The Cancer Industry: Hype vs. Reality

Cancer medicine generates enormous revenues but marginal benefits for patients

BIG PROBLEM, BIG BUSINESS, BIG HYPE

By John Horgan on 12 February 2020

Source:  https://blogs.scientificamerican.com/cross-check/the-cancer-industry-hype-vs-reality/

Basic Facts

  • Cancer is the second most lethal disease in the U.S., behind only heart disease.
  • More than 1.7 million Americans were diagnosed with cancer in 2018, and more than 600,000 died.
  • Almost four out of ten people will be diagnosed in their lifetime.

Big Business

  • Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media.
  • Total research spending since Richard Nixon declared a “war on cancer” in 1971 exceeds a quarter trillion dollars.

Big Bluff

  • Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress” and millions of “cancer deaths averted,”
  • Cancer experts and the media often describe new treatments with terms such as “breakthrough,” “game changer,” “miracle,” “cure,” “home run,” “revolutionary,” “transformative,” “life saver,” “groundbreaking” and “marvel.”
  • There are 1,200 accredited cancer centers in the U.S. They spent $173 million on television and magazine ads directed at the public in 2014.
  • 43 of the 48 top spenders “deceptively promot[ed] atypical patient experiences through the use of powerful testimonials.” A 2014 studyconcluded that cancer centers “frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability.”

Little Net Progress After 90 Years

What’s the reality behind the hype?  Azra Raza, an oncologist at Columbia, in her book The First Cell: And the Costs of Pursuing Cancer to the Last wrote:

  • No one is winning the war on cancer, Claims of progress are mostly hype, the same rhetoric from the same self-important voices for the past half century. 

Azra Raza, an oncologist at Columbia. She  has watched too many people die from cancer — her patients and her husband, also a cancer specialist.

New Treatments Yield Small Benefits, Big Costs

  • Pharmaceutical companies keep bringing new drugs to market. But … 72 new anticancer drugs approved by the FDA between 2004 and 2014 prolonged survival for an average of 2.1 months.
  • Most cancer drug approvals have not been shown to, or do not, improve clinically relevant end points, including survival and quality of life … the FDA may be approving many costly, toxic drugs that do not improve overall survival.
  • Costs of cancer treatments have vastly outpaced inflation, and new drugs are estimated to coston average more than $100,000/year.
  • More than 40 percent of people diagnosed with cancer lose their life savings within 2 years.

Immunotherapy

Immune therapies, which seek to stimulate immune responses to cancer, have generated enormous excitement.

Drugs firms aggressively market immune therapies, and patients are “pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.”

Oncologists Nathan Gay and Vinay Prasad estimated that fewer than 10 percent of cancer patients can benefit from immune therapies, and that is a “best-case scenario”.

Immune therapies trigger severe side effects, and they are also extremely expensive, costing hundreds of thousands of dollars a year.

Subsequent hospital stays and supportive care can drive the total costs to a million dollars or more … If widely prescribed, immune therapies could bankrupt the American health-care system.

Corruption In The Cancer Industry

The American approach (to cancer treatment) fosters corruption.

Many cancer specialists accept payments from firms whose drugs they prescribe. This practice leads us to celebrate marginal drugs as if they were game-changers. It leads experts to ignore or downplay flaws and deficits in cancer clinical trials. It keeps doctors silent about the crushing price of cancer medicines.

Top officials at Sloan Kettering Cancer Center “repeatedly violated policies on financial conflicts of interest, fostering a culture in which profits appeared to take precedence over research and patient care.

 

 

 

Chemotherapy Spreads Cancer

Chemotherapy spreads cancer!  You get the message? Is it a joke of some kind? And in this present age, is it fake news? Many people would argue — if chemo is that bad as implied by the title of this article, why then governments all over the world endorse such treatment? Chemotherapy for cancer is supposed to be proven and scientific, right? Why do doctors give chemo to their patients if it is that bad? Do I need to answer such questions?

Here are some facts presented by scientists.

On 30 December 2018, a group of medical researchers from the School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA and Department of  Developmental and Molecular Biology, Albert Einstein College of Medicine, New York, NY, USA, wrote an article in the Nature Cell Biology journal: Chemotherapy elicits pro-metastatic extracellular vesicles in breast cancer models https://www.nature.com/articles/s41556-018-0256-3.

Below is the abstract of this research report:

  • Primary tumours release extracellular vesicles (EVs), that can facilitate the seeding and growth of metastatic cancer cells in distant organs.
  • Two classes of cytotoxic drugs broadly employed in pre-operative (neoadjuvant) breast cancer therapy, taxanes and anthracyclines, elicit tumour-derived EVs with enhanced pro-metastatic capacity.
  • Chemotherapy-elicited EVs are enriched in annexin A6 (ANXA6), a Ca2+-dependent protein that promotes NF-κB-dependent endothelial cell activation, Ccl2induction and Ly6C+CCR2+ monocyte expansion in the pulmonary pre-metastatic niche to facilitate the establishment of lung metastasis.

Don’t blame yourself if you don’t understand what these researchers are talking about. You and me are just laymen — how are we to understand such scientific language? Moreover, some of us don’t read English!  How to understand if you only learn your native language in school? Such is our world today.

Let me try to explain what these researchers are trying to tell us by reproducing what others wrote about this particular research results. Perhaps it is easier to understand if it is written in layman’s language.

On 1 January 2019, the Science Daily posted this article, Tumors backfire on chemotherapy.  https://www.sciencedaily.com/releases/2019/01/190101094531.htm.  There is another article in the Daily Mail, UK –   Chemotherapy may cause breast cancer to SPREAD: Two commonly used drugs encourage the disease to develop in the lungs. https://www.dailymail.co.uk/health/article-6542277/Chemotherapy-cause-breast-cancer-SPREAD.html

If you have breast cancer, chemotherapy is often given before surgery. This is called neoadjuvant therapy. The idea in this case is  to shrink the tumour and make  it easier to remove. Or the chemotherapy is given to “weaken” the cancer. After chemo, the patient’s remaining tumor is removed by surgery.

Unfortunately, the treatment does not always shrink the tumour. If the growth resists neoadjuvant therapy, the cancer is more likely to spread to other parts of the body.

Basically these are what can happen when patients undergo chemotherapy:

  • The commonly prescribed chemo drugs: paclitaxel (or Taxol) and doxorubicin (or Adriamycin) cause breast tumours to release small fluid-filled sacs called exosomes.
  • Chemo-treated tumours makes exosomes that contain a protein called annexin-A6. Annexin-A6 is not found in sacs released from untreated tumours.
  • Once released from tumours, exosomes circulate in the blood until they reach the lungs.
  • They then give out annexin-A6, which stimulates lung cells to release another protein called CCL2.
  • CCL2 then attracts immune cells called monocytes, which fight certain infections and help other cells remove dead or damaged tissue.
  • This immune reaction can be dangerous, because those monocytes can facilitate the survival and growth of cancerous cells in the lung, which is one of the initial steps in metastasis.

Is this the only research showing the chemotherapy spreads cancer? NO – there are many more researchers in the US who have also reported the same message — chemotherapy spreads cancer!

On 6 August 2012, researchers at the Fred Hutchinson Cancer Research Center in Seattle, USA, published their research results in Nature Medicine. https://www.nature.com/articles/nm.2890. These are what they said:

  • Cancer cells inside the body live in a very complex environment or neighborhood. Where the tumorcell resides and who its neighbors are influence its response and resistance to chemotherapy.
  • In the laboratory, you can “cure” almost any cancer — you just give a huge dose of toxic chemo-drug to the cancer cells in the petri dish and the cancer cells are destroyed. But you can’t do that to patients, because the high dose would not only kill cancer cells but also healthy cells. The dose you would need to give the patient to wipe out the cancer would also kill the patient. So in real life, if you want to kill all cancer cells, you can also kill the patient at the same time!
  • So chemo treatment of common solid tumors has to be given as smaller doses paced out in cycles, to give healthy cells time to recover in the intervals. But the drawback is that this approach may not kill all the cancer cells. Those cancer cells that survive can become resistant to subsequent cycles of the chemotherapy.
  • Normal, non-cancerous cell, the fibroblast, that lives near cancer tumors are important for healing wounds and producing When their DNA is damaged, by chemotherapy, fibroblasts can release a broad range of compounds that stimulate cell growth. So you see, in the process of trying to kill cancer cells, chemotherapy may also spur healthy cells in the neighbourhood to release a compound that stimulates cancer growth, eventually leading to treatment resistance.
  • The researchers examined cancer cells from prostate, breast andovarian cancer patients who had been treated with chemotherapy. They found that when the DNA of fibroblasts near the tumor is damaged by chemotherapy, they start producing a protein called WNT16B in the microenvironment of the tumor.
  • When the protein reaches a high enough level, sometimes increased by thirty-fold. This protein, WNT16B, when secreted, would interact with nearby tumour cells and cause them to grow, invade, and importantly, resist subsequent chemotherapy.

Read these articles:

  1. Can chemotherapy before surgery fuel breast cancer metastasis? https://www.facingourrisk.org/XRAYS/neoadjuvant-chemotherapy-and-metastasis

2. Neoadjuvant chemotherapy induces breast cancer metastasis through a TMEM-mediated mechanism. https://www.ncbi.nlm.nih.gov/pubmed/28679654

3. Chemotherapy could cause cancer to SPREAD and grow back even more aggressive, new study claims

https://www.dailymail.co.uk/health/article-4669152/Chemotherapy-cause-cancer-SPREAD-new-study-says.html

  1. Can chemotherapy before surgery fuel breast cancer metastasis?

https://www.facingourrisk.org/XRAYS/neoadjuvant-chemotherapy-and-metastasis

Scientists at New York’s Albert Einstein College of Medicine, US,  have found evidence that chemotherapy is only a short-term solution  and can be dangerous. In their study they investigated chemotherapy-induced cancer cell dissemination in breast cancer.

  • While chemotherapy may shrink the tumors, chemotherapy could causecancer to spread and become more deadly.
  • And once cancer spreads to other organs it becomes almost impossible to treat and is often fatal.
  • Three standard chemo-drugs used in neoadjuvant treatment for breast cancer are: paclitaxel (Taxol), doxorubicin (Andriamycin) and cyclophosphamide. They are shown to increase the number of microscopic structures in breast tumors called tumor microenvironment of metastasis (TMEM), as well as the number of tumor cells circulating in the blood.

How chemo spreads cancer: Scientists believe that in order for metastasis to occur, three types of cells must come in close contact with each other on a blood vessel wall:

  1. tumor cells, that produce high levels of a specific protein.
  2. immune cells called macrophage, and
  3. endothelial cells (cells which line organs such as blood vessels).

These spots, called “tumor microenvironments of metastasis” or “TMEMs” are found on blood vessels within tumors.

To enable the cancer cells to spread, the macrophages in a TMEM loosen the normally tight connection that exists between endothelial cells, creating a temporary opening in the wall of a blood vessel for the tumor cell to squeeze through and enter the bloodstream, facilitating its spread to other parts of the body.

Watch this video. Hopefully it can  help you better understand the complicated process. https://www.youtube.com/embed/IvyJKrx5Xmw?feature=plcp&rel=0&showinfo=0&autoplay=1

This article, Is an anticancer drug helping cancer to spread? https://www.medicalnewstoday.com/articles/318846#1

reported the work of  another group of scientists at the Ohio State University (OSU) led by Tsonwin Hai, a professor of biological chemistry and pharmacology at OSU. They studied the effects of the commonly used chemo-drug paclitaxel (Taxol) on the spread of  breast cancer cells to the lungs. Taxol is also commonly used as a frontline medication in treating ovarian and lung cancer (besides breast cancer).

How a chemo drug can help cancer spread from the breast to the lungs? You can get the answers by reading these two articles: https://www.eurekalert.org/pub_releases/2017-08/osu-hac080417.php, https://www.medicalnewstoday.com/articles/318846.php#1

  • Paclitaxel may activate Atf3 (Activating Transcription Factor 3) gene: In those who had received chemotherapy, the gene Atf3is overexpressed, compared with patients who were not administered chemotherapy. ATF3 is overexpressed in a large fraction of various cancers including solid tumors in the breastlungspancreas, and colon. ATF3 is hyperactivated in most cells in Hodgkin’s disease. Overexpression of ATF3 in cancer cells have been proposed to promote proliferation and inhibit cell death.
  • According to the OSU researches, the findings suggest that paclitaxel may have a carcinogenic effect by activating this gene. This gene seems to do two things at once:
  1. essentially help distribute the ‘seeds’ (cancer cells)- increasing “the abundance of the tumormicroenvironment of metastasis, and 
  2. fertilize the ‘soil’ (the lung – by improving “the tissue microenvironment (the ‘soil’) for cancer cells (the ‘seeds’) to thrive” at the level of the metastatic lung. 

These changes, include increased inflammatory monocytes and reduced cytotoxicity.

Prof. Hai says: What is surprising to us is the multitude of pro-cancer effects that paclitaxel has! It not only enhances the escape of cancer cells from the primary tumor but also facilitates the preparation of distant sites (lung in our case) in such ways that when the cancer cells arrive, they can set up shop and grow.

