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

Sam (not real name) is 63 years old. Sometime in June 2016, he had pain in his right arm. An X-ray was done and the doctor said it could be due to muscle problem. He was asked to go for physiotherapy. It did not help.

In January 2017, his right arm was swollen and his condition became more serious. He consulted an orthopedic doctor. There was nothing wrong!

Sam was admitted into a private hospital on 11 February 2017 for further examination.

MRI on 12 February 2017 showed a 3.1 x 2.3 cm mass at the distal humerus (bone in the upper arm) involving the triceps muscle. Incidentally, the doctor also found a suspicious 4.4 x 5.2 cm lesion in the lower zone of his right lung.

A CT scan done the next day, 13 February 2017, confirmed the presence of an irregular 4.3 x 4.38 x 3.96 cm mass in his lung. There were also multiple enlarged lymph nodes in the pretracheal and carina. The largest being 2.69 x 1.77 x 1.9 cm and 3.48 x 2.91 x 1.61 cm respectively.

In short, the cancer had spread. But the question is: Spread from the lung to the bone, or from the bone to the lung? A biopsy of the bone showed negative for malignancy. A biopsy of the lung showed positive for cancer.

The total cost of the 4-day-stay in the hospital for the above procedures cost RM 12,595.90.

So what comes next? What to do. The doctor suggested the following options:

  1. Chemotherapy.
  2. Immunotherapy.
  3. Target therapy — taking of oral chemo-drug if it is positive for EGFR.
  4. Bisphosphonate, a drug that slows down or prevent bone damage. Depending on the type of drug given, this is to be taken either once a day, once a week (on the same day of the week), or once a month (on the same day of the month).

Listen to our conversation this morning!

Gist of our conversation.

Daughter: My father has lung cancer. It is positive for EGFR. The doctor suggested taking the oral targeted therapy, Tarceva. One box, lasting one month, cost about RM8,000. After we take Tarceva for 10 months, and if the medicine works, for the rest of his life the medicine will be free. But must complete the ten boxes first. That’s the deal!

Chris: You mean after spending RM80,000 they will give you Tarceva for free for life? But what happen if your father dies before the ten months?

D: I was thinking. May be my father cannot last that long. Maybe before the ten boxes, sure die one.

C: I have one patient who came and see me. She was asked to take Nevaxar (for liver cancer). The deal was buy one, free one. But must pay RM20,000 first (for the first month’s supply) and next month she will get one month’s supply of Nexavar for free! But after she took the drug for a week, her health deteriorated, had to be hopitalised and she died. Already paid RM20,000, cannot claim back.

So back to you, Tarceva is a good deal. Why don’t you want to take the drug? Can take the drug for life and no need to pay.

D: (Shaking her head) No, don’t want.

C: Did you ask if Tarceva can cure or not?

D: It will control the cancer cells, so that they never spread.

C: But cannot cure?

D: That’s what I asked him (doctor). The tumour is going to be there.

C: That means, cannot cure la because the tumour is still there.

D:  In about 5 percent of patients, the tumour shrink.
C: What happen to the 95 percent, tumour never shrink?

D; Under control.

C: I tell you. For some people the tumour was totally gone after taking the drug. But a few months later, the tumour came back again. And this time it was twice the size.

Did the doctor tell you about the side effects of Tarceva?

D: Ya, I asked. Diarrhoea, only that.

C: Only that?

D: Ya, mild one only.

C: You believe him or not?

D: May be not.

C: I tell you. Don’t just listen to me only. I can bluff you. Go back and read more. Read what others say.

D: I prefer natural medicine.

C: I shall do my best to help you. I shall give you herbal teas for his lung, lymph nodes and bone. The herbs are bitter — awful taste. Can or not?

Know that I cannot cure your cancer. But take herbs and see if they can help you or not. If you take the herbs for a month, I am going to ask you if you feel better or not. If you don’t feel better, then no need to come and see me anymore. If you feel better, continue taking the herbs.

When can you stop taking the herbs? I really don’t know. But if you are feeling better, why stop it? Because I know there is no cure for cancer.

In America, most people with stage 4 lung cancer die within a year. But, I am not saying you are going to die soon. Go home and read the stories (in the website).

Of course, all of us have to die. So don’t worry about death. What is important is, don’t die suffering. Want to die also cannot, want to live also cannot. That’s terrible.

So, I shall try to help you. If it’s good, continue. If no good, don’t continue. Go home, take care of yourself and take care of your diet.

Comments

They say knowledge is power. This is true! To me, with cancer, ignorance kills!

I am glad that Sam’s daughter is smart! She asked questions. And she “processed” the answers given!

In this world today, we read about “fake news”, “fake information”, “cybertrooper”, etc.. So please be on guard and beware.

As I was writing this story, one lady came to ask for help. She was also given Tarceva for her lung cancer. For about one month plus, Tarceva seemed good for her. Then she started to suffer side effects. After seven months the side effects were unbearable and she gave up Tarceva totally. No, she did not hit the 10-month-mark! The irony is, this lady is a medical staff of a hospital. She should know better!

Listen to her story.

Google “side effects of Tarceva” and you get this. No, it is more than just mild diarrhoea!

Side effects of Tarceva include:

  • Acid or sour stomach
  • belching
  • blemishes on the skin
  • bloated or full feeling
  • bone pain
  • burning, dry, or itching eyes
  • diarrhea (mild)
  • difficulty with moving
  • dizziness
  • dry eyes
  • dry skin
  • excess air or gas in the stomach or intestines
  • excessive tearing
  • fear
  • feeling sad or empty
  • feeling unusually cold
  • hair loss
  • headache
  • heartburn
  • indigestion
  • irritability
  • itching skin
  • joint pain
  • loss of interest or pleasure
  • nervousness
  • passing gas
  • pimples
  • rash, mild
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • shivering
  • stomach discomfort, upset, or pain
  • swelling
  • swelling or inflammation of the mouth
  • swollen joints
  • thinning of the hair
  • tiredness
  • trouble or inability to sleep
  • trouble with concentrating
  • weight loss
  • loosening of the fingernails
  • redness or soreness around the fingernails.

Source: https://www.drugs.com/sfx/tarceva-side-effects.html

More about the side effects of Tarceva:

Meaningless Shrinking of Tumor While on Tarceva https://cancercaremalaysia.com/2012/04/26/meaningless-shrinking-of-tumor-while-on-tarceva-treatment/ 

Meaningless Decline of CA 15.3 and Tumour Shrinkage Following Treatment With Iressa and Tarceva https://cancercaremalaysia.com/2012/04/26/meaningless-decline-of-ca-15-3-and-tumour-shrinkage-following-treatment-with-iressa-and-tarceva/ 

 

 

Swollen face, palm and foot gone after three days on herbs

lotus-3

 

MS is a 68-year-old man. About four years ago, he had colon cancer. He underwent an operation but did not undergo follow-up chemotherapy. He went on vegetarian diet. His cancer did not go away.

