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.

 

 

 

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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

 

 

 

THE SIDE EFFECTS OF CHEMOTHERAPY ON THE BODY

THE SIDE EFFECTS OF CHEMOTHERAPY ON THE BODY

Cancer cells divide more quickly than healthy cells, and chemotherapy drugs effectively target those cells. Unfortunately, fast-growing cells that are healthy can be damaged too. There are many different chemotherapy drugs with the potential for many different side effects. These effects vary from person to person and from treatment to treatment.

Chemotherapy in the Blood

Chemo Brain

Mouth Sores

Digestive Distress

The Signature Side Effect 

Balding:

Fingernail and Toenail Trouble

Chemotherapy and Fertility

Chemo in the Kidneys

Swollen Hands and Feet

Anxiety and Depression

Chemotherapy and the Heart

Muscles and Motor Skills

Nausea and Vomiting

Loss of Appetite

Skin in Need of Soothing

Sexual Dysfunction

Fast-Tracked Menopause

Chemo Effect on the Bladder

Chemo’s Long-Term Effect on Bones

Chemotherapy drugs are powerful enough to kill rapidly growing cancer cells, but they also can harm perfectly healthy cells, causing side effects throughout the body.

The Side Effects of Chemotherapy on the Body

Cancer cells divide more quickly than healthy cells, and chemotherapy drugs effectively target those cells. Unfortunately, fast-growing cells that are healthy can be damaged too. There are many different chemotherapy drugs with the potential for many different side effects. These effects vary from person to person and from treatment to treatment.

Factors that play a role in side effects include other ongoing treatments, previous health issues, age, and lifestyle. Some patients experience few side effects while others feel quite ill. Although most side effects clear up shortly after treatment ends, some may continue well after chemotherapy has ended, and some may never go away.

Chemotherapy drugs are most likely to affect cells in the digestive tract, hair follicles,bone marrow, mouth, and reproductive system. However, cells in any part of the body may be damaged.

Circulatory and Immune Systems

Routine blood count monitoring is a crucial part of chemotherapy. That’s because the drugs can harm cells in the bone marrow, where blood is produced. This can result in several problems. Red blood cells carry oxygen to tissues. Anemia occurs when your body doesn’t produce enough red blood cells, making you feel extremely fatigued. Other symptoms of anemia include:

  • lightheadedness
  • pale skin
  • difficulty thinking
  • feeling cold
  • general weakness

Chemo can lower your white blood cell count, which results in neutropenia. White blood cells play an important role in the immune system: they help fight infection and ward off illness. Symptoms aren’t always obvious, but a low white blood cell count raises the risk of infection and illness. People with an immune system weakened by chemotherapy must take precautions to avoid exposure to viruses, bacteria, and other germs.

Cells called platelets help the blood clot. A low platelet count, called thrombocytopenia, means you’re likely to bruise and bleed easily. Symptoms include nosebleeds, blood in vomit or stools, and heavier-than-normal menstruation.

Some chemo drugs can weaken the heart muscle, resulting in cardiomyopathy, or disturb the heart rhythm, causing arrhythmia. This can affect the heart’s ability to pump blood effectively. Some chemo drugs can increase the risk of heart attack.These problems are less likely to occur if your heart is strong and healthy at the start of chemotherapy.

Nervous and Muscular Systems

The central nervous system controls emotions, thought patterns, and coordination. Chemotherapy drugs may cause problems with memory, or make it difficult to concentrate or think clearly. This symptom sometimes is called “chemo fog,” or “chemo brain.” This mild cognitive impairment may go away following treatment, or may linger for years. Severe cases can add to anxiety and stress.

Some chemo drugs can cause pain, weakness, numbness, or tingling in the hands and feet (peripheral neuropathy). Muscles may feel tired, achy, or shaky. Reflexes andsmall motor skills may be slowed. It’s not unusual to experience problems with balance and coordination.

