When I started to ask these questions, I became more curious. To kill the curiosity in me, I googled cost of generic Tarceva in India.

This is what I get.

  • In many countries, the brand-name Tarceva 150 mg drug costs about $18,700to 19,000 (price subject to vary) per 30 tablets. However, the mass production of generic cancer drugs versions are available for less than 15% of the retail price of the brand-name drug. Mar 22, 2018

Click this link and you get prices of generic Taceva available in India

https://dir.indiamart.com/impcat/erlotinib-tablets.html

(Exchange rate: Indian Rupee 10,000 = RM 563)

In India you can buy a month supply of generic Tarceva for less about RM563. Wow, amazing — I learned something new today!  At one time Tarceva was selling for RM 8K per month. Now the price dropped to RM5K — and that is still many times more expensive than the Indian generic.

Erlotinib   Rs 11,900, 150 mg, 30 tablets

Erclocip  Rs 7,230 for 30 tablets

Erlonat  Rs 6,000 for 30 tablets

Erlonat by NATCO,Rs 10,000 for 30 tablets

I have another question. I wonder why the Power-that-Be in developing countries do not look to India for the cheaper, generic drugs? Is that not a good way poor for poor countries to save money?

If you are skeptical about this suggestion, that is okay. Go ahead and spend your money.

But if you are poor and cannot afford to buy these expensive, American drugs, I believe my suggestion makes sense.

Take this case, FY paid for the  “expensive original” Tarceva, right? For less than a year, he already spent RM45,000. Look what happened to him?

Go to these links and read:

Generic cancer drugs that we can trust

Access to cancer medicines in India

India to supply generic cancer drug to US 

India approves generic cancer drug

Dying to Survive: Indian generic medicines have a tale to tell

Terminally ill dad saves more than $200k bringing in cancer drugs from India

 

 

 

Cancer: It’s the elephant and the six blind men

I started schooling some seven decades ago. It was a Malay school next to our home. At school our classes were often held under the shade of a large tree. Our teacher told us stories and sometimes made us act it out. One of the stories that got imprinted in my mind up to this day is about some blind men trying to figure out what an elephant is like. I am sure many of you reading this article also have heard this same story at some point in your life.

Dr. M. Laura Nasi, an integrative oncologist in private practice in Buenos Aires, Argentina. Besides advocating surgery, chemo and radiation as the necessary protocol for cancer, she also embraces certain principles of alternative healing. In her book,Cancer as a wake-up call, Dr. Nasi explains her healing protocol.

In trying to explain “what is cancer?” she has this illustration.

For the first time, I learned that this parable was attributed to The Buddha.

The Buddha told a story about six blind men who were asked to describe an elephant. Each man touched a different part of the elephant’s body. They came up with different “perceptions” – one saying it is a pillar, another a rope while another said it is a fan! They argued and defended their “truth” based on what they had “discovered.” Who can blame them — that was what they figured out by feeling for themselves.

Today, don’t be surprised that cancer is just that elephant in The Buddha’s parable.

  • The surgeons see cancer as a tumour or mass that must be surgically removed — the sooner the better!
  • The oncologists see cancer as a “disease” that can spread or metastatize to other parts of the body. Therefore itmust be “killed” by radiation and/or toxic, chemo-drugs.
  • From the study of genes, cancer is about mutated genes that we inherit from our parents or are damaged by certain factors. Doctors are now using targeted therapies to kill off these mutated cells.
  • Some researchers see cancer as a metabolic disease caused by bad nutrition, toxic chemicals and environment. Therefore they try to use nutrition and supplements to treat cancer.
  • The psychologists see cancer as an out of balance emotional distress. To heal cancer we need to take care of our stress, emotions, relationship with others, etc. etc.
  • Some religious practitioners see cancer as an attack by evil forces that need to be exorcised. This resulted in various forms of faith healings.

Let me quote what Dr. Laura Nasi said:

  • Like the blind men and the elephant, each perspective probably offers a part of the truth.

Take note, it is just a part of the truth not the whole truth!

So what is cancer?