CT scan done on 1 August 2016, showed large mass in his right lung measuring 10 x 7.4 x 10.0 cm in size. It invaded the mediastinum. There were also multiple smaller lesions in the right and left lungs, measuring up to 2.4 cm.

MS did not receive any more medical treatment and opted for supplements. He took Transfer Factor, Probiotics, Tea4Life, etc.

MS became breathless.  X-ray done on 29 August 2016, showed a 12.0 x 9.0 cm mass with pleural effusion (fluid in the lung) as below.

tham-lung-xray

Ultrasound guided drainage of the lung fluid was done. Blood test showed the following results.

Platelets count 522
CEA 900.7
CA 125 148
CA 19.9 193.07

 

MS stayed at home and took whatever supplements, but these did not help him. On 3 January 2017, a son of MS came to seek our help.

I was told that MS had difficulty breathing and his face, hands and legs were swollen. He was not able to lie down flat when sleeping.

This was what I told his son: This is a serious case and there is no cure. Let us try to tackle the problem slowly. First is to try and resolve this swelling and also get rid of the fluid in his lungs.

MS was prescribed Lung 1, Lung 2 teas plus Lung Phlegm. In addition he was given Upper Edema tea.

Wonderful results: Listen to what his son told us.

 

 

  1. Swelling of the face, hand and feet were gone after taking the herbs for three days!
  2. He had more strength.
  3. He urinated a lot.
  4. He coughed out a lot of phlegm (effect of the Lung Phlegm tea).

Comment:  We often tell people that we are not magicians and we cannot do magic. But sometimes that in this special case, magic did happen. It is beyond our expectation even though we have seen such results happened many times before!  Praise God for this wonderful blessing.

 

He Died Of Lung Cancer — Treated by the Best Oncologist in One of the Best Hospitals in the World

It was 3 a.m. when I finished reading the last page of this 224-page-New York Time #1 Bestseller.

When breath becomes air

The Author: Dr. Paul Kalanithi was an outstanding neurosurgeon with very impressive academic credentials. He graduated from Stanford University with a BA and MA in English literature and a BA in human biology. He earned an MPhil in history and philosophy of science and medicine from the University of Cambridge. Later, he went to Yale School of Medicine where he graduated with a cum laude. Paul then returned to Stanford to complete his residency training in neurosurgery.

To Paul, being a neurosurgeon is a noble calling. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is.

Unfortunately, fate has it that Paul did not end up being a full-fledged neurosurgeon. Well into his six-year-residency  he was diagnosed with stage 4 metastatic lung cancer. Less than two years (22 months) after the diagnosis he died — just when he was ready to graduate.

I read this book with a heavy heart — sad that such a brilliant and caring doctor like Paul had to leave so soon.  Lucy — Paul’s wife wrote, When I see the hospital where Paul lived and died as a physician and a patient, I understand that had he lived, he would have made great contributions as a neurosurgeon and neuroscientist. He would have helped countless patients and their families.

Such is the sad, cruel reality about life. Lucy wrote, What happened to Paul was tragic, but he was not a tragedy. True indeed. I always believe for anything that happens, there must be a reason if only we look at the bigger picture.

Salute the Neurosurgeon!

Paul did well in life — he studied literature, history and philosophy before doing medicine. With such academic background he was well prepared to become a caring doctor — a cut above others. Here are some quotations of what Paul wrote in his book:

  • As a resident, my highest ideal was not saving lives — everyone dies eventually — but guiding a patient or family to an understanding of death or illness. Where there’s no place for the scalpel, words are the surgeon’s only tool.
  • Our patients’ lives and identities may be in our hands, yet death always wins. Even if you are perfect, the world isn’t. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win for your patients.
  • Like my own patients, I had to face my mortality and try to understand what made my life worth living. With limited time, Paul wrote this book. He did not get to finish it.

Prognosis and Statistics

As a neurosurgery resident Paul had operated on brain cancer. After surgery it is the standard practice to send patients for follow up chemo and/or radiation. Here doctors often talk about prognosis with their patients and family members.

This is something Paul wanted us to know. He wrote, By this point, I had learned a couple of basic rules. First, detailed statistics are for research halls, not hospital rooms … Second, it is important to be accurate, but you must always leave some room for hope — Median survival is eleven months or You have 95 percent chance of being dead in two years — I come to believe that it is irresponsible to be more precise than you can be accurate. Those apocryphal doctors who gave specific numbers (The doctor told me I had six months to live): Who were they, I wondered, and who taught them statistics?

Limitation of Science

  • Although I had been raised in a devout Christian family …I, like most scientific types, came to believe in the possibility of material conception of reality, an ultimately scientific worldview that would grant a complete metaphysics, minus outmoded concepts like souls, God, and bearded white men in robes.
  • Scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units.
  • Science is based on reproducibility and manufactured objectivity.
  • Science … its inablity to grasp the most central aspects of human life: hope, fear, love, hate, beauty, honor, weakness, striving, suffering, virtue.
  • Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. 

Stage 4 Lung Cancer

  • At age thirty-six, I had reached the mountaintop; I could see the Promised Land …. then a few weeks later I began having bouts of severe chest pain … my weight began dropping … from 175 to 145 pounds. I developed persistent cough. Little doubt remained.
  • In May 2013, it was confirmed that Paul had a stage 4 non-small cell EGFR-positive lung cancer. At that time he was in his sixth year of residency — one more year to
  • The irony was that Paul had never smoked.

The World’s Best Oncologist

  • The search was on — to find who was the best lung cancer oncologist (USA). Houston and New York had major cancer cancers …The replies came back quickly and more or less unanimously: Emma (also in Stanford) not only was one of the best — a world-renowned oncologist who served as the lung cancer expert on one of the major national cancer advisory boards — but she was also known to be compassionate, someone who knew when to push and when to hold back.
  • On many occasions when consulting Emma, it was clear that this compassionate oncologist did not “dictate things” to her patient. I could hear Emma’s voice again: You have to figure out what’s most important to you.
  • Emma once told Paul: I’m totally happy for us to make your medical plan together; obviously, you’re a doctor, you know what you’re talking about, and it’s your life.
  • At their initial consultation, Paul wanted to discuss the prognosis — possibly how much time left. Emma evaded the question and said, We’re not discussing that.
  • Two months in, Emma remained vague about any prognostication, and every statistics I cited she rebuffed with a reminder to focus on my values.