Chemotherapy is ‘a double-edged sword: Paclitaxel seems to set off a molecular chain reaction, the end result of which is the creation of a cancer cell-friendly environment in the lungs. Prof. Hai ventures a possible explanation for the study’s findings. She says, I think it’s an active process – a biological change in which the cancer cells are beckoned to escape into the blood – rather than a passive process in which the cancer cells get into the bloodstream because of leaky vessels.

Summary

  • Researchers found that the use of chemotherapy — extremely toxic class of drugs — can trigger the onset of new tumors in other parts of the body.
  • Chemotherapy drugs in breast cancer results in production of specific proteins. These circulate in the blood and, upon reaching the lungs, cause the release of further proteins and immune cells that can facilitate the development of metastatic cancer cells.
  • It is like, chemo makes the cancer tumor produce more seeds. These seeds are then carried away to other parts of the body. The chemo also makes the soil so fertile and conducive for the seeds to grow!

Why condone and still “selling” such therapy?

  • Through its continued sale and promotion of toxic chemotherapy drugs for cancer, the pharmaceutical industry is thus ensuring that, far from eradicating the disease, it continues to exist.
  • Small wonder, therefore, that the size of the global oncology market is expected to reach an eye-watering $200 billion annually by the year 2022.
  • The World Health Organization estimates that cancer is now responsible for 9.6 million deaths per year. Breast cancer and lung cancer are the most common forms of the disease, with each seeing over 2 million cases per year.
  • The total annual economic cost of cancer is equally startling, amounting to more than $1 trillion each year. Not only is there no sign of this decreasing, but with the price of some new so-called monoclonal antibodies or biosimilar molecules for cancer now reaching $700,000 per patient per year.

Cancer Drugs Are The Most Profitable For Big Pharma

https://www.dr-rath-foundation.org/2020/02/cancer-drugs-are-the-most-profitable-for-big-pharma/

Drugs for cancer have been the largest business sector of the global pharmaceutical industry for several years now. This is the real reason why cancer still exists.

With annual revenues from the disease exceeding $123 billion a year, drug companies have no interest in preventing the disease. Instead, they prefer to profit from it by selling patented chemical treatments that don’t address its primary cause.

For more information you can read our previous articles

Chemotherapy Spreads Cancer and Makes It More Aggressive: Articles From the Internet

Compiled by Yeong Sek Yee & Khadijah Shaari  

https://cancercaremalaysia.com/2013/05/14/chemotherapy-spreads-cancer-and-make-it-more-aggressive-articles-from-the-internet/

Chemotherapy SPREADS and MAKES cancer more AGGRESSIVE

https://cancercaremalaysia.com/2013/03/09/chemotherapy-spreads-and-makes-cancer-more-aggressive/

 

 

 

 

Colon Cancer: Surgery and chemo did not cure them – ended up in a more dire situation.

One morning in November 2019.

Two Indonesians came to seek our help. One of them is from Medan and  the other from Jakarta. Both of them had colon cancer. They had surgery followed by chemotherapy. The treatments did not cure them. Let us examine each case in detail. And let us hope we can learn something from their experiences.

Case 1: SPW is 53 years old. He is from Jakarta. About eight months ago, SPW passed out blood-stained stools.

A colonoscopy indicated tumour in his colon.

A CT scan done on 20 March 2019 showed gallstones, in addition to a tumour in the colon.  SPW underwent surgery to remove the mass in his colon and the gallbladder stones.

Pathology report confirmed cancer,  adenocarcinoma, pT3NxMx.

After the surgery, SPW was sent home without further treatment.

About two months later (Jun 2019), a PET scan was done. The result showed the cancer had recurred at the previous operation site. There was NO spread to the liver, lung, lymph nodes or bone.

PW underwent 6 cycles of chemotherapy, at a private hospital in Jakarta. The chemo was given every two weeks. The regimen used was FOLFOX-4, consisting of  Eloxatin (or oxaliplatin) + 5-FU + Leucovorin (folinic acid).

About five months later, in November 2019, another PET was done. The results were disappointing.

  1. The doctor suspected the cancer had spread to the liver.
  2. Metabolic activity of the recurrent mass in the colon was less intense but the cancer did not go away.
  3. PET scan showed reactive lymph node.

The oncologist asked SPW to undergo more chemotherapy but he refused further treatment. Why?

SPW said he suffered severe side effects during the chemo.

  • He lost 15 kg of body weight within that few months of treatment.
  • He was depressed.
  • He suffered severe fatigue.
  • He lost his appetite.
  • He could not sleep at night, and had to take sleeping pills.
  • His fingers were numb.
  • He had difficulty walking.

Current condition: He has to urinate four times during the night.

Case 2: Wongso is a 67 year-old from Medan. In March 2018 he passed out stools with blood. A colonoscopy was done in a hospital in Medan. There was a mass in his colon.

Wongson underwent an operation to remove the tumour in his colon in April 2018. The pathology report confirmed cancer – adenocarcinoma, pT4N1Mx. One of the two lymph nodes was affected. A CT scan on 9 May 2018, showed the cancer had spread to his liver.

Wongso underwent chemotherapy at the government cancer hospital in Jakarta. He received 6 cycles of chemotherapy. The regimen used was FOLFOX-4,  consisting of oxaliplatin, folinic acid and 5-FU.

A CT scan on 5 September 2018 showed that the tumour in his liver had shrunk from 2.49 cm to 2.06 cm. But it did not go away.

Wongso was prescribed an oral drug – Xeloda. He took the pill for two weeks followed by a week of rest. This constitutes a cycle. Wongso took a total of 12 cycles of Xeloda. His CEA was initially at 2.6 but this increased to 79.8 in November 2019.

CT scan on 29 October 2019 showed:

  • Mild ascites around the liver.
  • Multiple cyst in both lobes of liver.
  • Fractured compression at L4 vertebrae.

In spite of this failure, the oncologist still insisted that Wongso continues to take the Xeloda. Wongso was still on Xeloda when he came to seek our help. His complaints were: stomach pain, probably due to “wind”. He moved his bowels 3 to 4 times a day. He had to urinate 3 to 4 times each night.

Comments

The standard treatment recipe for colon cancer is: surgery, chemotherapy and oral drug such as Xeloda. Sometimes patient is also asked to go for radiotherapy before surgery. This is the cases where the tumour is too large.

If you have cancer, you have to go through these treatments no matter where you are – in the most famous  and expensive hospital or in just any ordinary cancer hospital. Yes, you need to undergo this so called proven method of treatment. But, the question you need to ask is: does this proven and scientific method of treatment works for you? I cannot answer that question! But if you come to see after being diagnosed with colon cancer, my only advice is to go for surgery to remove the tumour, that is if the cancer has not spread extensively elsewhere. If there is a widespread metastasis, the value of surgery is questionable. So, that is as far as I would go. In fact, after I met with the two patients above, the next day, there was another Indonesian who also had colon cancer. He has not undergone any treatment yet. My advice to him was: Go and have the tumour removed. Go to this surgeon X in Hospital Y in Kuala Lumpur. He is a good doctor. I think he would be able to help you.

Looking back over the past twenty plus years helping colon cancer patients, I could recollect many sad experiences. In the early years, I have a few patients who underwent chemotherapy with 5-FU after surgery. At that time the only drug deemed effective was 5-FU. One patient went all the way to Sydney for his 5-FU treatment.  He died while undergoing the treatment. Then there was this building contractor. He too had colon cancer and underwent chemotherapy after his surgery. He did not make it. Before he died he told his daughter to not forget CA Care and she should try to help us whenever we need to do any renovation work. Over the years, I lost many good friends.

Now, the chemo regimen for colon cancer has been “updated.” In the case of SPW and Wongso, the oncologists treated their colon cancer using FOLFOX-4 regimen, which consists of a combination of  fluorouracil, leucovorin, and oxaliplatin.

In fact, besides FOLFOX, there are other variations such as:

  • FOLFIRI – consisting of folinic, 5-FU and irinotecan.
  • CAPOX – consisting of capecitabine or Xeloda and oxaliplatin.
  • XELOX – consisting of Xeloda (trade name) and oxaliplatin.

If you study the above carefully, these are merely different combinations of the same five drugs below:

  • 5-FU.
  • Folinic acid or
  • Oxaliplatin
  • Irinotecan
  • Capecitabine or Xeloda.

One important question which most patients want to ask is: Can chemotherapy cure colon cancer? Or What is the success rate of chemotherapy for colon cancer. I tried to search the answers from the internet and these are what I got.

  • Chemotherapy is used after surgery in many colon cancers which are stage 2, 3, and 4. It has been shown that it increases the survival rates. This is not the case in stage I cancers, and therefore chemotherapy is rarely used in this setting. The vast majority of stage I cancers are cured with surgery alone.
  • Although clinical trials have demonstrated that adjuvant chemotherapy improves survival for stage-III colon cancer, the benefits remain controversial for stage-2 lesions. Stage-2 colon cancer patients receive adjuvant chemotherapy despite its uncertain benefits.
  •  Surgery is the primary curative modality in 70–80% of colon cancer patients who present with a non-metastatic disease. However, recurrence is common and is seen in nearly 30% of stage 3 cases after 5 years.
  • Nearly a quarter of all colon cancer cases are stage 3 at diagnosis.
  • Chemotherapy does not cure metastatic colorectal cancer, but it can improve symptoms and prolong life. 
  •  Upon diagnosis, 20% of newly diagnosed colorectal cancer patients present with metastatic disease (Stage 4) with no curative treatment options currently available. 
  • The overall five-year relative survival of colorectal cancer patients in the US is 64% and in England it is 50.7%.
  • Below is the survival rate in England, based on the stage of disease at diagnosis.
Stage at diagnosis Number of cases 5-year relative survival (%)
Dukes A / Stage 1 26,727 93.2
Dukes B / Stage 2 74,784 77.0
Dukes C / Stage 3 72,806 47.7
Dukes D / Stage 4 28,377 6.6

 

  • The above data are obtained with patients in the US and England. We need to take note that survival rate does NOT mean cure. Unfortunately many patients are told that if they can live five years and more you are considered “CURED”. Unfortunately this is a wrong advice.
  • Take note also that the above result need not apply to you. You may respond differently from these people. The above result should be treated as just an indicator of what can happen to you.
  • In summary, if you are diagnosed with advanced or Stage 4 cancer, you chance of survival is probably 10 to 15%, no matter what you do. On the other hand, if you have a Stage 1 cancer, you don’t need chemotherapy at all after surgery. Even for Stage 2 cancer, chemotherapy is of doubtful benefit.
  • Overall, that data tells that for colon cancer, you have a 50:50 chance with chemotherapy if your cancer is at Stage 3.

Most patients believe that surgery and chemotherapy can cure their cancer. Unfortunately this is often not the case. In the case of SPW and Wongso, were they ever told the truth about their chances? Unfortunately, they had to learn the hard way.

 

 

 

 

Pancreatic Cancer: Can Chemo Cure You? or Can the Treatment Kill You or Bankrupt You?

SH is a 62-year-old Singaporean. Many years ago, his father had lung cancer. He underwent chemotherapy and according to SH’s wife, “it was very fast, within a year he died. He had chemo.”

Fast forward to early 2018.  SH had difficulty moving his bowels which led to pains in the abdomen and loss of appetite. The problem persisted for some six months.

Sometime in June 2018, SH went to a government hospital and did a colonoscopy. There were some polyps. USG showed “air bubbles” in the intestine. Nothing was done and SH was asked to go home. Not satisfied, SH went to a “well known” private hospital (in Singapore). A CT scan was done, followed by a biopsy.

SH was told he had pancreatic cancer, Stage 3. The cancer might have spread to the small intestine.

On 1 July 2018, SH sent me an email:

Dear Dr. Chris,

I am SH from Singapore I want to check with you how can I come and consult you in Penang?

I have done a CT scan and  found to have “abdomen/pelvis: mass in neck of pancreas, encroaching the portal vein causing portal obstruction with cavermosum formation. Also abutting hepatic artery and SMA”.

May I know how to make an appointment to see you? I look forward to your reply.

My reply: Go and see the doctors first and find out what they can do for you.

Dear Dr. CHRIS,

Thank you for your advice. I will discuss with my doctor first. I understand that he recommends chemo followed by surgery. I will come back to you once I have gone through the treatments and assess my health condition.

From 11 July 2018 to 9 July 2019, SH underwent chemotherapy. This was done at the clinic of a “famous Singapore oncologist”.

In total, SH received 11 cycles of chemotherapy using the drugs, Gemcitabine + Abraxane. This is the standard recipe used to treat advanced pancreatic cancer.

This treatment was stopped after 11 cycles because, according to SH, the treatment was not effective. For this treatment alone, SH spent about SGD100,000.

In November 2018, SH underwent treatment with HIFU – high frequency focused ultrasound.

Then from end of July 2019 to end of August 2019, SH received 28 cycles of radiotherapy. This treatment cost him SGD20,000.

On Jan 19, 2019, I received this email from SH.

Dear Dr. Chris Teo,

I am SH from Singapore. I contacted you in July 2018. You asked me to see my oncologist first. I did that. I would like to visit you to seek alternative herbal treatment. I have completed 13 chemo sessions for treatment of my pancreatic cancer. Please advise how to make appointment to see you?

On Nov 4, 2019 SH again wrote:

Dear Chris Teo,

Can I come to see you in November (date to be confirmed)? My chemo treatment is not working for me. I will not hold you responsible. I am desperate to seek alternative treatment. Can you agree to see me? Thanks.