Digestive System

Some of the most common side effects of chemotherapy involve the digestive tract. Mouth sores and dry mouth can make it difficult to chew and swallow. Sores also may form on the tongue, lips, gums, or in the throat. Mouth sores can make you more susceptible to bleeding and infection. Many patients complain of a metallic taste in the mouth, or a yellow or white coating on the tongue. Food may taste unusual or unpleasant.

These powerful drugs can harm cells along the gastrointestinal tract. Nausea is a common symptom, and may result in bouts of vomiting. However, anti-nausea medications given in conjunction with chemotherapy drugs can help alleviate this symptom.

Other digestive issues include loose stools or diarrhea. In some people, hard stools and constipation can be a problem. This may be accompanied by pressure, bloating, and gas. Take care to avoid dehydration by drinking plenty of water throughout the day.

Side effects involving the digestive system can contribute to loss of appetite andfeeling full even though you haven’t eaten much. Weight loss and general weakness are common. Despite all this, it’s important to continue eating healthy foods.

Hair, Skin, and Nails (Integumentary System)

Many chemotherapy drugs affect the hair follicles and can cause hair loss (alopecia) within a few weeks of the first treatment. Hair loss can occur on the head, eyebrows, eyelashes, and body. As troubling as it can be, hair loss is temporary. New hair growth usually begins several weeks after the final treatment.

Some patients experience minor skin irritations like dryness, itchiness, and rash. You may develop sensitivity to the sun, making it easier to burn. Your doctor can recommend topical ointments to soothe irritated skin.

Fingernails and toenails may turn brown or yellow, and become ridged or brittle. Nail growth may slow down, and nails may crack or break easily. In severe cases, they canactually separate from the nail bed. It’s important to take good care of your nails to avoid infection.

Sexual and Reproductive System

Chemotherapy drugs can have an effect on your hormones. In women, hormonal changes can bring on hot flashes, irregular periods, or sudden onset of menopause. They may become temporarily or permanently infertile. Women on chemotherapy may experience dryness of vaginal tissues that can make intercourse uncomfortable or painful. The chance of developing vaginal infections is increased. Chemotherapy drugs given during pregnancy can cause birth defects. In men, some chemo drugs can harm sperm or lower sperm count, and temporary or permanent infertility is possible.

Symptoms like fatigue, anxiety, and hormonal fluctuations may interfere with sex drive in both men and women. So can worrying about loss of hair and other changesin appearance. However, many people on chemotherapy continue to enjoy an intimate relationship and an active sex life.

Kidneys and Bladder (Excretory System)

The kidneys work to excrete the powerful chemotherapy drugs as they move through your body. In the process, some kidney and bladder cells can become irritated or damaged. Symptoms of kidney damage include decreased urination, swelling of the hands and feet (edema), and headache. Symptoms of bladder irritation include a feeling of burning when urinating and increased urinary frequency.

You’ll be advised to drink plenty of fluids to flush the medication from your systemand to keep your system functioning properly. Note: Some medications cause urine to turn red or orange for a few days. This isn’t cause for concern.

Skeletal System

Most people—and especially women—lose some bone mass as they age. Some chemotherapy drugs can cause calcium levels to drop and contribute to bone loss. This can lead to cancer-related osteoporosis, especially in post-menopausal women and those whose menopause was brought on suddenly due to chemotherapy.

According to the National Institutes of Health (NIH), women who have been treated for breast cancer are at increased risk for osteoporosis and bone fracture. This is due to the combination of the drugs and the drop in estrogen levels. Osteoporosisincreases the risk of bone fractures and breaks. The most common areas of the body to suffer breaks are the spine and pelvis, hips, and wrists.

Psychological and Emotional Toll

Living with cancer and dealing with chemotherapy can exact an emotional toll. You may feel fearful, stressed, or anxious about your appearance and your health. Some people may suffer from depression. Juggling work, financial, and family responsibilities while undergoing cancer treatment can become overwhelming.

Many cancer patents turn to complementary therapies like massage and meditation for relaxation and relief. If you have trouble coping, mention it to your doctor. They may be able to suggest a local cancer support group where you can speak with others who are undergoing cancer treatment. If feelings of depression persist, professional counseling may be necessary.