Temporary Response

Paul had an EGFR-positive tumour. No intravenous chemotherapy was indicated for the moment. He was put on an oral targeted drug called Tarceva.

His cancer responded to the treatment — My lungs, speckled with innumerable tumours before, were clear except for a one-centimetre nodule in the right upper lobe … there had been a clear, dramatic reduction in tumour burden.

Paul regained strength and he returned to work in late 2013, completing his seventh year of residency.

Relapse — Chemotherapy: Too many cooks spoil the broth?

In spring of 2014, the cancer relapsed. The only option left was chemotherapy.  This was what happened after one of his chemo sessions.

  • I began to deteriorate, my diarrhea rapidly worsening … my kidneys began to fail. My mouth became so dry I would not speak or swallow … my serum sodium had reached a near-fatal level. Part of my soft palate and pharynx died from dehydration and peeled out of my mouth … I was transferred to the ICU. I was in pain …. a pantheon of specialists was brought together to help: medical intensivists, nephrologists, gastroenterologists, endocrinologists, infectious disease specialists, neurosurgeons, general oncologists, thoracic oncologists, otolaryngologist …. 
  • I was acutely aware that with this many voices, cacophony (unpleasant mixture of loud sounds) In medicine, this is known as the WICOS problem: Who Is the Captain Of the Ship? The nephrologists disagreed with the ICU doctors, who disagreed with the endocrinologists, who disagreed with the oncologists, who disagreed with the gastroenterologists. I felt the responsibility of my care… tried to corral all the doctors to keep the facts and interpretations straight.

It is hard to tell laymen, like you and me, to take charge of your own health and treatment when you are in the hospital surrounded by all those experts. But yet, that should be the way it should be!

Chemotherapy took a heavy toll on Paul. He wrote: Withered, I could see my bones against my skin, a living X-ray. At home, simply holding my head up was tiring. Lifting a glass of water required both hands. Reading was out of question.

Chemo Failed – He Died

  • Treatment wasn’t an option — not until I regained some strength.
  • Emma, I said, what’s the next step?
  • Get stronger, That’s it.
  • But when the cancer recurs … I mean, the probabilities …. I paused. First-line therapy (Tarceva) had failed. Second-line therapy (chemo) had nearly killed me. Third-line therapy, if I could even get there, made few promises.
  • You have five good years left, she (Emma) said. She pronounced it, but without authoritative tone of an oracle, without any confidence of a true believer. She said it, instead, like a plea… Doctors, it turns out, need hope, too.

Paul did not live to write the closing chapter of his book. It was left to his wife, Lucy, to document his last hours on earth in the Epilogue. Paul died, two months short of two years (on Monday, 9 March  2015) after his diagnosis. He was 37 years old.

  • In the Epilogue Lucy said, Writing this book was a chance for this courageous … (Paul) to teach us to face death with integrity.

To us who is still living, I also say, Let us learn to embrace death with courage and understanding.

Lessons from Paul’s Experience

As I read this book, I learned many things. And I kept thinking and asking. Let me share my thoughts with you.

Family of Doctors

Paul came from a family of doctors. His father, brother, uncle, wife  are all doctors. Paul was not any ordinary doctor. He was trained in one of the best medical schools in the country. When he had cancer, he had the best oncologist in the world to treat him. Few of us would not have that privilege and opportunity. Perhaps we don’t need the best when it comes to cancer? What difference would that make?

Modern medicine had contributed very much to lighten human sufferings. Let no one doubt about that. But when it comes to cancer and its treatment, perhaps we need to take a step backward, pause and explore more.

43 Wrong-battle-wrong-weapons

48-We-fought-ca-Cancer-won

Yes, many people wrote about the need to rethink the war on cancer, but there are many others who would strongly defend the status quo. Why change? Why look for something else when the present ways serve the Cancer Industry so well?

When my wife and I started CA Care in 1995, to help cancer patients, I knew absolutely nothing about cancer and its treatment. No, I did not go to medical school. I relied on my Ph.D. and my research experience on plants to do what is right for those helpless and hopeless patients. After 20 years of dealing with cancer patients, I can say this to all and sundry. As far as cancer treatment is concerned, there  are other options than just chemo and radiation. Perhaps by taking the non-conventional path, you could live longer, with less suffering and not having to deplete your life’s saving to pay for the medical bills.

I have written numerous studies in these two comic books.

Title-Page-600

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

In Lung Cancer – What Now?  I have documented 12 cases of lung cancers – nine of which are about patients who failed to find the cure that they wanted, in spite of spending hundreds of thousands of ringgit on their medical treatments.

Meaningless shrinkage of tumour by Iressa

1 2

Meaningless shrinkage of tumour by Tarceva

3

These two cases happened with patients in Jakarta (above) and in Malaysia (below). And this also happened some years later with Dr. Paul in Stanford. What can we learn from such cases?

Title-page-600

Available:  http://bookoncancer.com/productDetail.php?P_Id=73

In Lung Cancer – Success Stories, I presented 12 cases of patients who opted for “alternative” treatment for their lung cancer.

Statistics of Lung Cancer Survival

4 5 6 7

 

Dr. Paul had Tarceva. This drug helped him for about a year. Then the cancer came back again. He then had chemotherapy and died. He survived 22 months after his initial diagnosis. That happened in Stanford under the care of the best oncologist in the world.

Back in Malaysia, there is also a professor who is the best for lung cancer. According to him, most of his patients who were treated in his clinic died after two years.

The same achievement as in Stanford?

If you do the same thing over and over again. You can expect the same results. Is that not what science teaches us? Remember what Henry Ford and Einstein said.

Insanity both

In this story above, mom opted for CA Care Therapy. She declined chemotherapy even though she was told that without chemo she would die within six months. Professor X was surprised how mom had survived for four years without chemo. Is that an achievement or quackery (like many in the medical industry want us to believe)?

Why haven’t you die yet?

89 10 11

CA Care has been around for about 20 years now.  Like Dr. Paul, my wife and I went into this because it was a “calling” — an answer to my prayer. Looking back, we have no regrets. Instead, we feel blessed to be able to help patients who need our help. They come from far and near.