When SH came to seek our help in November 2019, he said he had learned from his father’s bitter experience about chemotherapy. From the beginning he was not happy to undergo chemotherapy but he had no choice. In the end, he decided to give up chemotherapy because of the severe side effects.

Did chemo and radiation treatments cure his cancer?

Take a look at the CA19.9 values during the course of his treatments:

SH was scheduled for a third cycle of chemo in mid-November 2019 but he decided to give up further medical treatment.

In fact SH was told that if he was to continue with chemotherapy, the drugs to be used would be changed to: 5-FU +irinotecan or 5-FU + irinotecan + oxaliplatin.

Alternatively, SH could opt for targeted therapy using Olaprarib.

If you check the internet, Olaprarib is a drug used to treat ovarian and breast cancer!!!!!!!

How much does Olaparib cost? In the US, the cost of Olaparib (internet information) is estimated to be USD3,000 per month!

SH’s blood test results on 5 November 2019 is a follows:

RBC 3.14  low
HGB 9.3    low
Platelet 86     low
eGFR More than 60 high
Alk phos 55
AST 32
ALT 24
GGT 50

Below are the results of the PET scan done on 1 October 2019 (top row) compared to the one done on 15 July 2019 (bottom row). It is obvious that his cancer did not go away in spite of the treatments given.

My Comments

One question I asked SH (and his wife). Before you undergo the chemotherapy, did you ever ask the oncologist if the treatment is going to cure you? Yes, they asked that question. And the answer was, “No, cannot cure. It is just to prolong life or to promote quality of life.”

Is that what patients want — no cure but prolong life? Ask these questions — prolong life for how long? And at what cost in terms of suffering or money?

What about chemo promoting quality of life? Someone must be joking! SH said, “spend money is okay” but it is the suffering that he could not endure.

At the end of it all, ask yourself, Is it worth it? I can’t answer that question – only the patient who suffered the consequences would know better.

I always tell patients, understand that the decrease of tumor markers (in this case CA19.9) is meaningless! But many patients don’t want to understand this. To them if the tumor marker comes down, it means the treatment is effective! So patients like to go for blood test or do a CT scan soon after each or a few shots of treatment. Some even do the most crazy thing — doing a PET scan every month!

Let us look at SH’s case.

  1. On 5 July 2018 before chemo, SH’s CA19.9 was at 5,248. That was high! Okay, after a shot of chemo, his CA19.9 went down to 1,658. Hooray, the chemo worked! That was what SH thought and it was probably what his oncologist also thought and wanted SH to believe — the chemo was very effective!

So go for more and more chemo — good, isn’t it?

  1. By 28 February 2019, SH’s CA19.9 went down to its lowest level, at 206. Wonderful achievement.

But was that really wonderful? Don’t be fooled. If you have enough experience or if you are observant enough, know that this decrease of tumour marker may not last. It could be just an illusion; a temporary relief and a good start to make patients excited and spend their money. But it may not last. I have seen enough cases like this happen.

  1. See, from the lowest CA19.9 level of 206 in February 2019, SH’s CA19.9 started to increase again. By July 2019 it went up to 500 – 600. That was just within five months.

It was at this point that the doctor told SH that the Gemcitabine + Abraxane concoction did not work anymore!

SH needed to be given another “magic” concoction of Oxaliplatin + 5-FU (or + irinotecan).

  1. By October and November 2019, even with the new concoction, SH’s CA19.9 shot up to 4,329.

Remember before SH was started on chemo in July 2018, his CA19.9 was at 5,2438. After spending more than SGD120K for the treatment, he was back to square one — that was just 15 months later.

  1. SH suffered severe side effects. In spite of not seeing meaning benefit, the oncologist would not want to give up yet. If SH had already developed a phobia for the needle, he can go for a “high sounding name treatment called Targeted Therapy”. This is to take an oral drug called Olaprarib. This is the first time I have heard of this drug. So I goggled to find out more about this. I learned that this drug costs a bomb — USD3,000 per month in the US?!? I have no idea how much this cost here.

But what is most bewildering about this drug is that it is meant for ovarian or breast cancer!!!!  Has someone forgotten that SH has pancreatic cancer? That being the case, how good can this new drug be for SH?

So let’s go back to the title of this post — Can chemo cure you? Can the treatment kill you? or Can the treatment bankrupt you? I would not be able to answer that question. Patients, you answer that question!

 

 

 

 

Neuroendocrine Cancer: Magic? Fluke Shot? Hocus pocus? or God’s Blessing?

Status

Jim (not his real name) is a 29-year-old Indonesia. He is an engineer – a graduate of one of Australia’s prestigious universities. He and his wife, Grace (not her real name) came to seek our help. Let me briefly relate to you his story.

Some time in January 2019, Jim went out with friends for a drinking session. He vomited blood.  Later, he passed out blood in his stools. Jim has a history of gastric ulcer.

Jim went to a private hospital in Melaka and did an endoscopy and CT scan. The result showed:

  • Enlarged liver with multiple solid nodules in both lobes. The largest in the right lobe is about 6 x 6 cm.
  • There is an enlarged perigastric node about 2 cm.

Jim went to Hospital A in Singapore for a second opinion where an endoscopy was again done followed by a PET scan and a biopsy. The results showed:

  • The 1.8 x 1.3 cm lesion in the gastric fundus, represent the known primary neuroendocrine neoplasm.
  • Pericoeliac and paracaval lymph nodes are likely nodal metastases.
  • Numerous lesions in the liver, representing metastases. The largest lesion is approximately 6.8 x 5.9
  • There a several 0.2 to 0.4 cm nodules in both lungs. Lung metastasis remain a consideration.

After being told that he had neuroendocrine cancer, Jim and his family decided to go to Koh Samui, Thailand to undergo a 11-day detox program. This cost him SGD5,000.

On his return from Koh Samui, Jim decided to seek further treatment in Hospital B in Singapore. On 12 February 2019, he did a PET gallium dotatate scan – an imaging procedure specially for neuroendocrine cancer.

Note:  A small amount of a radioactive drug called Dotatate is given by injection before the PET scan. Dotatate attaches to neuroendocrine tumors (NETs) and shows up on the PET image as bright spots.

Below are the results:

On 13 February 2019, Jim was started on chemotherapy. The drugs used were: Cisplatin + Etoposite. In addition, he was also given Denosunab,  an injection for his bone.

(Note: Denosumab (trade names Prolia and Xgeva) is a human monoclonal antibody for the treatment of osteoporosis, treatment-induced bone loss, metastases to bone, and giant cell tumor of bone).

Jim continued to receive another shot of chemo with Cisplatin + Etoposite. But for the third shot, the drugs were changed to Irinotecan + Temodal.

(Note: Temozolomide or Temodal is used to treat brain tumour – glioblastoma multiforme or recurrent  anaplastic astrocytoma. It is sometimes used to treat bone cancer that has come back. This drug is usually used with irinotecan).

So from the third to eighth chemo, Jim received Irinotecan + Temodal.

Together with chemo, Jim also received Neulastim Booster.

(Note: Neulastim Injection is used for boost production of white blood cells, to help with fever due to low WBC in patients undergoing chemotherapy).

After the seventh chemo Jim’s started to have problems. He developed skin rashes, intially under his arm and parts of the body.

On 29 June 2019, Jim received his first shot of hormone injection called Lanreotide Autogel. Thiis cost SGD4,000 each injection and he had this twice.

(Note: Lanreotide lowers many substances in the body such as insulin and glucagon (involved in regulating blood sugar), growth hormone, and chemicals that affect digestion. It is used to treat acromegaly (increased level of growth hormone), carcinoid syndrome and a certain type of pancreatic or digestive tract tumor that may spread to other parts of the body).

(Note: Carinoid syndrome – signs and symptoms of carcinoid tumors in the digestive tract include: Abdominal pain, diarrhea, nausea, vomiting and inability to pass stool due to intestinal blockage (bowel obstruction), rectal bleeding, rectal pain and redness or a feeling of warmth in your face and neck (skin flushing).

After the eighth chemo Jim started to have more rashes. They spread throughout the body from head to toes and hands.

On 12 July 2019, Jim was give another type of hormone injected called Sandostatin.

(Note: Sandostatin is given to control symptoms such as diarrhea or flushing in patients with tumors such as carcinoid, pancreatic islet cell tumors, gastrinoma, or vasoactive intestinal peptide-secreting tumors.It is also used to treat acromegaly, when the body produces too much growth hormone, and the hands, feet, face or head grow too large).

On 12 Septermber 2019, Jim decided to give up medical treatment and he and  wife Grace flew to Penang seeking our help.

Take a quick look at the time line Grace prepared for this article.

1 4 &5 Sep-17 Endoscopy Melaka Hospital
2 10-Jan-19 Gastric pain, cold sweat, throw out blood & black stool
3 19-Jan-19 CT Scan, Blood test, Endoscopy & Biopsy Melaka Hospital
4 23-Jan-19 Re-do Endoscopy & Biopsy Singapore Hospital
5 23-Jan-19 PET Scan Singapore Hospital
6 29-Jan-19 Positive Biopsy report Singapore Hospital
7 29-Jan-19 Detox program for 11 days Resort, Koh Samui
8 8-Feb-19 Consult to Dr. X for another Singapore Hospital Singapore Hospital B
9 12-Feb-19 PET Gallium Dotatate Scan ( special for Neuroendocrine ) S’pore Hospital B
10 13-Feb-19 1st Chemo (Cisplatin & Etoposite) 3 days/cycle + Neulastim Booster S’pore Hospital B
11 13-Feb-19 1st Bone Injection Denosumab (xgeva)
12 5-Mar-19 2nd Chemo (Cisplatin & Etoposite) 3 days/cycle + Neulastim Booster
13 26-Mar-19 3rd Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster
14 27-Mar-19 Insert Port a cath Surgery Centre, SG
15 1-Apr-19 Hydration 1day S’pore Hospital B
16 12-Apr-19 Hydration 2 days & Albumin IV S’pore Hospital B
17 15-Apr-19 4th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster
18 17-Apr-19 Start taking herb 2x a day Herbalist Singapore
19 6-May-19 5th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster S’pore Hospital B
20 20-May-19 Hydration 1 days 1 L Hospital in  Melbourne
21 27-May-19 6th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster S’pore Hospital B
22 17-Jun-19 7th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster
23 26-Jun-19 Skin rashes started come out at under arm & body side
24 29-Jun-19 1st Hormone Injection Lanreotide Autogel (1 month dose 1 syringe) S’pore Hospital B
25 29-Jun-19 Hydration 1day S’pore Hospital B
26 2-Jul-19 Albumin IV 4 days S’pore Hospital B
27 3-Jul-19 Kidney USG S’pore Hospital B
28 8-Jul-19 8th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster S’pore Hospital B
29 8-Jul-19 Hydration & Albumin IV 5 days S’pore Hospital B
30 12-Jul-19 Rashes spread to head , toes, palm hands
31 12-Jul-19 3days Hormone Injection Sandostatin ( 3x injections daily ) S’pore Hospital B
32 16-Jul-19 Hydration 2 days S’pore Hospital B
33 29-Jul-19 Hydration & Albumin 3 days S’pore Hospital B
34 30-Jul-19 1st Consult Dermatology Dr. Y S’pore Hospital B
35 31-Jul-19 2nd Bone Injection Denosumab (xgeva) S’pore Hospital B
37 31-Jul-19 2nd Hormone Injection Lanreotide Autogel (1 month dose 1 syringe) S’pore Hospital B
37 12-Aug-19 Very tired, almost black out, skin getting worse, water retention
38 20-Aug 2nd Consult Dermatology Dr Y S’pore Hospital B
39 21-Aug Hydration & Albumin 3 days S’pore Hospital B
40 2-Sep Hydration & Albumin 4 days S’pore Hospital B
41 9-Sep 3rd Consult Dermatology Dr Y, Steroid Injection S’pore Hospital B
42 11-Sep Did IgG Food Sensitivity test Diagnostic, Singapore
43 12-Sep Consult with Dr Chris Teo, taking herb CA Care Penang
44 19-Sep Consult Dr Z for blood test Melaka Hospital
45 3-Oct Shingles Infections Skin Clinic Melaka
46 7-Oct 2nd consult with Dr Chris Teo CA Care Penang
47 16-Oct Low Albumin, IV 100ml a day x 3days Melaka Hospital

 

Was Jim cured by those highly scientific, up-to-date medical treatment in Singapore?

You make your own conclusion after seeing the photos below. By the way, for all the adventure in Singapore Jim spent no less than SGD100,000 (that is 0.3 million ringgit).

Feb 2019 before chemotherapy ——– Feb 2019 to Sept 2019, after chemo and hormone injection. SGD 100,000 gone. Ended up bald, severe skin peeling, severe diarrhoea, swollen feet, etc. Worth it?

Jim said the severe peeling of the skin  was indeed a very painful experience. His skin peeled and peeled for about 10 to 13 times. It addition, he suffered severe diarrhoea – about 20 times a day to the extent that he said he virtually fell “asleep” in the toilet. Jim will share his experience in the next posting.

Let us look at the results of his PET scan.