Dr. Laura said again:

  • To answer this (question)we need to look beyond what we call cancer and focus on the person.
  • Cancer is a multifactorial disease, more than a genetic, metabolic disorder, more than a psychological, emotional or spiritual imbalance.
  • It is more than just finding a tumour in our body.Autopsies of people who have died in accidents or “from old age” show a high percentage of undiagnosed tumours. And some disappear with no observable treatment at all.
  • The truth is, we produce small tumours all the time that our immune system destroys or keeps under control, and they remain unnoticed throughout our lives.

The word cancer embraces hundreds of different diseases … We call them all cancer, but actually they’re a lot of different diseases.

  • Breast cancer is different from skin cancer, and not all breast cancers behave in the same way.
  • Different cancer types and subtypes develop in unique ways and have entirely different prognoses. Some subtypes of lung cancer grow slowly, while others spread quickly. Some respond well to therapy, while others are difficult to treat.
  • Each case is unique, just as each individual is unique. Two people may develop cancer in the same part of the body, but the disease’s progression might vary depending on the response to therapy and the way each person lives the experience.

What now?

  • By taking into account different points of view, like the blind people in the story, we can understand the elephant in its wholeness and seek combined strategies that consider the human as a multidimensional being with a body, mind, emotions, spirit and social context.
  • These strategies will include healthy habits – nutrition, exercise and sleep, restoring emotional balance and spiritual reconnection to positively affect the PNIE (psycho-neuro-immuno-endocrine) intelligence network that for so many decades knew how to maintain our health and allow it to play the main role again.
  • That is why cancer, though located in only one organ, is an illness that affects the whole person and not just the affected organ. Hence, the treatment should, from the very beginning, focus on the whole person.
  • The system view paradigm invites us to abandon linear thinking – a single cause for a single effect … It isn’t a mathematical equation where A + B = C. The causes of cancer are usually multifactorial and different for each person. In some people, a combination of unhealthy diet, divorce and losing a job might develop a cancer, while in others it doesn’t.

In the preface of her book, Dr. Laura Nasi wrote:

  • Disappointment was a milestone in my professional life … I was spending time on a project that was dependent on economic factors, people were dying of cancer. I found that deeply unsettling.
  • The paradigm I was immersed in viewed cancer very narrowly and was probably leading us the wrong way.Attempting to discover a cure for cancer only by looking through a microscope at the cells that are part of a tumour seemed myopic.
  • We know there’s a permanent dialogue between cancer cells and the immune system, so how could we suggest a treatment that doesn’t take the person into account, the life challenges they’re facing, and how their emotions might be affecting their well-being?
  • I realized that conventional medicine can play only a limited role in what we call health.
  • I found that to begin to understand why a person got sick, I needed at least a two-hour first consultation. I realized that if I gave enough time to listening, I could help the person see that they already knew what was making them sick.
  • I firmly believe that healing requires looking at people as a whole, helping them become aware of the life they are living and addressing and modifying the things that are making them sick.
  • We encountered a great deal of resistance from other medical sectors in Argentina … it’s not always easy to forge one’s way against convention, but I can’t see any other way to practice medicine effectively.

Some advices from Dr. Laura Nasi:

  • Disease is a message from the soul. Attempting to restore health by attending only to its physical aspects is too limiting. Becoming aware of what’s happening is the first step in bringing about change.
  • Allopathic medicine sees the body as a machine …. the part that isn’t working is removed through surgery and replaced by another one, or the body is given medicine to repair the broken part or at minimum to suppress the symptoms.
  • But we are more than machine.
  • The way we live affects our health. If we eat processed, nutrient-deficient foods, don’t exercise, suffer from sleep disorder, accumulate stress, don’t process emotions, use harmful substances like nicotine or don’t find meaning in our lives, our health is affected.
  • Chronic stress challenges the immune system and makes us vulnerable to diseases. A combination of internal (e.g. anxiety) and external (e.g. divorce, death of loved one, a hostile workplace) is responsible to making us more vulnerable to sickness.
  • Up to 60 percent of cancer cases could be avoided with a healthy diet, regular exercise, stress management and refraining from smoking. We can live a healthier and more balanced life, taking more responsibility for our own well-being.
  • Forty percent of new cancer diagnoses cannot be attributed to unhealthy diets, smoking or sedentariness. Other possible factors include internal conflict, self-criticism and negative self-judgement, emotional instability and existential dissatisfaction. We can’t explain all cases in one way.