 

 

 

 

Chemo and Tarceva Did Not Cure His Lung Cancer: Another meaningless decline of tumour markers

Jack (not real name) was 43 years old when he was diagnosed with lung cancer.  His problem started in October 2013, when there was a swelling in the right collar bone. Apart from this, there was no other symptoms — no cough, etc.  Jack said in 2013, he had fevers on three occasions that make him feel tired.

A blood test on 24 October 2013 showed his CEA was at 133.3 and CA 19.9 at 9,524.0

A CT scan on 30 October 2013 showed:

  • An irregular lesion in the right lung apex, 35 x 42 x 28 mm.
  • Speckles of calcification in both lungs upper lobe suggesting prior tuberculous infection.
  • Bilateral supraclavicular lymph node 10 to 20 mm.
  • Multiple enlarged mediastinal and right hilar lymph nodes.
  • Numerous small nodules in both lungs – likely metastases.
  • Liver shows a least 7 hypodense lesions, largest 30 x 32 mm in the left lobe – likely metastases.
  • Multiple enlarged lymph nodes in the celiac and paracaval regions.
  • Sclerotic lesions at vertebral bodies of L3, L4 and L5 – likely metastases.

A tru-cut biopsy of the right lung mass was performed and confirmed a moderately differentiated adenocarcinoma.

Jack underwent 6 cycles of chemotherapy. The drug used was Cisplatin. Each cycles cost about RM10,000. The treatment lasted until February 2014.

Let’s follow the progress of Jack’s treatment.

Table 1:  Blood test results during chemotherapy.

Date 24 Oct 13 25 Nov 13 16 Dec 13 6 Jan 14 27 Jan 14 17 Feb 14
Total bilirubin 18.1  H 13.7 15.5 13.5 14.8 17.8
Alkaline phosphatase 210   H 217 147 132 (normal) 148 125
ALT 49 62 59 34 26 23
AST 28 30 30 21 19 17
GGT 114   H n/a n/a n/a n/a n/a
Platelet 495   H 477 250 258 233
CEA 133.3  H n/a n/a n/a n/a n/a
CA 19.9 9,524  H 2,394 325 268 246 195
Before chemo After chemotherapy
At this stage, chemotherapy was very effective and helpful.  Alkaline phosphatase declined. Platelet count was down and CA 19.9 decreased from 9,524 to 195. Bravo – great results.

After the completion of chemotherapy in February 2014, Jack was put on the oral drug Tarceva. He was on Tarceva until June 2015.

His tumour markers – both the CEA and CA 19.9, continued to decrease (Table 2).

 

Table 2: After intravenous chemo, patient was on oral drug, Tarceva.

Date 25 Mar 14 15 Apr 14 14 May 14 16 Jun 14 21 July 14 18 Aug 14
Total bilirubin 31.6 37.7 27.5 25.5 24.6 27.8
Alakaline phosphatase 142 136 125 84 78 66
ALT 26 43 36 17 16 14
AST 27 56 24 20 19 16
GGT n/a n/a 40 26 23 23
Platelet 370 253 281 313 266 281
CEA n/a 28 2.3 1.9 1.6 1.4
CA 19.9 n/a 14 5.0 6.5 <2.0 3.8
Six months on Tarceva (from February 2014 to August 2014) the CEA and CA 19.9 decreased significantly.Again, great results!

From April 2014 to December 2014 Jack also received 6 to 8 monthly injections of Denosumab. This is a monoclonal antibody used to treat bone cancer. It is also known by its brand name, Xgeva and Prolia.

 

Table 3:  CEA and CA 19.9 started to increase even though Jack was on Tarceva.

Date 22 Sep 14 20 Oct 14 24 Nov 14 29 Dec 14
Total bilirubin 21.8 21.6 21.9 27.1
Alakaline phosphatase 66 76 69 77
ALT 16 15 16 16
AST 18 22 19 20
GGT 23 23 26 24
Platelet 277 329 294 299
CEA 2.2 3.9 7.4 12.6
CA 19.9 7.2 6.6 11.4 27.9
From September 2014 both the CEA and CA 19.9 started to increase in spite of Jack being on Tarceva. In September 2014 the CEA was 2.2 and it increased to 12.6 by December 2014. Similarly, CA 19.9 increased from 7.2 to 27.9 during the same period.

Because of the rising CEA and CA 19.9, Jack was again given 4 cycles of chemo. This time the drugs used were Carboplatin + Gemzar. The total treatment cost RM40,000.

 

Table 4: The second round of chemo with Carboplatin + Gemzar produced limited benefits.

Date 26 Jan 15 27 Feb 15 6 Mar 15 13 Mar 15 27 Mar 15
Total bilirubin 24.6 17.6 19.9 15.6 24.7
Alakaline phosphatase 74 87 54 67 61
ALT 16 19 25 20 15
AST 21 17 16 16 14
GGT 27 27 27 27 23
Platelet 315 295 453 192 259
CEA 22.3 21.6 22.0 28.6 29.9
CA 19.9 47.2 44.6 31.9 52.5 70.2
From January to April 2015, Carboplatin + Gemzar regime managed to stabalized the CEA level ranging from 22 to 30. CA19.9 stabalized from 31 to 70 during the same period.

 

Table 5: CEA and CA19.9 on the march — treatment failed!

Date 3 Apr 15 17 Apr 15 24 Apr 15 19 Jun 15
Total bilirubin 20.4 25.8 24.8 33.7
Alakaline phosphatase 49 73 65 73
ALT 24 14 23 12
AST 16 14 18 14
GGT 24 22 24 24
Platelet 509 276 268 321
CEA 29.6 32.7 31.6 93.2
CA 19.9 45.1 52.5 37.7 511.5
Error in platelet reading? In April CEA was around 29 to 31 while CA 19.9 was around 37 to 45.But  barely 2 months after the completion of chemotherapy, the CEA shot up to 93.2 and CA19.9 went up to 511.

Jack said he was disappointed with the results, in spite of the initial good response to chemotherapy. He decided to “shop” for alternative medicine while waiting for his doctor to take the next step.

Comments

This is indeed a sad case but not a unique one. Over the years we have seen cases after cases like this. After the chemo, the tumour markers dropped or the tumour shrunk or disappeared. But such responses did not last long. After a few months, the cancer recurred and this time it became more aggressive.

We sat down with Jack and tried to understand what was going on. No doubt about it, he was very much encouraged with the initial results. Within 8 months of treatment his CA 19.9 which was at 9,524 dropped to less than 2.0. That was a great achievement indeed. Who would not be excited about such feat? But what many patients don’t know or what those who should know do not want to know is that such dramatic drop of CA 19.9 (or even total shrinkage of tumour) is not permanent. It NEVER translates into a cure. It is meaningful in the short term but meaningless in the long term.