Comparison of scan results: 29 July 2019 (top row) vs 12 February 2019 (bottom row)

Comparison of scan results: 29 July 2019 (left row) vs 12 February 2019 (right row)

Something wrong with the bones? Scan on 29 July 2019 (left column) seemed to be more serious than scan done on 12 Feb 2019 (right).

Did the cancer go away after all the treatments?

Again, ask this question: From the above, do you see any improvement? And what had  scientific, modern medicine done to him? Study what the reports carefully and you will know the answers.

My comments

Most patients who come to see us are like Jim and Grace. They have come to the end of the road as far as medical treatments are concerned. Where else can they go to for help? Yet the medical world sees alternative medicine as hocus pocus. They call people like me snake oil peddlers!

When I first saw Jim in such a  pathetic condition, I was really upset. Here is a young man being subjected to such torturous treatments in the name of “science.”  But deep in my heart, there was a feeling that I would be able to help him — no, not to cure him but to help and make his life a lit bit better.

Each morning, as I prepare to come to the centre to see patients, my prayer to God, the Almighty Healer is always  this — God show me your way. Teach me what I have to do to help people in need. This is what I call  asking for God’s blessing for whatever happens after that!

In the next posting I shall present  you videos of our conversation. You will learn about the traumatic experience that Jim went through.

I prescribed Jim some herbs and was very concern if the herbs would help him or not. Below are some of the emails for you to evaluate.

 Sun, Sep 15, 2019:  Hi Dr Chris,

Currently Jim’s face & toes got water retention due to lack of albumin. This has happened 5 to 6 times  already since the past 4 months. This water retention is followed by tiredness, swollen & not feeling well.

Doctor at SG will give Albumin IV usually 2 bottles for 5 days. But it will become low again after 1-2 weeks & he need another albumin again. Which is not helping at all.

Last time you said you have herb for swollen face & toes. Please advice what herb to overcome this? Please advice.

Sat, Sep 21, 2019: Dear dr chris,

The past few days, 10 minutes after drinking the herb, Jim will need to go to the toilet. One day he can pass motion for around 7 times. Do you mind if we send you picture of the poop?

Lately, he is also feeling a bit tired. Is it the side effect of the herb? Should we be worried about it?

Also, we just started on Edema today. Will let you know how it goes in the next few days.

Tue, Oct 1: Hi Dr,

Thank you for your reply. After taking Lower Edema for 10 days until today, his leg still swollen, but not getting worse. And he still pee 6-7x a day (last time when his leg swollen he only pee 2-3x a day. Means all liquid intake become water retention. During that time we have no choice & did Albumin IV 10bottles 5 days in a row, then slowly his albumin level going up & he starting to pee 7- 8x per day & his water retention gone. But It will recurrence every 2 weeks time which make us worried.

Do you think this swelling due to his liver not good or what else?

The first 2 weeks he feels tired, skin still worse, sometimes nausea, & more bowl movements more than 5x. Every time he drink herbs, 10 mins later confirm go toilet.

But now after taking herbs for 3 weeks time, he is much better now. The skin, the energy, mood are better and can go out to do some activity which we are very happy to see his condition now.

Now only his leg swollen & still having lack of leg power (since few months ago).

He took the herbs regularly & diets following your cook book. Totally no meats except fish sometimes.

Please advice on this current condition.

Mon, Oct 21: Dear Dr Chris,

 I compiled Jim’s medical record since his first symptom until now.

– Medical Timeline (excel)

– All scans & Endoscopy

– Each month blood test

– Histopathology report

– Photos of his peeled skin

We are very happy if you can help us look through these file for your further analysis. His current conditions is much better after taking your herb, and we are very happy & thank you and auntie for your kind help.

Tue, Oct 22, 2019 : Dear Dr,

Thank you for your kind reply. He feels good, can do some activities & he continues  using the machine also. Overall the energy is good can go out around 5 hrs a day.

Thank you for your help.

Wed, Oct 23, 2019: Dear Dr,

We are the one should thank you because you help us through this struggling time. We are fine with the pictures, sharing with others.

Thu, Oct 24, 2019: Hi Dr Chris, 

After reading the story you wrote, I felt happy because now we are on the right track. After chemo  so many side effect & no improvement. We were really down at that time and luckily we came  to see you. Hopefully this story will help others patients too. We really appreciate your kindness & help.

Thank you Dr Chris!

He is doing quite well now, but I understand he can’t over do. So we trying to manage it.

  1. Now no more diarrhea problem. Only during 3rd to 8th chemo (Irinotecan side effect), diarrhea 15-20x a day (even after atrophine injection 1-2x a day). After stop chemo no more. Currently 4-5x a day. Not painful.
  2. His last Albumin IV on 16 Oct for 3 days. After that blood test shown still border line 33 L (range 35-50). But last 4 days we soaked his toes on warm water + Epsom salt. It’s help reduce the swelling. Now looks normal already. Hopefully will stay normal because it happened so many times already & no solution until now.
  3. Now, skin no more peeling off, only dry in some area (near lips, thigh). After taking herb about 2 weeks his skin does not peel off anymore.
  4. He can sleep well now, no more melatonin / sleeping pill this past one month until now.
  5. His shingles is gone, leaving scars only.

AFTER TAKING THE HERBS

 

Let me conclude by asking you to reflect seriously these words of advice:

   

Acknowledgment: Thank you Grace (not her real name) for your help in providing us with all the pictures and medical reports to enable us to write this story.

 

 

 

 

 

 

 

Surgery, 27 times radiation and 16 cycles of chemo failed. Oncologist shrugged and said, “Do more chemo. Try but at same time, just pray.”

More chemo and pray

LW is a 63-year-old lady from Indonesia. This is her sad story.

LW went for a Pap smear every year. Everything seemed okay. In 2014, she was told there was an infection but she need not have to worry!

Not satisfied LW consulted another doctor. She was told she had cancer of the cervix. Immediately she underwent an operation but refused follow-up chemotherapy and radiotherapy.

One year later, a check-up showed that the cancer was still there — meaning the operation did not cure her.

In early 2015, LW came to a private hospital in Penang and underwent 5 cycles of chemotherapy. She also had 25 sessions of radiotherapy and two times of brachytherapy (internal radiation).

In June 2016, examination showed LW still had cancer. She underwent another 6 cycles of chemotherapy. This time radiotherapy was not indicated.

After completion of the treatment, a PET scan on March 2017 showed the cancer did not go away. Again LW underwent another 6 cycles of chemotherapy. The treatment was completed in mid-December 2017.

A PET-CT scan on 9 January 2018 showed the following:

  • Metabolic active lymph nodes in both hila, subcarinal and middle mediastinum — slight decreased in size, measuring 1.6 cm.
  • Metabolic active lymph nodes at para-aortic and para-caval region and bilateral common iliac region — slight increase in size.
  • Metabolic active left cervical lymph node at level 2 — measuring 1.2 cm.
  • Metabolic active left cervical lymph node at level 4 — measuring 1.8 cm.

In simple language, the chemotherapy and radiation treatments thus far did not cure LW.

Chris: Did you ask your oncologist why he cannot cure you?

The oncologist shrugged and could not answer. He only suggested that LW undergo more chemo! Kita berusha saja sambil berdoa (we try and at the same pray!).

 

Comments 

What can cancer patients learn from this case — i.e. if you want to learn!

  • Ken Murray is a Family Medicine doctor. He said, Poor knowledge and misguided expections lead to a lot of bad decision. 

Kathleen Phalen in her book, Integrative Medicine, she wrote, We’ve been misguided into thinking that our doctors … are deities capable of performing the greatest of miracles. 

Dr.Edward Creagan (in How NOT to be my patient) said, The doctor does not always know the best … some (patients) still believe that the doctor knows best. We don’t … You can guard against being an innocent victim.

In simple language I would say, Read, educate and empower yourself. It is you and you alone who suffer the consequences of whatever treatments you undergo. Here again, I must say straight and blunt, Cancer patients do not read! They prefer to be led by the nose.

  • Three rounds of chemotherapy (in addition to surgery and radiotherapy) did not cure her cancer, yet LW was asked to more of the same. Is that logical? When will you stop putting poison into your body?

Remember what Albert Einstein said, Insanity is doing the same thing over and over again and expecting different results.

  • Think back, when chemo after chemo failed, did your doctor ever admit that what he was doing for you is wrong? No? And did he try to find a scapegoat? And why are you so dumb and “insane”?

An Indonesian lady had surgery, radiation, chemotherapy and Tamoxifen. After five years she was told by her oncologist that she was cured! One year later a bone scan showed extensive metastasis to the bones. The oncologist told her it was no fault of anyone, “it is just your luck.” Ho, ho, bad karma? 

Another Indonesian lady had similar treatment for her breast cancer. She had chemos after chemos for almost three years, yet the cancer did go away. Doc., why am I not cured? The oncologist said, Ibu, ini tidak bisa sembuh (Mama, this cannot be cured). This “confession” came after 3 years of chemo and the patient having to sell a piece of land to pay for the RM300,000-treatment. The question to ask, Why is the truth not told at the very beginning, and not after all treatments had failed? 

A young Malaysia lady had breast cancer and her husband brought her to a very famous oncologist. The oncologist told the husband and the patient, No problem the lump is small, Stage 2. I can cure her. Do chemotherapy right away — this afternoon.

The husband trusted this oncologist so much that in his heart he felt God had sent him to this “great” doctor and this doctor is the one who is going to cure his wife — not God. 

This young lady had chemo after chemo — and after spending RM500,000 — she was not cured. Within a year, the cancer spread to her brain. The husband asked the oncologist why? His reply, I am not Jesus. How do I know it will recur.

George Lundberg was fired after 17 years being the editor of the Journal of the American Medical Association. Reflect seriously what he wrote in his book, Severed Trust, Physicians’ ego is enormous. The god image has been around for ages. They don’t like to make mistake. It’s even hard for them to acknowledge that they are capable of making mistakes. 

In his book, Second Opinions, Jerome Groopman, professor at Harvard Medical School wrote, Physicians are not used to admitting when they are wrong and plainly stating to the patients and family that an error was made … or an incorrect drug prescribed.

Harold Kushner is a Jewish rabbi who I have great respect for. In one of his books he wrote, Many people use God like an aspirin and some use God as antibiotics! 

  • There is no cure for cancer! I have been helping cancer patients for 20 plus years. I have come to the conclusion that there is no cure for cancer! It will come back — 5, 10,or even 20 years later, even after an “apparent” cure!

Let us not fool anyone. So when patients come to CA Care, the first information dished out to you is, If you come to us hoping to find a magic bullet to cure your cancer, then this is the wrong place. We don’t have any magic bullet. We want be honest and truthful from the very beginning.

No cure does not mean you are going to die soon. Far from it. We shall try our best to help you. I have patients who come to us after their doctors said they only 3 to 6 months to live! The reality is some of these patients are still alive after 3 to 10 years! What more do you want?

In this video, this is exactly what I told LW. Everyone has to die one day — it does not matter if you get cancer or not. For each day that you are alive, learn to be grateful to God for being able to see another day. Unfortunately not many patients have this sense of gratitude.

Yes, I believe in the power of prayer. I believe God heals you — not my herbs. I want to be careful not to use God as an aspirin or antibiotic. At CA Care we want you to learn to trust your God — whatever God you believe in, that’s okay with me (even though I am a Christian).

When you pray, ask God to give you the wisdom to do what is right. Ask Him to guide you and show you the correct path to good health. Don’t only ask, you need to WALK that path! Do something positive for yourself.

I think the key to any healing is to realize that good health is your responsibility. You decide whether you want to get sick or to be healthy. God is fair. Don’t blame God for your sickness or failures.

 

 

 

 

 

Part 2: What did you get out a failed, RM150,000 treatment?

zebra

We felt sorry for SF, her hope crushed. After 12 cycles of chemo and spending RM 150,000, she was told the tumors had shrunk and she was cured! (Or did she misunderstood her doctor’s message?). But after one month at home, she had bleeding and came back to her doctor again. Her tumour had grown back to its original size. It was a failure. Her doctor did not have time for her and hurriedly told her to for surgery.

With wounded feelings she and her husband left the hospital and sought the help of another oncologist in another hospital. She was started on radiotherapy to be followed by chemotherapy. We felt SF should just continue with her medical treatment and not take our herbs yet. We sent set her away without any herbs.

SF and her husband came back to see us again after a few days. We spent almost 2 hours talking. It was a “heart-breaking” morning for me. I laid out my advice as clearly, honestly and bluntly as possible.  But I was mindful not to cause panic or to instill fear in her. Many times during our conversation,  I asked her and her husband to think clearly and deeply the implications of what she wanted to do. She should then make her own decision based on what her heart wanted, after considering various points I raised.

What did you get out of your failed RM150,000 treatment?

 

 

  1. Diarrhea after radiotherapy

Patient: I had diarrhea after the radiation.

C: Did you have any diarrhea before you went for radiation?

P: No, the diarrhoea started 2 days after the radiation (note: it continued as of this writing — already 3 weeks).

C: I really cannot tell you what else can happen after this. Did you ever ask the doctor if these treatments — radiation and chemotherapy — are going to cure you?

P: No, we never ask.

C: You should ask before you undergo all these!

  1. Tumor shrunk after the first round of chemotherapy!

P: After 6 cycles of chemo, I was told the tumour had shrunk. And I needed another 6 more cycles. The doctor said I was cured. I requested the doctor to do a CT scan for me to confirm the result. The doctor said, No need, you are already cured. Go home.