Read more:  http://www.healthline.com/health/cancer/effects-on-body#nervous_and_muscular_systems

Three Options for Chemotherapy After Mastectomy


Mastectomy,  RM 12.000

Must undergo chemotherapy. Offered three options:

Option 1: 17 cycles, one year

4 cycles @ RM 2.000  = RM 8,000

4 cycles @ RM 4.000  = RM 16.000

9  cycles @ RM 11.000 = RM 99.000

Total cost RM 123,000

Option 2: Six cycles of chemo @ RM 7.000 to RM8.000

Total cost RM 45.000

Option 3: Six cycles of chemo @ RM 3.000 – RM 4.000

Total cost RM 20.000

Can chemo cure?

Option 1: Out of 10 patients, 6 were cured.

Option 2: Out of 10 patients, 5 were cured.

Option 3: Out of 10 patients, 4 were cured.

Was this patient told the REAL truth?

Consider these cases below:

Patient 1: Went to China for treatment  – 125 radio-iodine seeds, 8 cycles chemotherapy, 9 injections of stem cell. Total cost RM 300.000.

Result: Cancer spread to her bones, liver and lungs.

Patient 2. Went to China for treatment – radiotherapy,  6 injections of stem cell, 1 cycle of chemo, Tamoxifen and 6 cycles of Xeloda.

Result: Cancer spread to her bone and liver.

Quotations:

There is no cure for metastatic breast cancer. It never goes away. You just move from treatment to treatment ~ Amy Soscia who died after fighting breast cancer for 13 years.

The overall contribution of …chemotherapy to 5-year survival in adults was estimated tobe 2.3 percent in Australia and 2.1 percent in the USA ~ Morgan, Ward & Barton. Clinical Oncology 16:549-560.

Leukemia: Chemotherapy – RM100,000 – Failed

 

May 2013, bloated stomach – diagnosed as gastric problem.

Gastric drugs did not cure.

Had consulted 7 doctors.

Consulted specialist in a hospital in Jakarta. Diagnosed as leukemia.

Came to Penang, Malaysia – bone marrow biopsy, confirmed Leukemia – AML.

Had chemotherapy – 6 cycles, from June 2013 until February 2014.

Costs almost RM 100,000.

Blood tests on February 11, 2014, fine.

Follow up after 3 months, May 6, 2014, Recurrence, extremely low platelets, only 4.

The doctor said chemo again, try 2 cycles first. Need to pay RM 50,000.

Before undergoing chemotherapy  did you ever ask the doctor these questions:

1. Can chemotherapy cure you?

2. What is the total cost of the chemo treatment?

3. How long would you have to undergo chemotherapy?

Breast Cancer: Why I Refused Chemotherapy: Mother died after surgery and chemo

 

 

• Diagnosed with breast cancer

• Undergone mastectomy, costing Rupiah 30 plus million.

• Doctor asked to do chemo – I refused.

• My mother had ovarian cancer, Stage 3B. She had surgery and chemothrapy.

• Prior chemotherapy, she was well.

• After chemo cancer recurred, lumps grow again.

• Doctor recommended surgery and chemo again.

• Mother was too weak and declined medical treatment.

• She died within a year.

Lung Cancer: Declined Biopsy and Chemotherapy – Money Gone Then Die

 

After an X-ray and CT scan, the doctor found a 7 cm tumour in my lung. It was a Stage 2 cancer. I refused to have a biopsy because I don’t want to undergo chemotherapy. I prefer to take herbs.

Why don’t you want to go for chemo?

No, no, it is not successful.

How do you know?

I have many friends – chemo, chemo, and 6 months later die!

One of my friend had lung cancer and he went for treatment in Singapore. He had to sell 2 houses to pay for the medical bills. He had chemo and chemo. Before 2 years were up, he was dead. Each chemo cost a few thousand dollars. He died and property also gone!