Read some of the stories here:

https://cancercaremalaysia.com/2015/04/02/lung-cancer-meaningless-temporary-drop-of-cea-after-iressa/

https://cancercaremalaysia.com/2014/07/05/the-story-of-moms-lung-brain-bone-cancer/

https://cancercaremalaysia.com/2014/04/24/two-billion-rupiah-chemo-and-surgery-failed-oncologist-said-more-chemo-you-just-have-to-trust-me/

https://cancercaremalaysia.com/2014/01/27/lung-cancer-meaningless-shrinkage-of-tumour-and-decline-of-tumour-markers-reading/

https://cancercaremalaysia.com/2013/11/29/lung-cancer-chemo-experiments-that-failed-and-failed/

https://cancercaremalaysia.com/2012/10/08/metastatic-lung-cancer-meaningless-fall-and-rise-of-cea-with-iressa-and-tarceva/

Let me ask you to ponder what Einstein wrote:

1 Insanity-by-Einstein

Do you see any truth is that statement?

Many of us may want to ask: Where is the problem? What causes this problem? What can we do about it?

Jack told us that his oncologist is a very nice man and he was trying his best to cure him. Understandable. We cannot blame the doctor. Legally and medically, apart from chemo or oral drugs, he has nothing else to offer you. He can’t ask you to take supplements or herbs, etc.

Unfortunately, some oncologists will rip apart those who dare to suggest that patients  take herbs, vitamins or control their diet. Nonsense they say — all these non-medical ways are not scientifically proven.

But hang on, is the present day treatment like above  based on “real science”? Granted, these chemo-drugs have undergone clinical trials and have been approved by Government Authorities. But, what does all this mean? The approved drugs can cure your cancer? Far from it! Ask,  why do we see failures after failures being repeated over and over again? It appears that failures  seems to be the norm rather than an exception.

Chemo drugs 3 percetn effective chemo drugs only 25 percent effective

I have one suggestion for those who want to do something!  Think about it seriously.

Granted, chemo-drugs sometimes can make the tumour markers drop to normal level or the tumour shrunk completely after the treatment. But what do you do after this achievement? Send the patient home and ask him to live the same style of life that he/she had before — the earlier life that promoted his/her cancer?

Free fall

  • What if we have a program that teaches patients how to live a healthy life after being effectively treated?
  • What if we teach them to change their life style and diet?
  • What if we ask them to take supplements, vitamins or herbs to make them healthy?
  • What if we ask them to take time to exercise?

These are things that patients can do for themselves when they go home after their “apparently successful” medical treatment.  Above all, these are “harmless” efforts that can result in a better and healthier cancer-free life.

  • In short, why can’t the medical establishment work together with the alternative healers to try and help patients prevent or minimize their cancer recurrence?

At CA Care we teach patients all the above. We take over after patients decide not to go for any more medical treatments. And often for those who are really committed, we succeeded in helping patients to heal themselves.

 

 

 

Lung Cancer and Prostate Problem — Refused chemo & radiation, and still alive?

Aman is a 72-year-old Indonesian male. He and his wife came to seek our help two years ago, April 2013.  He brought along the report of his Whole Body CT scan, dated 21 March 2013, which indicated the following:

  • Spiculated soft tissue mass noted in the right upper lobe of lung, measuring 4.7 x 4.2 cm. The mass extends medially to right hilum and is abutting the adjacent right oblique fissure.
  • No nodule noted in left lung.
  • Enlarged lymph node in precarina region, measuring 1.4 cm.
  • Prostate is enlarged, measuring 5.1 x 6.1 x 5.8 cm with compression effect to urinary bladder.
  • No evidence of distance metastasis in brain and liver.

Composite

Aman was asked to undergo chemotherapy. He refused. Later, he agreed to radiotherapy but could not start the treatment after the machine broke down. Aman then came to seek our help and was started on herbs. We did not get to see Aman again after his first visit.

About two years later, in June 2015, Aman ‘s wife came to our centre and said Aman was doing fine and she wanted some more herbs for her husband.

Here is the gist of our conversation that day (listen to the second half of video below).

Chris:  You (and your husband) first came in 2013 – two years ago. He was scheduled for radiotherapy — did he go for that radiation?

Wife: No, we came here right away — no radiation done. Since then he (husband) never came back to Penang again.

C: In April 2013, he took the herbs. Is he okay now?

W: Yes.

C: Did you ever go back to consult with the doctors again?

W: No.

C: It has been 2 years now and his condition is okay?

W: Yes, okay. Sometime in the morning he has phlegm in the throat. On and off there is a bit of cough.

C: Apart from that, are there any other problem?

W: No problem — every morning he goes for morning walk.

C: Oh, he does not stay home — feeling sick?

W: No, no. He operates a grocery store selling sugar, rice, etc.

C: And he can work?

W: Yes.

C: Amazing indeed. It’s been 2 years . I can’t believe this. (Tell me again) is he okay? No problem, can work?

W: He wakes up early morning and at 6 a.m. and goes for a walk, round and round the neighbourhood. Everyone who sees him says he is healthy!

C: Oh, and he has no other complaints at all?

W: No.

C: His breathing is good?

W: Okay.

C: What is the problem now?

W: No problem.

C: Okay, amazing healing indeed. Continue to do what you are doing!

Comment

This is rather an amazing healing story. How could he survived for that long without chemotherapy or radiotherapy? That is if you believe these treatments are good for cancer! But for us at CA Care, surviving lung cancer for a few years without medical treatments is nothing unusual.

Let’s go back to Aman’s first visit to our centre two years ago and see what transpired during that visit.

 

 

Chris: Come, come. You are from Aceh (Indonesia)?

Patient: Yes.

C: You speak Hokkien?

P: Yes.

C: Who is sick?

P: Me, with cancer.

C: What happened? Tell me what happened from the beginning.

Wife:  We went for a checkup in Hospital A. This was in September 2012. They said his lung was “dirty”.

C: He went for a checkup. He had no problem at all? No cough, etc.?

W: Nothing. Actually I went for a checkup. After that he also had a checkup.  The doctor said his lung was “dirty” and his prostate (PSA) was also high, 8.8.

C: Did the doctor give you any medication?

W: Nothing.

C: No medication?

W: No. So we went to Hospital B and did another CT scan. We were told there was a mass. But we went home without doing any treatment.

C: You went to Hospital B. Did another scan.  You knew there was something inside but you did not want any treatment? Now to come and see me — it’s already April 2013 — what did you do from September 2012 till April 2013?