C: What? He said chemo cured you?

P: He asked me to come back after 2 months for review. But one month at home, I had bleeding and we brought forward our travel and came back to see the doctor again.

Husband: The tumour had grown bigger (back to its original size, see table below).

pelvic-mass

C: Did you ask the doctor why? Only last month he said you were already cured. Now, what happened.

P The doctor was angry.

C: Har?

H: We were confused. We returned to see the doctor one day before he was to go on leave. It seemed he was “uncomfortable” and told us crudely — You just go for the operation! We then went to see another oncoloogist in another hospital.

  1. Elevated liver function parameters

C:  Let’s look at your liver function results (table below).

liver-function

On 8 June 2016, after finishing 6 cycles of chemo, your liver function was still okay. But you see what happened after you did 12 cycles of chemo. All the liver enzymes values were elevated. Your liver was going downhill. Okay, some people may want to rationalize that it is normal after chemotherapy. The liver function enzymes will go back to normal again after you stop chemo. Well, I don’t know if you want to believe that or not.

You are going to be given more chemo. I cannot tell you what is going to happen to your liver after this. I don’t know how many more cycles of chemo they are going to give you, and what drugs they want to use. If they give you the more toxic or aggressive drugs, what is going to happen to your liver?

They want to give you more chemo because they hope to shrink the tumour before they proceed with surgery. You have already done 12 cycles of chemo in Hospital A before. The tumour shrunk and grew back after a month. Think carefully, what do you hope to achieve this time with chemotherapy? Shrink the tumour again?

  1. Lung nodules disappeared

P: The doctor told me that the nodules in my lungs were all gone after the chemotherapy. At least, my lungs are free of cancer.

C: Wrong Ibu (mama)! Yes, the lung nodules were completely gone after the chemo but in the October 2016 scan, there was again a 0.6cm nodule in your lung. So the impression you had was wrong.

P: I did not know this. I did not understand all this. Only now that you have told me this.

lung-nodule

  1. Chemotherapy means sufferings

C:  Two days ago, a lady came to see me on behalf of her elderly father who had lung cancer. She consulted the same oncologist (the second oncologist, not the first oncologist in Hospital A) that you went to. This oncologist told the lady that her father needs chemo but chemo is going to cause many side effects and he would suffer. The oncologist also said that the father could go for oral drug. But oral chemo-drug can also cause sufferings.

On hearing this, the daughter “ran away” and would not want any more medical treatment for her father! At least we should be glad that this oncologist was honest to tell us this.

Patients are an ignorant lot!

C: This episode really make me sad. For years I have been trying to “educate” patients. I wonder if I have failed miserably? I understand all that you have said and gone through. You put your full trust in your doctors — they are your gods — and the gods failed you!

docs-are-gods

Also, unfortunately some of these gods are not honest. They don’t tell you the whole truth that you need to know.

doctors-lie

P: Indeed I don’t understand all these.

C: You came to see me twice. I have explained to you what I know and I ask you to think carefully what you want to do.

H:  Before this I believed that after the surgery — the tumour gone —  all problems would be solved! That was what I thought. I did not know all these before your explanation. Now, I understand and realise the implications.

P: I was hoping that after the chemo, I would be cured. I did not want to go for surgery!

 

 

 

Breast Cancer: IDR 4 Billion Gone, One Breast Lost

Jenny (not real name) was 44 years old when she found a lump in her right breast. A mammography done in a Singapore hospital on 21 December 2009 indicated no mammographic evidence of malignancy.

An ultrasound done on 22 December 2009 in another hospital showed the following:

Right breast

  • 1 o’clock palpable nodule, 2.15 x 1.8 x 0.9 cm
  • 2 o’clock nodule, 0.72 x 0.56 x 0.39 cm
  • 12 o’clock nodule, 0.36 x 0.54 x 0.29 cm

Left breast

  • 4 o’clock nodule, 0.84 x 0.72 x 0.41 cm
  • 10 o’clock nodule, 0.45 x 0.74 x 0.22 cm

Bilateral axillary lymph nodes

  • Right – 1.07 x 1.35 x 0.66 cm
  • Left – 1.31 x 1.44 x 0.55 cm

A lumpectomy was done and the histology report showed:

  • Extensive high grade ductal carcinma-in-situ with foci of stromal invasion.
  • Largest grade 3 invasive ductal carcinoma is 12 mm across.
  • Lymphovascular involvement suspected.
  • Multiple resection margins involved.
  • Tumor is positive for estrogen and progesterone receptors.
  • There is HER2 and p53 over-expression.

In September 2010, Jenny and her husband came to seek our advice. We told Jenny to go and have her entire right breast removed. She hesitated and we did not get to see Jenny again until 5 years later.

In November 2015, Jenny and her husband came to seek our help again and shared with us her IDR 4 billion adventure with the oncologists in Singapore.

Listen to our conversation that day.

 

 

Gist of our conversation.

Chris: You came in 2010.

Husband: Dr. Chris asked to go for mastectomy. My wife did not want to go for the operation. She had chemo.

C: Wait, first there were lumps in her breast. Why did you not want to go for operation?

H: Afraid.

Chemo and More Chemo — Bleeding Financially

C: After you consulted us, you went home and then went to see an oncologist in Singapore. You had chemo. Did you ask if the chemo was going to cure you?

H: The doctor said, yes can cure — guarantee!

C: Oh, that oncologist guaranteed that the cancer could be cured? Another breast cancer patient also went to this same oncologist — also guaranteed a cure! But unfortunately, after chemo and more chemo the cancer went to her brain. She eventually died (see story under comment). So for you, chemo after chemo — also can cure?

H: The lump was gone.

Jenny: Normal.

H: Normal but the oncologist kept wanting us to have more chemo. So we ran away from that oncologist.

C: Why did you run away from that oncologist?

H: Cannot afford to pay anyway — we were bleeding financially.

C: Oh, you ran away because you could not afford paying for the treatments. That was after how long of receiving the chemo?

H: Almost one to one and half years of chemo like in the chart below (chart prepared by husband).

1-chemo-injections

Note: From 25 October 2011 to 14 June 2012, Jenny received:

  • 12 injections of Herceptin.
  • 16 injections of Navelbine.
  • 20 injections of 5-FU.
  • In addition, she was given Eprex and Gran (self administered at home) to deal with her low blood counts. Refer to comment section to know what this blood boosting injection is all about.

Another oncologist: Don’t worry. We have a lot of medicine to treat you!

C: You ran away from the first oncologist and found another one. This oncologist once told a patient, “Don’t worry, we have a lot of medicine to treat you!” And this oncologist gave you one drug after another? When one medicine is not effective, change to another one? So you were started on oral drugs. Was it cheaper?

H: Ya, much cheaper because my wife just need to swallow the pills.

Jenny: Cheaper!

C: Did you ask the oncologist if the medicines were going to cure you?

J: Just to control.

C: How long were you taking these medicines — one type after another?

H: A long time, from January 2013 to November 2015. When the first round of oral drugs failed, the oncologist started her on Herceptin injections as well.

2-Oral-1

  • January 2013 to November 2013: On Cyclophosphamide + MTX. PET scan showed failure.
  • December 2013 to July 2014: On TS1 + Herceptin injection.
  • July 2014 to October 2014: On Herceptin injection + Kadcyla (Trastuzumab emtansine)
  • October 2014 to November 2014: Back to oral drug TS1 again + Tykerb (lapatinib).

3-Oral-2a

  • January 2015 to June 2015: On Herceptin injection + Tykerb (lapatinib) again.
  • July 2015 to September 2015: On Herceptin injection + Perjeta (pertuzumab) + Taxotere + Filgratim (Gran).
  • November 2015: On Aromasin (exemetane).

C: What happened after taking all those oral drugs for more than a year?

H: The cancer came back again. The oncologist then started her on Herceptin injection again. She had a total of 7 injections.

C: Did you ask if this kind of injection was going to cure her?

H: The oncologist said the medicine given earlier did not work. Because of that the medicine had to be changed and changed. After one medicine failed another different medicine was tried. Then the doctor tried Kadcyla injection. This too did not work and the doctor changed to lapatinib. After lapatinib failed it was back to chemo injection again.

C: Then what eventually happened?

H: When the cancer did not go away in spite of all those treatments, Jenny had to remove her breast. After the mastectomy the doctor wanted to continue giving her chemo again — more Herceptin and pertuzumab (Perjeta).

Confused

C: I am really confused!

H: Me too. I also know that Herceptin can adversely affect the heart.

C:  When you first came to see us, I asked you to remove your breast. But you did not do that. You opted for chemo. Then after chemo and more chemo and also spending a lot of money you also lost your breast. How much did you spend for all those treatments?

H: A lot of money, about IDR 4 Billion.

C: Do you think the oncologists are good?

H: They spin money!

J: More and more chemo, until we have no more money!

Comments

When injecting toxic chemo drugs into patients, the oncologists also gave their patients Eprex and Gran. These are blood boosting shots. Perhaps this was done as a precaution because chemo could make the platelets, red and white blood go down. Perhaps too this is also a way to keep patients happy and well. Of course patients pay for such injection. But what is not known to patients is that this “red juice” and “white juice” may encourage tumor growth! Dr. Otis Brawley is an oncologist. Read what he wrote below:

Read juice

Different Oncologist, Different Business Model but Similar Pathetic Story

  1. Cure Guaranteed!

APT 1 APT 2 APT 3

From: http://bookoncancer.com/productDetail.php?P_Id=76

 2. We have a lot of medicine to treat you!

Hw 1

Hw-Composite-1 Hw-Composite-2

Hw 2

From: http://bookoncancer.com/productDetail.php?P_Id=75

One final note. IDR 4 billion — I could not imagine how “big a sum” this is. A patient who went to China for treatment of his lung cancer also spent a similar amount. And he came home just as disappointed. According to his wife, IDR 4 billion is worth 2 bungalow houses if you live somewhere around Medan.

 

 

 

Chemo Kills

Dr. Russell L. Blaylock, a neurosurgeon and author of Excitotoxins: The Taste That KillsHealth & Nutrition Secrets to Save Your Life and Cancer Strategerieshttp://www.russellblaylockmd.com) wrote an article: How Modern Medicine Killed My Brother.

Let me quote some of what he wrote:

  • Earlier this month, I traveled to Monroe, La., to bury my dear older brother, Charles. Charles, unfortunately, began smoking when he was in law school, something I warned him about repeatedly.
  • After misdiagnosis after misdiagnosis, Charles was eventually diagnosed with lung cancer. Once the diagnosis was made, an oncologist was naturally called, who wanted to start a complete course of chemotherapy drugs.
  • I advised my brother against it, knowing the cancer would not respond and the toxic drugs would dramatically increase his breathing difficulties, hastening his death. He took my advice.
  • Then, a radiation oncologist suggested radiating the tumor to shrink it. I wasn’t supportive of this treatment, but my brother wanted something done. Soon afterward, he started five and a half weeks of radiation treatment.
  • The oncologist told Charles he was losing too much weight and he needed to eat more bread, pasta and even sweets to gain weight. …I told him that losing the weight would make it easier for him to breath. I had given him a copy of my book on the nutritional treatment of cancer and told him it was critical he follow the advice exactly.
  • Unfortunately, Charles decided he didn’t like the taste of the blenderized vegetables and would do what the oncologist suggested. He began to eat ice cream, cookies and other items that cancer patients should never eat. Once he finished the radiation treatments, he developed fever, severe shortness of breath and had to be admitted to the hospital… he had to be intubated and placed on a respirator.
  • The practice of medicine has changed drastically in the world, especially in this country.
  • The new breed of doctor, like my brother’s doctors … are convinced this “cookbook” medicine is superior and their elite journals and medical associations know best… they are mere cogs in the wheel …They are unable to think for themselves.
  • Unfortunately, doctors, like those who killed my brother, are being turned out of medical schools all over the country like robots.

Read carefully what Dr. Blaylock wrote and you will soon realize that such tragedy can happen anywhere and everywhere; over and over again. And yet no one seems to learn.

Let it be known, this is how the world operates — misdiagnosis after misdiagnosis; surgery, chemo or radiation if it is  cancer; eat anything you like, etc. etc. It is all the same in every hospital you are in no matter where you are. Then the patient may eventually dies! For those who can afford, not before spending a pile of money. Yes, the family feels good for putting up a great fight — heroic act, so to say, in trying to save their loved one.

I can fully understand how frustrated Dr. Blaylock felt having to go through the experience he had described — seeing first-hand how modern medicine killed his brother but being unable to do anything to help even though he himself is a medical doctor.

Chemo Kills

I decided to write this article to share with you my own experience, which is somewhat similar to Dr. Blaylock’s.  No, it did not happen to my own brother or sister, but a very close dear relative, two years younger than me.

Not too long ago (June 2015) this dear relative was diagnosed with a recurrent cancer. Unfortunately the cancer had spread to her liver which had ruptured, spilling fluid in the abdomen and pelvis. The cancer could have infiltrated the pancreas as well. The right lung was filled with fluid and the cancer could have also spread to her lungs.