One important lesson we can learn from what Dr. Laura Nasi:

Two cancer patients went to consult their oncologists.

Patient A, with pancreatic cancer, is a Singaporean. She consulted the best oncologist in town.

Oncologist: Oh, you stay in Sea View. What are you working as?

Patient: I am a forex trader in a bank.

Onco: Do you buy health insurance?

P: Yes, I did.

Oncologist asked patient to lie down. Checked here and checked there. He saw the scans. He put on his computer and showed four patients. One was a miracle case – he survived 6 years with no sign of cancer coming back. He said there are three types of people that he treated. One type is completely cured. The second type is in remission. The third type is just wasting his time. He is suggesting that I am the type who is wasting his time.

Onco: I can’t cure you.

Patient: But he asked me to go back and think and decide.

Onco: I can start you on chemo. Chemo is every week, for eight times.

Husband: What are the side effects.

Onco: Nothing. If you go for chemo, you must eat a lot of meat. And we will be generous with the painkiller.

Result: Shocked, upset and totally lost. P: He talked to me as if I am just wasting his time.

Duration of consultation: Not more than 15 minutes.

Cost of consultation: SGD 700 (RM2,100)

Patient B is a Malaysian who has breast cancer. After her surgery, she consulted an oncologist in Penang.

Husband: The oncologist talked about money first. Chemotherapy costs RM30,000. Twenty-five times of radiation costs RM7,000. After that my wife has to take hormonal drug (Femara or Tamoxifen) for five years. This costs about RM700 per month. Since she has a health insurance, they will made sure that all these expenses will be paid for by the Insurance Company.

Patient:  I have to go for six cycles of chemo with FEC. The only time left for discussion is, “What happen if I do all these treatments.”

The oncologist looked at the medical report, keyed in some data and read these numbers from his computer.

Oncologist: With chemo, the chance of cancer NOT coming back is 75 percent. Without treatment the chance of cancer NOT coming back is 30 percent.

Result:  Patient not impressed or happy.

Duration of consultation: About 10 minutes.

Cost of consultation: RM 106.

Question:

Based on what Dr. Nasi had said, do you think these two patients received the best possible advice for their cancer?

Dr. Nasi said for the first visit, she needed a whole two hours to be able to understand her patients’ problems!

These oncologists spent 10 –15 minutes “advising” Patient A and Patient B. Do you think their advice really make sense?

Whether you go to the best or worst for advice, eventually the most important consideration is the outcome.

So what had happened to Patient A? She underwent all the recommended treatments – suffered and died in the hospital even before her chemo was completed.

Patient B refused to undergo chemotherapy and radiotherapy. She came to CA Care for help. We spent hours advising her on what to do. She took herbs, changed her diet, lifestyle and perception about her life. Almost seven years now, as of this writing, Patient B is still alive and well.

 

 

Alimta for lung-liver-lymph nodes-bone cancer: Buy two, free two. If you make it to 12 cycles, free for life!

A young couple came to me on behalf of his father. The young man sounded very disorientated. I could not figure what he was saying in his soft voice. Luckily he brought along his wife who could present their father’s case clearly and logically.

Ono (not real name) is a 64-year-old. He lives in an Indonesia town about seven-hour-bus ride to Kuching, Sarawak.

Ono’s problem started about four to five years ago when he had abdominal problems. He consulted a doctor in a private hospital in Kuching. According to the doctor there was stone in his gallbladder. He was told not to worry and was sent home.

About two to three years later, Ono suffered a mild stroke. He was given medication and was okay after that.

In July 2018, Ono had severe abdominal pain with cold sweat. According to the daughter-in-law this was not due to gastritis or wind in the stomach.

In mid September 2018, Ono went to a private hospital in Kuching. An USG showed his gallbladder had pus and there was infection of the liver.

Ono underwent an operation to remove his gallbladder. A pathology report indicated a perforated gallbladder with malignant glands. It was a moderately differentiated adenocarcinoma.

Blood test on 10 September 2018, showed elevated liver function enzymes.