W: We came back to Penang again in January 2013. This time we went to Hospital C. We did another scan.

P: They also took a tissue out — through my back.

C: What did they say?

P: It was cancer.

C: What did you do after that (biopsy)?

P: Nothing.

C: You came to Hsopital A, then Hospital B and then Hospital C. You did one scan after another. Then the biopsy. And you did nothing after all these — what were you trying to do? Okay, in January 2013, after the biopsy you did nothing. Was there any pain? What happened after that.

W: We came back to Penang again in February 2013 and went to a cancer hospital. They gave us an oral medication to take (showing the prescription of Tarceva). But the medicine was not good for him.

C: How long were you on this drug (Tarceva)?

W: After taking 28 tablets (two tablets per day), it was not suitable. We told the doctor about this but he said not to worry and asked us to continue taking the medicine.

C: Why did you say not suitable?

P: Rashes and itchiness (showing hands and face).

C: Whole body?

P: Yes.

C: How much did you pay for this drug?

P: RM 7,500 per month.

C: Before taking this drug (Tarceva) did the doctor not warn you about this side effect?

W: Yes, he did tell us. When we phoned him he told us: Continue. It’s okay. You are reacting to the drug!

C: Did you ask if the drug can cure you?

W: He (husband) did not want chemo injection. So the doctor offered this oral drug instead.

C: After you stopped taking this drug (Tarceva), did you go back to the doctor again?

W: We came back on 21 March 2013 and did a CT scan. They scheduled us for radiotherapy.

C: Did you go for radiotherapy?

W: Not yet. We were supposed to do 30 times. When we turned up for the treatment, we were asked to come back the next day because the machine was not working. Then, the next day, they called to say that the machine was still not working.

C: Have you paid the money for this treatment? How much?

W: Yes, we have already paid the money to the hospital. It was RM 8,000 plus. They told us to come  back again tomorrow to start the treatment.

C: So now, are they going to refund you the  RM 8K that you have you paid?

W: I don’t know.

Advice from CA Care

C: You come here to seek our help. I am going to tell you honestly that I cannot cure your cancer. You must learn how to take care of yourself. Now, you have to stop smoking! Go home and take care of your diet. You cannot eat all those fried foods. No sugar, no diary. No banana for people with lung problems. So you have to take care of your diet. Then take the herbs properly. No cure but these may help you. If you have no problems after this – that’s good enough.

Then don’t be “dumb” anymore — no more going from one hospital to another to take pictures. There are still many more hospitals for you to go to! There is no need to do all these scans. Enough. I can’t cure you but if you are okay — no problem — then don’t ask for more.

For those who want to know more about the “bad and good” stories about lung cancer, read these two comic books.

Lung Cancer: What Now?

Title-Page-Book 1

Lung Cancer Success Stories

Title page Book 2

 

 

 

 

Lung Cancer: Chemo prolongs life? Why do a biopsy if you don’t want chemo?

KB is a 67-year old Indonesian — with a history of heavy smoking for some 50 years. About 3 months ago, he had fevers and started to cough; sometime with white phlegm and sometimes just dry cough. He also lost a lot of weight.

He went to see a doctor in a private hospital. X-ray and CT scan indicated:

  • a 9.8 x 11 cm mass in the right upper lobe.
  • a non calcified 1.2 cm nodule in the left lower lobe.
  • small (1-1.5 cm) mediastinal lymph nodes.

A FNA of the right lung mass done on 17 March 2015 confirmed lung cancer, likely an adenocarcinoma, Stage 4.

Composite

Chemo does not cure stage 4 ca

 

KB was asked to undergo 8 cycles of chemotherapy. The total cost of the treatment is about IDR 120 million.

Chris: Did you ask the doctor if chemo is going to cure your father’s cancer?

Daughter: Can only extend his life.

C: So what do you want to do now?

D: No, we don’t want to do chemo.

Questions to ask

The above are the standard questions I often ask patients when they come to seek our help. Almost all patients were told that in spite of their terminal cancer, they should undergo chemotherapy to either stop the cancer from spreading or to prolong their life. Chemotherapy is also said to improve quality of life.

Frankly, I find these justifications rather hard to swallow.

Ask these questions:

  1. Can chemotherapy really prolong life? Many patients told me that they would not go for chemo because their relatives, friends, parent, etc. had chemo and died. To these people chemo did not prolong life.

Nose (NPC) Cancer: Chemo and He was Dead Six Months Later – Why?

Dissecting Chemotherapy Part 7: Avastin + Alimta Nearly Killed Me (after saying this, the patient died).

Of course, some patients benefited from chemotherapy and remain alive but NOT without enduring severe side effects.

I googled “does chemotherapy prolong life” and here are some interesting answers I got.

One person asked: Does chemo work? I don’t think it will prolong my life, and most likely kill me? He got the following responses.

  • 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 often thought it would be better to not use chemotherapy in situations where no cure had ever been achieved with drugs – pancreatic cancers, advanced non-small cell lung cancers, many brain malignancies, etc. I spent a great deal of time trying to talk some patients out of taking chemotherapy. In the USA, many people will not accept the ‘supportive care only’ option no matter how carefully it is explained that chemotherapy has never cured some types of advanced malignancies.
  • Nobody can or will give you any guarantees with chemotherapy.Why do you 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. Distressed relatives sometimes look for something or someone to blame, and some conclude that it was the treatment that killed the person. People with aggressive and advanced cancers who agree to chemotherapy aren’t duped; they do so in the full knowledge of these facts because they have a life-threatening disease and this is their best chance. Chemo and other cancer treatments are not perfect, very far from it.
  • No, if chemo worked there would be fewer people dying, and in most cases it’s the “therapy” rather than the cancer that killed the patient. The drug severely damages the liver and ravages the immune system.
  • Wow, what a question. It’s a personal choice. You should research it very carefully, all positive and negative opinions about it.I know that I would never choose chemo. I would be willing to have surgery, and I’m not sure about radiation, but chemo, never. We are all going to die anyway, and we should die the way we want to and not let others tell us how. Chemo would take away my will to live, so what’s the point?

Another person asked: Will Chemo buy me more time ?? Anyone, Ideas? I was diagnosed 6 weeks ago with stage IV non small cell lung cancer with a tumor in left lobe, 1 brain tumor and several swollen lymph-nodes. I was told today I could expect to live 1 year. Beyond 12 months will be in God’s hands. I had targeted radiation on the brain tumor. I have started chemo and it has made me feel horrible. I’m short of breath and I little tired. But when I take the Chemo I feel like it’s speeding up my clock. What I mean is I cannot help but wonder if the side effects of the chemo will steal more days of my life than this dreaded cancer. Close friends and family are telling me to stop killing myself with chemotherapy!!! Has anyone out there been thinking the same way? I’m so afraid of losing the ability to function normally daily.