Her CA 125 = 775.6; CA 15.3 = 234.5; and CA 19.9 =171.2

No doubt, to anyone who knows something about cancer, this is a very serious case with no chance of a cure. Her doctor wrote: she is not a candidate for surgery due to the advanced disease and also her poor general condition. However, she may perhaps benefit from systemic therapy. In simple language, she had to undergo chemotherapy (what else?).

I was not involved in any decision that the family made — rightly, this is what it should be.  Everyone in the family should have a say but no outsider involved!

Perhaps, as a matter of “courtesy”,  I received a call informing me that she was going for chemotherapy as advised by the “best oncologist in the best hospital” in the country.

On hearing this, I did my part — not to object to chemotherapy but to explain what chemo is (even if I am aware that the family consists of medically educated members). It took me more than an hour to deliver my simple but crude message: Chemo is going to kill her.  My estimation was she would not go pass three rounds of this poisonous treatment. She will die.

Round one of chemo caused much misery.

Round two of carboplatin resulted in an almost total disaster. She had to be hospitalised — she was weak, unable to walk, was very fatigued and had very poor appetite. All along, she was on morphine due to severe pain.  Her blood was low and she needed blood transfusion. Fluid had to be tapped out of her right lung.  At last, the doctor’s recommendation —  supportive cares, no further chemo.  In simple layman language they gave up on her after two shots of chemo.

It was at this point that the family went into a frenzy and started to call me for help. Needless to say, I was glad that the doctor had come to realise the folly of giving chemo to terminally ill patient. Chemo had been shown to add misery to the already miserable patient.

My advice to the family were:

  1. Let her stay in the hospital for a while more to stablize her condition after all the damage done.
  2. Okay, put in the blood because she is anemic.
  3. Take care of the diet …no rubbish food.
  4. Bring the house maid to our centre so that we can teach her how to cook “healthy food.”
  5. Drink juices. But can take porridge BUT no meat, egg, sugar, oil, etc. … a bit of fish okay.
  6. Once she is stable then we can slowly give her the herbs.
  7. From the medical reports, she needs a lot of herb teas but I am not going to be too ambitious or aggressive because after the chemo had destroyed the stomach lining, she may react badly to the herbs.
  8. Slowly, later, I shall replace the morphine with Pain Tea. But for now she can still take the painkiller because of the pain.

We need herbs for her liver, pancreas, lymph nodes, lung (even fluid in the lung) and abdominal distension / ascites. I have herbs for all these problems … but as I have said let her recover from the chemo damage first otherwise she would throw out all these.

Please let me know how she is recovering after the transfusion. Be sure that I am ready to do my best to help in whatever way I can.

Sadly, a day after I wrote the e-mail, a message came through that this dear relative died.

I took this news with a heavy heart but I expected this tragic end all along. I was sad at the same time angry because I felt helpless.

Nevertheless, after seeing deaths like this happen a hundred and one times, it dawned on me that the ultimate and  true healing for any terminal cancer patient is death. If possible, let death comes without pain or any added man-made sufferings.  Let us die with  dignity surrounded by our loved ones. Let us not die as a rotten vegetable. That is what I would want it to be — for me.

Do you really know what chemo is?

Onco dont tell the truth about chemo

Chemo one poison combination

Chemo kill  Compassonate onco Chemo kill patient

Chemo-MORE Harm than-g

Chemo-drug-makes-cancer-wor

Chemo drugs 3 percetn effective

 Chemo-and-Prolong-Life

Ang Peng Thiam

Chemo-Suffer-near-death

Wrong

Lies-Damned-Lies-and-Medica

Let me end by asking you to reflect on what Henry Ford and Albert Einstein said:

 Insanity both

To my dear relative. Now that you are gone, rest in peace with the Lord.

Heaven is such a beautiful place. In the not too distant future, we shall meet again.

Related articles:

https://cancercaremalaysia.com/2015/09/16/what-really-matters-at-the-end-of-life/

https://cancercaremalaysia.com/2011/11/26/the-cold-hard-facts-about-the-us-cancer-program-part-2-misguided-and-ineffective/

https://cancercaremalaysia.com/2011/11/03/dissecting-chemotherapy-11-no-chemo-for-dad%E2%80%99s-liver-cancer-%E2%80%93-wisdom-of-a-daughter/

https://cancercaremalaysia.com/2014/06/01/using-emotions-of-fear-or-hope-to-sell-cancer-treatments/

 

 

 

Why do cancer drugs get such an easy ride?

BMJ 2015350 doi: http://dx.doi.org/10.1136/bmj.h2068 (Published 23 April 2015)Cite this as: BMJ 2015;350:h2068

Donald W Light, professor and Joel Lexchin, professor 

Rushed approvals result in a poor deal for both patients and cancer research

Unlike most other diseases, cancer instils a special fear and “is treated as an evil, invincible predator, not just a disease.”

The ability of drug companies to charge very high prices, even when most approved cancer drugs provide little gain for patients, drives much of the research, as desperate patients lead some governments and private insurers to pay whatever companies charge.

Officials within the US Food and Drug Administration are enthusiastic about new cancer drugs. Richard Pazdur, who oversees oncology activities for the FDA says that new cancer drugs are so effective that “We don’t have a lot of questions on [these] drugs because they’re slam dunks. It’s not if we’re going to approve them. It’s how fast we’re going to approve them.”

The methodological weaknesses in oncology trials do not support such enthusiasm.

Trials for cancer drugs were 2.8 times more likely not to be randomised, 2.6 times more likely not to use a comparator (single arm), ….

and to READ MORE ….. Article access for 1 day: Purchase this article for £23 $37 €30 * http://www.bmj.com/content/350/bmj.h2068

If you don’t have the money to pay for a one day access to this article, try “googling” the subject matter, and with some luck you get a “free ride” and enjoy comments from various sources.

From http://www.sciencedaily.com/releases/2015/05/150507135917.htm: Highly priced cancer drugs get rushed approvals despite poor trial methodology and little effect on the longevity of patients, cautions York University Professor Dr. Joel Lexchin in the School of Health Policy and Management.

“Patients and their doctors should demand that regulators require pharma companies to provide clear evidence of clinical effectiveness of the drugs, resulting from rigorous methodology,” suggests Lexchin. “Drug agencies like the Food and Drug Administration (FDA) and the European Medicine Agency (EMA) don’t actually look at whether people live longer.”

In an article in the British Medical Journal, titled “Why do cancer drugs get such an easy ride?,” Lexchiin and co-author Donald Light, a professor in the School of Osteopathic Medicine, Rowan University in New Jersey, note that accelerated approval and shortened review times also make it a smooth sail for cancer drugs.

Lexchin cites earlier research reviewing solid cancer drugs within 10 years of EMA approval to point out that these drugs improved survival by just over a month.

“Similarly 71 drugs approved by the FDA from 2002 to 2014 for solid tumours have resulted in median gains in progression-free and overall survival of only 2.5 and 2.1 months, respectively,” he says adding, “Also, only 42 per cent met the American Society of Clinical Oncology Cancer Research Committee’s criteria for meaningful results for patients.”

From: http://www.yourhealthbase.com/ihn260.pdf: How Effective Are Newer Chemotherapy Drugs?

  • An editorial in the April 23, 2015 British Medical Journal examined the recent accelerated drug approval process for cancer drugs in both the US and Europe. The subtitle was “Rushed approvals result in a poor deal for both patients and cancer research.”
  • This editorial contains some extremely disturbing statistics and information the authors obtained from reviewing the chemotherapy clinical study literature and other papers over the last 8 to 10 years.
  • Between 2007 and 2010, … almost 9000 oncology clinical drug trials were compared with trials for other diseases, the former were 2.6 times more likely not to use a comparator and 1.8 time more likely not be blinded (open to bias from the investigators) … this undermine the validity of the outcomes, it also reflect what regulators will allow. (In lay man language this means bad research. And the regulators — FDA, allows that!).
  • The European Medicine Agency … found that new oncology drugs improved survival by a mean of 1.5 months and a median of 1.2 months.
  • The 71 drugs approved by the US FDA from 2002 to 2014 for solid tumors have resulted in median gains in progression-free survival of 2.5 months and overall survival of 2.1 months. (Pay thousands of ringgit plus suffer side effects and you live 2.5 months longer? Not cured? As you told about this before you started paying though your nose?).
  • Post-marketing changes in the package insert (so-called label) were substantially greater for oncology drugs given priority approval as compared to those going through the much longer standard process, which the authors suggest reflects deficiencies in the accelerated review process. (In layman language it means, quicky, sloppy job — a rush to make quick bucks?)
  • Both the European and US regulators allow companies to test cancer drugs using a surrogate endpoint rather than survival or other more patient-centered outcomes. Tumor size is given as an example of an unreliable endpoint since it is highly variable in predicting overall survival. (In layman language the measure of trial outcome is not reliable. Just making the size of tumor smaller — or tumour shrinkage — may not mean anything. Surely it does not mean the cancer is cured! So, the measure of effectiveness is faulty).
  • In 2013, two peer-reviewed papers appeared where a total of over 100 oncologists protested against the high prices being charged for cancer drugs when 11 out of 12 approved in 2012 provided only small benefits for patients. (Do you realize that chemo drugs are getting more expensive …the prices of the newer drugs are beyond our imagination. But are they effective? Yes, make you live longer by 2 or 3 months????? But patients want a CURE)
  • The authors term the approval process an “Easy Ride” and suggest that this serves both patients and research badly.
  • It can also be argued that the majority of cancer drug development research currently leading to new drug approval is bogged down in merely getting more ineffective drugs approved in the hope that marginal improvements in survival will lead to enhanced profits. (The root of this evil is greed! They go after your cancer or after your money?)
  • … generally priced so high that the choice is between bankruptcy or declining treatment except for the wealthy.
  • The results discussed above are consistent with those presented in 2004 by Morgan et al14. Based on reports from Australia between 1992 and 1997, the contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was 2.3% whereas in the US it was 2.1%. These results suggest that over this period in these two countries chemotherapy made little contribution to cancer survival. (Yes, they tell you … chemo will give 60% chance, 99% chance, bla, bla …the Australian showed chemo is only 2 or 3% effective).
  • Furthermore, not much appears to haves changed between 1992 and 2014 from the patient’s perspective. It is important to note that we are talking about cancers that involve solid tumors. (Why change or improve? As it is – the drug companies are happy, hospitals and doctors are happy! And patients believe and trust them!)
  • BOTTOM LINE: When offered one of the new “wonder” chemotherapeutic drugs, it is important to ascertain the actual expected life extension in order to weigh this against the side effects. Trivial life extensions are sufficient to gain regulatory approval and allow patients to be told the treatment will extend their life. Unless carefully qualified, such an approach appears unethical.

 

 

Stomach Cancer: No to surgery and chemo. Why?

EK is a 66-year-old female. About 2 years ago, she felt stomach discomforts after eating. If she had soft diet, then she was okay. She did nothing about this problem. During the Chinese New Year, 2015, she felt something blocking when she took food. Then she vomited. The problem went away after that. In June 2015, she went to a medical clinic and the doctor said she might have thyroid problem. However, an endoscopy and biopsy in July 2015 indicated stomach cancer.

EK and her son came to seek out help after being told that EK had to undergo chemotherapy followed by surgery. EK did not want to undergo these procedures. Why? Listen to our conversation that day.

 

 

Summary of our conversation

Chris:  Does your mother know about this?

Patient: Yes. When doing the scope, the doctor told me on the spot that I have cancer. The doctor then asked me to undergo chemo. Must decide immediately. Chemo is to shrink the tumour first. After that, they will operate me, to remove my stomach.

Son: He was trying to convince her to immediately proceed with the treatment. But when I did research on line the chemo does not work so well with diet causing cancer.

C: I understand. You are not the only one. Many others are like you too. You do not get cancer only yesterday. Perhaps it has been there for the past 5 or even 10 years already.

P: Only 2 years ago.

C: Perhaps 5 years ago it was already there but it did not show up and you did not feel anything. Most people do not “listen” to their body. For you, only now it shows up. What do you want to do? You have to decide. Correct, on the one hand you can have it removed and maybe it is gone. Do you want to operate?

P: I don’t want to operate. The doctor told me if I do not operate the tumour will grow. It may cause blockage and  bleeding. And it is going to be very painful.

C: The doctor said you have to do chemo first and then surgery. Did you ask him if these procedures are going to cure you?

P: No doctor would guarantee that.

S: Why I feel not satisfied is every time we discuss with the doctor — he never want to tell us the probability. They don’t know. Depend on patient, this can happen, that can happen. They don’t know and dare not go into this subject.

P: The doctor told me it is going to be 50: 50.

S: They never tell us about the side effects. What can happen after that? I spent about 2 weeks researching (in the internet) I know that there are a lot of (side effects).

C: Okay, take it easy. Relax. Go home and think about it and decide. Listen to your heart and not your head. If your heart says operate, then go for the operation. If your heart says no operation, then don’t do the operation.  Take it easy.

This is a major surgery. The whole stomach has to be removed. Understand this. If the cancer does not spread, then removing it is good. Clean and throw it away and it is gone. But if the cancer has already spread, that is where the problem is. If it has already gone to the liver, what do you do? Cut the liver also? It is hard for us to decide what is the best thing to do now.

After removing your stomach, you can’t eat anything you like any more. You need to adjust your diet. It is going to be a bit difficult.

Then that 50:50 chance — may be it may not end up 50:50 at all — we don’t know.

You can’t blame the doctor because that is all they know.