Alkaline phosphatase 133 H (30-120)
GGT 152 H (0-50)
AST 34 (0-45)
ALT 44 (0-55)

CT scan on 27 September 2018 indicated the following:

  • metastatic liver nodules.
  • metastatic paraortic lymph nodes.
  • right upper lobe lung mass (2.3 x 3 cm), likely tumour, metastasis.
  • small left lower lobe nodule, likely metastasis.
  • right hilar and mediastinal lymph nodes.

Biopsy report dated 29 September 2018 confirmed:

  • right upper lung lobe mass — moderately differentiated adenocarcinoma.
  • subcarinal lymph node — no malignancy. Another report C2354-18 on the same date, subcarinal lymph node aspirate: few atypical cells that are suspicious for carcinoma.

MRI on 2 October indicated:

  • T4 pathological facture causing compression on the thecal sac and spinal cord.
  • T2 – T7 and S1 – S2 metastatic vertebral lesions.
  • mild L4/5 posterior disc bulge.

EGFR PCR 6 October 2018: None of the mutations were detected.

11 October 2018: Tumour cells do not demonstrate a staining reaction to ALK-1.

Blood test on 13 October 2018 showed the following:

Alkaline phosphatase 114 (30-120)
GGT 137 H (0-50)
AST 32 (0-45)
ALT 65  H (0-55)
CEA 69.3 H (0-5)

Ono was referred to the oncologist for follow up. He underwent one cycle of chemotherapy using Alimata, dosage 690 mg. The total cost per cycle is RM8,500. Ono was told that he might need to go for four to six cycles.

Was Ono better after the first shot of chemo? According to the son, he had less pain but he is still in great pain. The pain was in the chest. It was more severe at night than daytime. Ono’s son said he had to massage his father’s legs throughout the whole night to make him comfortable. In fact that was the reason why he was so disorientated when he came to see us due to lack of sleep. Ono had no energy and need to lie down all the time. His breathing was difficult.

I had to be up front with Ono’s children. I said, I cannot cure your father. Actually I told them to go home and continue with the chemo if they want to. Either way, the  outcome would not be different. Ono’s children was very disappointed. They wanted to try the herbs.

Comment 

At CA Care I learn many things each day. Today’s lesson is something I did not know before until I encounter Ono’s case.

The total cost of one cycle of chemo (Alimta and Carboplatin) is RM8,520.70. Of this total

  • Alimta 500 mg cost RM4,600
  • Alimta 100 mg cost RM2,560
  • Kemocarb – carboplatin 450 mg cost RM151.50

So the total cost of the chemo-drugs is RM7,311.50. The remaining RM1,209.20 is the cost of hospital care inclusive of RM500 oncologist’s fee.

There are two interesting points to highlight after studying the detailed medical bills.

 Alimta Special Offer

From the above, for every two cycles of Alimta, Ono will get the next two cycles free of charge. So it is like buy two, free two. And the offer gets even more attractive after that. If Ono could make it to a total of 12 cycles of Alimta, he will receive free Alimta for life!

One point that bothers me is this, does the offer: buy two free two and after 12 cycles you get free for life, really makes business sense? Like the Malay saying, ada udang disebalik batu? (is there a prawn behind the rock?). I am sure you are smart enough to come to your own conclusion.

Why not use generic Alimta from India?

Ono paid a total of RM7,160 for Alimta. Just for curiosity, what would this generic drug cost in India?

In India you have a choice between the expensive and cheap generic Alimta.

  • Eli Lily or US brand cost Rs 91,343 for 600 mg injection (or RM5,175 as opposed to Kuching which cost RM 7,160)
  • The generic Alimta cost one-fourth the price, Rs 23,990 to Rs 24,000 (or RM1,359).

Indeed if the Power-that-Be in the developing countries is wise, why don’t they opt for the cheaper generic drug from India?

But you may say, the Indian stuff does not work. The American one is better. Really?

Take a look below. In addition to Alimta, Ono also received carboplatin. The oncologist in Kuching did not use the American stuff. He used generic carboplatin from India called Kemocarb. Ono paid only RM151.50 for this generic carboplatin. Great doc., you tried to save money for your patient. That’s the way to go!