The following are some comments from readers.

  • My mother struggled with this decision when she was diagnosed with leukemia. Hers was a very aggressive form that didn’t respond well to treatment. Her doctor then wanted to start her on a very aggressive chemo regimen called CVP, which has tons of nasty side effects (it is one of the regimens they give when getting patients ready for bone marrow transplants). She was torn with the decision of what to do. I had already told her that if I had to choose between quality and quantity, I would rather have her feeling good for a month, than a year of her being miserable. When the decision came, she asked me what she should do (I am an only child). I told her there was no way I could answer that. It was her decision, her body, her life. I told her that I would love her and support her in whatever decision she made. She went to church regularly, so I told her to pray about it and she would find the answer. In a few days, she told her oncologist that she wanted to suspend her treatment. She never started the aggressive chemo, and I cared for her until she passed away.

    Now as I watch my husband go through chemo for lung cancer, and see how he suffers with it, I can even more clearly see how my mom made the right decision for her. My husband is a different personality, therefore he has a different approach. No one can blame you for the choice you make at this point. It is yours to make. I know you will make the right choice for you, and I pray you find peace as you make that choice.

  • I’m sorry that this disease as come in to your life, yes it SUCKS!!! I pray that you will feel better soon. My dad is 55yrs old and was diagnose just about a year ago, and yes they told him he’s terminal and only had 6 months to a year to live. Is going to chemo worth it?? That just depends on YOU ….
  • My wife, 53 years of age, was diagnosed in May 2011 with two tumours in the lung and three brain mets. We were told ‘months rather than years’! Decided on no radiation treatment as there is no conclusive proof that it extends life. Began chemo at the end of June (Cisplatin and Pemotrexed). The first two scans on the lung showed a reduction in the tumour size each time. The third lung and brain scan in December showed that the lung tumours were continuing to shrink and one of the brain mets had disappeared completely. The oncologist told my wife ‘that without this treatment you wouldn’t be here now’. My wife has had a pretty horrid time with nausea and vomiting … Fatigue is another problem, along with a sore mouth but she hasn’t lost her hair. She’s been working in our garden, and has considered going back to work but I think the constant need to have naps might prevent that. Overall, very happy with the way things are going.
  • It’s definitely your choice. Chemo is doable and not everyone has a horror story to tell about it. For me the worst part was the fatigue. Maybe I’m fortunate that I have no long term side effects. No doctor should be telling you that you only have a year to live, as they’re not God and don’t know how you’ll respond to treatment.
  • My husband, Jerry, was diagnosed with stage IV lung cancer the last week of Jan. 2011. When his oncologist saw him for the first time he said “I can’t cure you, but I can give you an extended amount of time, and a better quality of life”. After 7 weeks of chemo and radiation the tumor that was the size of an orange is now the size of a pea and is inactive. The other four active spots in his other lung are gone as is the spot on his lower neck and lower spine. His oncologist now is saying he can have surgery to remove the dead tumor (we have till Jan. 26 to decide if he wants to go through surgery as he is 74 years old). Please don’t believe everything your doctors tell you. With your own determination, the help of all medical options, and with prayer, anything is possible.
  • My sister just passed from non-small cell lung cancer (BAC). She was on Alimta as her chemo drug. As soon as the dr. gave her a time frame of life expectancy she went downhill. We had her on supplements, vitamins, etc. There are tons of alternative treatments if you just type in alternative cancer treatments you will find tons of treatments. Most of the alternative treatments you can do at the same time as chemo. I believe all green is the way to go – I could not get my sister to try that.
  • The first line of chemo can be very difficult – I won’t sugar-coat it. But they should know pretty quickly if it’s working or not, and may be able to adjust your dosage if the side effects are too hard. When I got the first scan back that said the chemo had shrunk my tumor by almost half, I decided I could handle it for awhile longer. It was worth it. The second line of treatment was much, much easier My hair grew back, the side effects were only 2 or 3 days and very manageable. That chemo worked so well that all signs of active cancer have disappeared, and I was able to stop chemo and do a watch and wait. I am now 2 1/2 years past my Stage IV diagnosis, and doing great.
  • If only we could clone ourselves, try various treatments, then pick the one that worked best.
    I was diagnosed in August with stage IV NSCLC with a dozen mets to ribs femur pelvis, skull, and spine.
    I had 2 week radiotherapy to the skull, which was effective in stopping progress, and headaches.
    I cancelled my scheduled Chemo after testing showed I had no identifiable mutations, So was not eligible or targetted therapy. I have adopted a strict vegetarian diet, I meditate and do Gigong. I have 5 fresh vege juices a day, and take a few supplements. A herbalist specialising in traditional medicine has made me a tonic I take 3 times a day. This is my alternate chemo.
    My latest scan showed no new cancer and a mild progressive enlargement of the existing ones.
    I feel fine, no one would suspect I was ill. Apart from the 2 weeks Radio I have spent VERY little time in the hospital environment
    I had chemo 30 years ago for leukemia, so it does not worry me. I do not believe chemo offers me much advantage. It will also do a huge amount of damage to my own defense system.
    Maybe I am just fortunate to have a slow growing cancer, or maybe what I am doing is right. I will never know. But I am so happy i gave my body a chance to figure this out for itself before embarking on toxic intervention. Chemo might be the right thing for me down the track, but for now my body’s immune system has a chance to catch up to the disease and maybe stop it. Myself, my wife and my oncologist are very happy with my situation and see no reason to change, at this stage.

Many thanks to each of you who took the time to give me your opinions. I will re read your notes and think carefully. My Dr was intent on me starting chemo full speed ahead. To be honest I wonder if money is a driving force in the push for so much random chemotherapy. I wonder how they select a drug for each person. I would like be sure it’s not eny meney miney mo —- let’s try this one to see if it will help her. They gave me so little information I have had to hunt the internet for details … Poison is poison —- and poison kills right?

  1. If chemo prolongs life, don’t you want to ask ” prolong by how long or how much” – – days, weeks, months or years?
  2. Next question, Prolonging life at what cost — in terms of suffering and money?