Then, back to this again. What if you do not do operate? First, the tumour may grow and block (the passage way). You cannot eat and vomit. So, you may have to face these problems.

All these basically mean — you cut, you die; you don’t cut you also die. But everybody also has to die. The question to ask is: How do you want to die? That is the most important thing.

If you go for surgery, you may die on the table. We don’t know.

P: Yes, that was what the doctor told me. If something goes wrong, you die.

C: You also need to know this. If you cut, you also need to suffer later … due to the chemo, etc. Go through all these sufferings and die. May be not worth it. This is one scenario. Another scenario is, now you are still well with no problem. If you can take care of yourself, maybe you don’t have to die sooner, may be you don’t have to suffer so much. But know that one day you have to die. So, which one do you want” Think for yourself.

You come and see us — can we cure you? No, we are not god. But we also know that we have helped a lot of people already. They don’t die that soon. But they have to learn how to help themselves. Learn how to live with your cancer. Tell your cancer — you stay in there but don’t disturb me, and I don’t disturb you. If I die, you (cancer) also die.

If there is blockage, then you have to go for surgery. If not, relax.

We know this is dangerous, we know this is a rare cancer. In one year, we do not see many case like this.

Okay, do you want to go home and think first what you want to do?

P: No, I don’t want surgery. Then go for chemo — no, my whole body would collapse! The doctor also told me that even if I did the operation, he would not be able to remove everything. May be something may be left behind. Because of that, I want to go for natural therapy.

C: Do you understand that it may not cure you? People come and ask us to cure them. Our answer is, No we cannot cure you. Because we know that cancer cannot be cured, but to help you — YES. But you have to want to help yourself first. But how long you want to help yourself is up to you. Some people get well after 6 months — they forget what we taught them after that!

S: Professor. Thanks for reminding us. I know in terms of diet, it is not easy to change.

Comments

EK and her son were desperate. And they need help. The doctor wanted her to go for chemo and surgery for her stomach cancer that had probably spread to the liver, pancreas, spleen and lymph nodes. In simple language, this is an advanced cancer,  where surgery alone cannot cure her.  The cancer cannot be totally removed. That means, the chance of recurrence is very high. In addition EK has to undergo chemotherapy. EK knew what she was asked to go into and decided not to follow the medical way.

EK and her son clearly need help. CA Care was set up to exactly to do this — to help those in need of direction and help. And we are ready to help. But for those who come to CA Care in search of “magic bullet” or any easy way out, then we say you have come to the wrong place. Please go elsewhere to shop for your cure.

EK’s son took time to browse the internet for more information. He was clearly unhappy that he could not discuss anything with the doctors. Understandable, doctors are busy people and they don’t have the time to explain things to the patients or their family members.  Read what Dr. Heymann wrote:

Doctor visit 12 minutes

It is unfortunate that doctors do not have the time to show much concern about the patients. EK was told right there and then, while doing the scope, that she has cancer and chemo has to be done immediately. The message came like a bomb. No doubt about, the “death sentence” as many like to call it, caused much anxiety and distress not only to the patient but also the entire family. Patients and their family members want to know MORE, but they cannot get much information from the doctor. At CA Care, we try our best to answer your concerns and provide information as honestly as we can — to empower you with knowledge so that you can make informed decisions.

Bill-Henderson-Informatin-i

While in the midst of writing this story, a patient came to our centre. He was diagnosed with pancreatic cancer that has spread extensively to his liver. After the CT scan, the doctor told him: We cannot operate you. We cannot chemo you. Go home, eat anything you like and go and play as much golf as you like. The patient told us, I know what that mean. The doctor virtually told me to go home and wait to die. It was indeed a great let down. We don’t know how he took it, knowing that this man was once the deputy head of a state government, a VVIP.  He and his wife spent about one and half hours at our centre. We answered everything that they wanted to know. No doubt, they were satisfied. They now know what they CAN and NEED to do next.

Read again what Dr. Jody Heymann wrote:

Hospital not concern of patients

Pose this question to the Power-that-Be, Given the above situation, what can we do to improve the situation? Is building more hospitals  the answer? Perhaps we don’t need expensive hospitals but train people who run hospitals with a more “human heart”.

I am fully aware too that during our consultation, I am often very blunt. To most people, may be the mention of the word “death” is a taboo and is very objectionable. But at CA Care, we often bring this subject up with the patients. This is because we want them to understand the bigger picture of the problem. We fully understand, ALL patients want to be cured of their cancer, no matter how advanced their disease may be. Many patients say they want to “fight” to the end. Well said, but do you still want to fight with the SAME weapons,  if you know with almost certainty that you are going to lose the war. In addition, you  suffer as a consequence. Some even leave a “big hole” in their bank account for the next-of-kin to settle. The only winners in the game are the doctors, hospitals and drug companies!

Perhaps you may wish to reflect on these two quotations:

47-Late-stage-cancer-no-tre

 

Chemo-Suffer-near-death

We are not implying here that patients with terminal cancer should just give up — go home and wait to die like the case of the VVP above. Far from it. Perhaps the question to ask is, If the expensive, scientific medicine cannot cure your cancer, can there be another option? At least another option which can allow patients to live in peace without suffering, even though we all know that cancer cannot be cured.

EK and the VVIP above did not give up. At least they came to CA Care and they found “peace” and a new “hope”.

 

 

 

When Chemotherapy Does More Harm than Good

Chemo-MORE Harm than-g

One of the news reports above was written by Alice Park,  Time: 23 July 2015. You can read it here: http://time.com/3968918/when-chemotherapy-does-more-harm-than-good/

Some points highlighted in the article:

  • Latest data suggests that chemotherapy can also do more harm than good for some patients.
  • Holly Prigerson, director of the Center for Research on End of Life Care at Weill Cornell Medical College and her colleagues studied the use of chemotherapy among a group of 312 terminal cancer patients. All had been given no more than six months by their doctors, and had failed at least one if not multiple rounds of chemotherapy. About half were on chemotherapy, regardless of its ineffectiveness, at the time of the study.
  • Despite the common assumption that any treatment is better than none, there is not much evidence that chemotherapy is the right choice in these cases—and it may very well be the wrong one.
  • Prigerson’s analysis showed that these patients experience a drop in their quality of life if they get chemo, and that they are therefore worse off than if they hadn’t opted for the treatment.
  • Prigerson said: “The finding that the quality of life was impaired with receipt of the toxic chemotherapy was not surprising. The surprising part was that people who were feeling the best at the start of the therapy ended up feeling the worst. They are the ones most harmed and who had the most to lose.”
  • In other words, the chemo made the patients feel worse without providing any significant benefit for their cancer.
  • Previous studies have shown that chemotherapy in terminal patients is essentially ineffective.
  • And whatever tumor shrinkage occurred wasn’t linked to a longer life.
  • The decision about how long to continue care, including chemotherapy, is up to each cancer patient.
  • Despite explanations from their doctors, many cancer patients still believe that more rounds of chemo will provide some benefit to them, and are therefore reluctant to stop receiving therapy. But at some point, the data shows, more treatment is not better.
  • For patients with end-stage cancer who are still relatively healthy and not feeling sick, additional chemotherapy will likely make them weaker, not to mention eat up more of the precious time they have left traveling to and from infusion centers.
  • Prigerson … hopes the latest findings at least convince doctors to reconsider how they advise their terminal patients about end-stage chemotherapy.

For those who want to believe only in “scientific papers”, let’s go to the study of Dr. Prigerson et al., published in JAMA Oncology: 23, 2015: http://oncology.jamanetwork.com/article.aspx?articleid=2398177

Chemotherapy Use, Performance Status, and Quality of Life at the End of Life

Holly G. Prigerson, PhD1,2; Yuhua Bao, PhD3; Manish A. Shah, MD4; M. Elizabeth Paulk, MD6; Thomas W. LeBlanc, MD, MA5; Bryan J. Schneider, MD7; Melissa M. Garrido, PhD8,9; M. Carrington Reid, MD, PhD2; David A. Berlin, MD10; Kerin B. Adelson, MD13; Alfred I. Neugut, MD, PhD11,12; Paul K. Maciejewski, PhD1,14

  • Physicians have voiced concerns about the benefits of chemotherapy for patients with cancer nearing death.
  • In 2012, an American Society of Clinical Oncology (ASCO) expert panel identified chemotherapy use among patients for whom there was no evidence of clinical valueas the most widespread, wasteful, and unnecessary practice in oncology.
  • Despite the lack of evidence to support the practice, chemotherapy is widely used in cancer patients with poor performance status and progression following an initial course of palliative chemotherapy.
  • Available data for patients with NSCLC (non-small cell lung cancer) show a response rate of 2% for third-line and 0% for fourth-line chemotherapy.
  • Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied.
  • The goal of palliative chemotherapy for patients with incurable cancer is to prolong survival and promote QOL.
  • We have shown that chemotherapy use among patients with metastatic cancer whose cancer has progressed while receiving prior chemotherapy was not significantly related to longer survival but was associated with more aggressive medical care in the patient’s final week and heightened risk of dying in an intensive care unit.
  • The objective of this study was to examine the effect of chemotherapy use on patient quality of life in the last week of life — QOL near death (QOD). Patient QOD was determined using validated caregiver ratings of patients’ physical and mental distress in their final week. QOD scale: 0 (worst possible) to 10 (best possible).

The results of this study showed that:

  • Chemotherapy use was not associated with patient survival.
  • Among patients with good (ECOG score = 1) baseline performance status, chemotherapy use compared with nonuse was associated with worse QOD.
  • Although palliative chemotherapy is used to improve QOL for patients with end-stage cancer, its use did not improve QOD for patients with moderate or poor performance status and worsened QOD for patients with good performance status.
  • The QOD in patients with end-stage cancer is not improved, and can be harmed, by chemotherapy use near death, even in patients with good performance status.
  • Patients receiving palliative chemotherapy with an ECOG performance status of 0 or 1 had significantly worse QOD than those who avoided chemotherapy. No difference in QOD scores was observed by chemotherapy use among those with ECOG performance status of 2 or 3.
  • Given no observed survival benefit in the studied patients with refractory metastatic disease and the observed significant association between chemotherapy use and worse QOL in the final week of life among those with a baseline ECOG score of 1, these results highlight the potential harm of chemotherapy in patients with metastasic cancer toward the end of life, even in patients with good performance status.
  • Chemotherapy use in patients with metastatic cancer with chemotherapy-refractory disease is common. A recent study found 62% of NSCLC patients received chemotherapy within 60 days of death.The trend toward more aggressive care of terminally ill patients is increasing and has been noted as a serious problem in the Institute of Medicine’s 2014 report Dying in America.
  • Our results raise questions about the benefits and use of chemotherapy in patients in the end-stage of their illness regardless of their performance status.
  • Our study does highlight the danger of continuing chemotherapy as patients approach the end of life.
  • Results of this study suggest that chemotherapy use among patients with chemotherapy-refractory metastatic cancer is of questionable benefit to patients’ QOL in their final week. Not only did chemotherapy not benefit patients regardless of performance status, it appeared most harmful to those patients with good performance status.

Let us look at another published article.

Chemotherapy Near the End of Life: First—and Third and Fourth (Line)—Do No Harm

Charles D. Blanke, MD1; Erik K. Fromme, MD.

JAMA Oncol. Published online July 23, 2015. http://oncology.jamanetwork.com/article.aspx?articleid=2398175

  • In reality, only 2 major reasons exist for administering chemotherapy to most patients with metastatic cancer: to help them live longer and/or to help them live better.
  • In exchange for treatment-related toxic effects (as well as substantial time, expense, and inconvenience), chemotherapy can prolong survival for patients with a variety of—though not all—solid tumors.
  • Chemotherapy may also improve quality of life (QOL) for patients by reducing symptoms caused by a malignancy.
  • In this issue ofJAMA Oncology, Prigerson and colleagues report some troubling trial results: chemotherapy administered to patients with cancer near the end of life achieved neither goal.
  • Patients might live longer at the cost of a brief decline in QOL from toxic effects. Patients might also feel better from a reduction of malignancy-related symptoms, even if they do not enjoy improved survival.
  • It is disturbing that this trial demonstrated no benefits of chemotherapy for patients with solid tumors or poor prognosis.
  • And it is disconcerting that oncologists still recommend and use systemic therapy so close to patient death.
  • What does this mean for clinical practice? Must we then just say no to late-line chemotherapy?
  • Patients often want systemic treatment until the bitter end. We have long known a substantial minority of patients with incurable NSCLC would desire chemotherapy, even in the setting of severe toxic effects for a 1-week gain in survival. Similar data exist for patients with breast and large bowel cancers.
  • It is hard to say no to chemotherapy, because doing so could potentially make an oncologist feel they are depriving the patient of all hope.
  • Importantly, this does not mean that the oncologist cannot have a meaningful conversation with most patients about prognosis, especially when there is suspicion that time is limited.
  • These data from Prigerson and associates suggest that equating treatment with hope is inappropriate. Even when oncologists communicate clearly about prognosis and are honest about the limitations of treatment, many patients feel immense pressure to continue treatment.
  • Patients with end-stage cancer are encouraged by friends and family to keep fighting, but the battle analogy itself can portray the dying patient as a loser and should be discouraged.
  • Costs aside, we feel the last 6 months of life are not best spent in an oncology treatment unit or at home suffering the toxic effects of largely ineffectual therapies for the majority of patients.
  • Oncologists with a compelling reason to offer chemotherapy in that setting should only do so after documenting a conversation discussing prognosis, goals, fears, and acceptable trade-offs with the patient and family.
  • Let us help patients with metastatic cancer make good decisions at this sad, but often inevitable, stage. Let us not contribute to the suffering that cancer, and often associated therapy, brings, particularly at the end.

 

 

 

Follow your heart not your head when it comes to deciding whether you should go for chemo /radiation or not

TT is 56-year-old Indonesia lady. She presented as a easy going, cheerful lady who takes care of her health rather seriously. One late morning we got a phone call from her requesting to see us immediately. Her urgency was rather understandable since she was to start her radiotherapy on Monday. We waited for her to come, even though our centre was about to be closed for the day!

This is her story.

In 2013, TT had her routine pap smear. According to her doctor, there was nothing, except some kind of fungus infection. She was given antibiotics. She was okay for 6 months. A checkup 9 months later showed fungal infection again. She was on antibiotics again and was better. But her problem persisted after that. TT was not happy and wanted to solve her problem. She was referred to another doctor. She was found to be positive for HPV (human papilloma virus — a virus associated with cervical cancer).

TT was referred to an oncologist who recommended surgery. TT came to a private hospital in Penang and  underwent a radical hysterectomy with bilateral salpingo-oophorectomy (that is the removal of the uterus, cervix, fallopian tubes (salpingo), and ovaries (oophor) and  omentectomy. Histopathology indicated squamous cell carcinoma, Stage 2B with pelvic involvement.

The operation cost about RM 25,000.

TT was asked to undergo follow up chemotherapy. She met up with 2 oncologists in the hospital. One oncologist suggested 6 cycles of chemo and 30 times radiation. Another oncologist offered 4 cycles of chemo and 20 times radiation plus 2 times of brachytherapy, also known as internal radiotherapy. Obviously, TT was drawn to the second oncologist because of less severe treatment.

During our conservation, we asked TT: Did you ask the oncologist if he could cure you with that treatment? She replied: 60 to 70 % chance of cure. When she asked the oncologist if there was any other option, the answer was: No, no other way. Must do chemo and radiotherapy as soon as possible. It you don’t do quickly the cancer is going to spread and will be more serious.

TT agreed to undergo the recommended treatments. She was scheduled to start treatment on 15 June but unfortunately the oncologist was on leave and her treatment was brought forward to 23 June 2015.

TT came back to Penang in mid June. However, TT said she was not satisfied and felt heavy in her heart. She was not sure if these treatments would be good for her or not. She was in a dilemma and went to see the oncologist again. The oncologist said these to her:

  • Don’t listen to what other people say.
  • The dosage you are going to get is only small dosage.
  • Your hair don’t drop.

TT had no choice. She paid RM 13,000 as an advanced payment for the radiation treatment. Then she drove to a cancer hospital to have her “marked.” TT said as she drove to that hospital she felt she was led to the “slaughter house.” When the young technicians removed her clothing to make markings on her body she felt she was being “processed” for a death. But again, she had no other choice.

Then she went back to the hospital where she was supposed to undergo chemotherapy. She met someone who told her: Let us sit down and pray together. After the prayer this someone said: Why don’t you go back and see the oncologist again and ask him again if you can skip chemotherapy. But for radiotherapy, you have already paid for it.

For the third time, TT went to see the oncologist and express her reservation about chemotherapy. The oncologist told her again:

  • Don’t worry I guarantee that you would not loose even 1 kg after the treatment.
  • If you have no appetite, I shall give something to help you with that.
  • If your blood count is low I will give injections to help avoid infection.

TT was not convinced with the above assurance because staying in the same boarding house was a patient who was undergoing chemotherapy. He was once a very strong man but with the treatment he lost 16 kg and lost his appetite and could not eat. He told TT, if I know I have to go through this, I would rather die.

The next day (i.e. Thursday) after meeting the oncologist, TT decided to go shopping — a way to take pressure off her. On Friday morning, while she was preparing food in her boarding house one person told her this:

  • Who is sick? You are not sick. Don’t go for chemo. It would be a disaster.
  • Before you proceed further with your treatment, go and see this Chris Teo first and talk to him.

So, that Friday, late morning we got a call from TT requesting to see us urgently.

At CA Care, we spent almost an hour talking to TT and her husband.

Knowing that TT was under so much stress and jittery about what she was going into, it would not be fair or ethical to put more pressure on her. In situation like this, we know patients are generally vulnerable and we don’t intend be become “vultures” taking advantage of such desperate patients.  So basically our advice to TT and her husband were as follows:

  • Relax and take it easy. Go home and talk to your God. It’s Friday and you still have until Monday morning to listen to what God has to say. God will not shout out loud to answer you but I believe He will touch your heart in one way or another. Listen to your heart.
  • We tell everyone who comes to us, God will answer your prayer if you sincerely ask Him for guidance. And if He does not answer you, in time of desperate need like this, then there is no reason why you should worship Him day in and day out.
  • Go home first and don’t make any decision yet, not until you have done your part. Read these two comic books: Knowing The Truth May Save Your Life And Money and The Treacherous Journey. At least before you ask God to help you, you need to help yourself first. Go home and read. At most you need only 1 or 2 hours to understand the messages in these books.
  • Come and see us again if you decide you don’t want to follow up with your oncologist. But if you decide you want to go ahead with your chemo /radiotherapy, then go ahead.
  • Nobody should decide for you what you should do.
  • Follow what your heart says for that is where God speaks to you.
  • For now, there is no need to take any herbs — why the rush? You do not get cancer only yesterday!
  • There is no need to pay any consultation fee. God bless you and guide you.

TT and her husband understood our message and their facial expressions showed they felt very happy indeed. There was no compulsion, no threat, no sales talk! This has always been our way — to help those who need our help as honestly as we know how.

Monday — TT and her husband came back to see us again. The first word that out of her husband was, God has spoken to us. The husband read the books aloud while TT relaxed and listened. The story of Ella inspired her a lot, No chemo you live only three months, with chemo two and a half years! 

Tuesday — We chatted with TT and her husband to know more of what had happened. Watch this video (in Bahasa Indonesia) to get more details.

TT was determined that she was not going for chemotherapy or radiotherapy as recommended by her oncologist. By reading and knowing more she and her husband felt that there is another option — not radiation or chemo. We make it clear to them that this important (life and death) decision has to be TT’s decision. She had made her choice and she should be prepared to enjoy or suffer the consequences of that decision. TT said, I felt very much relief. Peace! The heavy load in my heart has been lifted away.

You have already paid RM 15,000 as a deposit for your radiotherapy. What has happened to that money? That’s another story to follow.

 

 

 

NPC: Chemo — 80 percent cure! No thanks. Mom died after 5 cycles of chemotherapy

Ju (not real name) is 36 years old. Her problem started with severe headaches. Then both sides of her neck became swollen, making it difficult for her to turn her head. She had to take painkiller everyday.

Ju consulted an ENT specialist in a private hospital. She was told that she had either NPC (nose cancer) or lymphoma. Whatever it was, Ju was asked to undergo six cycles of chemotherapy. She would probably have to undergo radiotherapy as well. The doctor told Ju that with the treatments she would have a 80 percent chance of cure. Ju promptly rejected medical treatment and came to seek our help.

Gist of our conversation.

Chris: What did they want you to do?

Ju: Chemo (6 times) and radiation (did not ask how many times).

C: Did you ask if chemo and radiation are going to cure you?

J: Eighty percent chance of cure.

C: Eighty percent?

J: Yes.

C: What happen if you don’t do the treatment?

J: May be die la! No, I did not ask.

C: Do you believe that success rate is 80 percent?

J: No!

C: Why don’t you believe the doctor?

J: Because of bad past experience. My mother also had chemotherapy for her lymphoma. She was 63 years old then. She was supposed to do 6 cycles of chemo but she died after finishing 5 cycles.

C: She died?

J: Yes.

C: Where did she do the chemo?

J: In Penang (the same oncologist that Ju went to). That was 5 years ago, in 2010.

C: So you know that chemo does not cure cancer but can also kill.

J: She was bald.

C: She had 5 cycles and that means about 5 months of treatment.

J: Yes. Each cycles cost IDR 5 million.

C: So for 5 cycles it cost IDR 25 million. Money gone, mother also died. I understand. It is very hard for me to push you to go for chemotherapy. It is difficult. You are still young — 36 years old. And now they tell you to go for 6 cycles of chemo.

J: No, I don’t want chemo. That’s why I am here.

Comments

In the internet chat room, one doctor wrote:

  • I was a cancer chemotherapy specialist doctor for twenty years.I treated thousands of people with various combination chemotherapy regimens. I don’t think I killed any of them with the treatment – though over two thousand died from their cancers.

I am going to ask the same question that I asked Ju: Do you believe what this “great” cancer doctor said?

One reader wrote this.

  • Nobody can or will give you any guarantees with chemotherapy.Why do think it will most likely kill you? What evidence are you basing this on? … Some people conclude that the treatment is worse than the disease, and myths about people being killed by chemo bolster this belief. It isn’t always effective. But in those cases it is the cancer, not the treatment, that kills the patient – they have died in spite of treatment, not because of it.

So now, the logic is …. it is the cancer that kills you, not the poisonous chemo! That is what they want  you to believe. Another good selling point.

Read what some other people said:

22 Toxci-MelGraves

4 Chemo die OK if follow protocol

30-Chemo-hell-wife-died-of-

12 Chemo-short-cut-to-make-mon

 

 

Metastatic Colon-Liver-Lung Cancer: Surgery, Chemo, etc., But Where is the cure?

LK is a 52-year-old male. His problem started in January 2014 when he had problems moving his bowels. Later, LK was told that he had cancerous tumour in his colon which blocked the passage of his stools.

LK underwent surgery. This cost him RM 19,000. After surgery he had six cycles of chemotherapy. Each treatment cost him RM 3,000 plus. LK and his family members, did not know what chemo-drugs were used. However, LK know that he was also on oral Xeloda.

Although LK was scheduled for eight cycles of chemotherapy, the oncologist stopped the treatment after the sixth cycle because the treatment was not effective. Then the oncologist offered LK two options:

  1. Continue with more chemotherapy using new drug regimen.
  2. Or no more chemotherapy and go home!

The following are details of his medical records.

Histopathology report dated 18 June 2014

Cancer of rectum, lower 1/3, left lobe liver nodule, biopsy taken.

Interpretation:

  1. a) Poorly differentiated adenocarcinoma with extensive infiltration into perirectal fat, pT3 tumour.
  2. b) Lymphatic and vascular channel invasion found.
  3. c) Six of 14 nodes involved by tumour.
  4. d) Liver nodule – metastatic adenocarcinoma confirmed.

PET scan dated 10 July 2014

  1. There is an FDG avid left paraaortic nodal metastasis.
  2. There are multiple FDG avid liver metastasis.
  3. There are multiple non-FDG avid lung nodules seen in both lungs which may represent garnulomata or early lung metastases.

Blood Test Results

Date Platelets CA 19.9 GGT AST ALT
8 August 2014 199 2,101 43 14 17
30 Aug 2014 151 740 47 18 18
20 Sept. 2014 117 775 47 26 25
9 Oct 2014 78 660 51 38 35
7 Nov 2014 86 n/a 64 42 35
6 Dec 2014 93 10,922 99 45 41

Note: With more chemo – the platelets diminished, CA 19.9 initially decreased but eventually increased 10 times the initial value. Liver function parameters (GGT,AST, ALT) increased.

CT scan on 11 December 2014

Liver nodules are larger and more in number compared with previously. Three largest nodules are 2.7×2.5 cm and 2.7×2.4cm in the right lobe and 2.7×2.2cm in the left lobe.

Lung nodules are seen in both lung fields and the largest is 1×1 cm. The rest all tiny nodules.

Rectum and colon wall at the anastomotic site appear thickened.

Impression

  1. Recurrent ca. colon.
  2. Worsening liver metastasis.
  3. Lung metastasis.

Comments

Based on the results above, the cancer had spread to the liver, lymph nodes and also the lung. This is a Stage 4 cancer that cannot be cured. But was the patient told about this?

The chemo treatment initially caused the CA 19.9 to decrease from 2101 to 740 and eventually to 660. As I have pointed out earlier this drop of the tumour marker is MEANINGLESS. In October, the CA 19.9 was 660 but with more chemotherapy the CA19.9 increased to 10,922 in December.

The blood test results also confirmed that with more chemotherapy the platelets dropped from 199 to 93. The liver function parameters – GGT, AST, ATL, deteriorated.

Eventually a CT scan in December 2014 confirmed that LK suffered recurrence of colon cancer. His liver metastasis worsened.

The game was up! The oncologist suggested “new bullets” probably more expensive as well. The patient declined and lost confidence in his doctor and came to seek our help.

I told the patient and his family, “I am not god and I cannot cure your cancer.” And I am telling this to all patients as well. There is no cure for cancer — you just move from treatment to treatment. And after spending you life’s saving you die.

 

Reflect on these quotations

17 One-thrid-dont-respond-to-c

10 Chemo-not-responsive-useles

8 Chemo-no-benefit-response-n

7 Chemo-good-moneyPatient-hop