Drs Tito Fojo and Christine Grady in the USA appear to swim against the current too. They wrote an interesting paper: How much is life worth: Cetuximab, non-small cell lung cancer and the $440 billion question. The first author is from the Medical Oncology Branch of the National Cancer Institute, Bethesda, USA, while Dr. Grady is from the Clinical Center, National Institutes of Health, Bethesda, USA.

This is what Dr. Fojo & Grady wrote in their paper:

  1. In the United States, Treatment with Erbitux treatment for lung cancer costs an average of US$80,000 (to prolong life by 1.2 months), which translates into an expenditure of US$800,00 to prolong life of one patient by one year.
  2. The median US household income is US$50,233.
  3. The cost of Avastin treatment is US$90,816 and that is said to prolong life by 1.5 months.
  4. The cost of Tarceva treatment is US$15,752 and it is said to prolong life by 10 days.
  5. The cost of Nexavar treatment is US$34,373 and it is said to prolong life by 2.7 months.
  6. Greater than 90% of the anticancer agents approved by the FDA in the last 4 years cost more than US$20,000 for a 12-week treatment.
  7. These examples challenge the oncology community to address some serious questions:
  8. What should count as a benefit in cancer?
  9. What is the minimum amount of benefit needed to adopt a therapy as the new standard?
  10. Is 1.2 months of additional life a “good” in itself?
  11. How much should the quality of that 1.2 months matter? Or the cost?

(Take note: none of these drugs cure cancer. They just prolong life by just a few days or months)

In concluding their paper, Dr. Fojo & Grady wrote:

  • The all too common practice of administrating a new, marginally beneficial drug to a patient with advanced cancer should be strongly discouraged.
  • In cases where there are no further treatment options, emphasis should be first on quality of life and then cost.
  • For therapies with marginal benefits, toxic effects should receive greater scrutiny.
  • We must deal with escalating price of cancer therapy now.
  • The current condition cannot continue … the time to start is now.

For more read:

1.  Dissecting Chemotherapy Part 4: How Much Is Life Worth? Erbitux for Lung Cancer

2.  Are Medical Bills Killing Patients?

3.  The cost of cancer drugs 

What about the side effects?

Read this research paper on chemo-radiation. http://www.oncologynurseadvisor.com/chemoradiotherapy-prolongs-life-for-older-patients-with-lung-cancer/article/245291/

Median overall survival for the chemoradiotherapy group was 22.4 months, compared with 16.9 months for the radiotherapy-only group. This means chemotherapy prolongs life by 5.5 months.

Although chemoradiotherapy was well tolerated, grade 3 and grade 4 hematologic toxic effects were more prevalent among those patients:

  • Leucopenia occurred in 63.5% (61) of the chemoradiotherapy participants, but in none of the radiotherapy patients;
  • neutropenia in 57.3% (55) of the chemoradiotherapy patients and none of the radiotherapy patients; and thrombocytopenia in 29.2% (28) of the chemoradiotherapy patients and just 2.0% (two) of the radiotherapy patients.
  • Grade 3 infection also was more common with chemoradiotherapy (occurring in 12.5%, or 12 patients) than with radiotherapy (4.1%, or four patients).
  • Incidences of grade 3 and grade 4 pneumonitis and late lung toxicity were similar between groups.
  • Seven treatment-related deaths occurred, in three chemoradiotherapy patients (3%) and four radiotherapy patients (4.0%).

No thanks to chemo

In this case, KB decided not to go for chemo. The choice is easy to make. The treatment is going to cost him IDR120 million or RM 33,171 — to prolong life with no cure. Then there are the side effects to contend with. The daughter said, My father would not be able to stand it.

Yes, chemotherapy can make you feel nauseated and make you throw up. It can make your hair fall out. It can temporarily depress the immune system. It can cause bleeding complications, such as GI bleeding. It can cause kidney damage. It can cause heart damage. It can cause lung damage. it can cause nerve damage. It can make you lose weight. It can even result in your death from complications. In short, it is not something to be taken lightly. Unfortunately, the disease it’s meant to fight is a formidable foe indeed. It is your own cells, and often the difference between the toxicity of chemotherapy against the cancer and against normal cells is all too often not that great. http://scienceblogs.com/insolence/2009/05/20/chemotherapy-versus-death-from-cancer/

  1. Does chemo really improve quality of life?

Chemotherapy is the primary treatment approach for metastatic … lung cancers. Although the treatment can prolong life—by weeks or months—it is not likely to produce a cure. While chemotherapy may prolong life and provide some relief from symptoms of disease, it is also associated with substantial side effects. Patients facing incurable cancer must weigh the risks and benefits of a treatment that will not cure their disease, but could prolong their life. Unfortunately, the reasons for choosing chemotherapy treatment in the face of incurable disease may be unclear to patients. http://news.cancerconnect.com/patients-with-advanced-cancer-may-have-inaccurate-expectations-of-chemotherapy/

Our advice

  • As you can see from the above, different people have different perceptions about chemotherapy –confusing indeed. Eventually it boils down to, It is all about your own choice! Do what you feel comfortable with… follow your heart! There is no definite answer, we are each different and for some chemo works and for some others it does not.
  • Referring to this case (and many others like this), I have this advice: If you don’t want to do chemo, why do a biopsy?

Read more:

1.  Lung Cancer: Why do a biopsy when you don’t want to go for chemotherapy?

2.  The Truth About Biopsy

 

 

 

Lung Cancer: Meaningless Temporary Drop of CEA After Iressa

In September 2013, Liz – a 54-year-old Indonesian – has pains around her right rib-cage. An USG indicated fluid in her lungs. Liz was referred to a lung specialist who thought she had tuberculosis (TB). Liz was prescribed TB medication for three months.

After three months, there was again fluid in her lungs. About 1.3 litres of fluid was tapped out. Liz was told to continue taking her TB medication.

Liz went to Jakarta and  consulted another doctor. Pleural tapping was again done and 0.6 litre of fluid was removed from her lung. Liz was again asked to continue with her TB medication.

Not satisfied Liz went to Singapore. Blood test, CT and PET scan were performed (note: no CT or PET scan were ordered by doctors in Indonesia).

Blood test results, 14 April 2014

Alkaline phosphatase 188 (H)
AST/SGOT 84  (H)
ALT/ SGPT 83  (H)
GGT 100  (H)
CEA 44.3  (H)
CA 125 26.6  (H)
CA 19.9 4.6
AFP 6.4

 

CT Scan of the Thorax, 14 April 2014

  • A large right -side pleural effusion is seen involving the upper lobe of the right lung and extending to involve the middle lobe.
  • Suspicious of a nodular mass more than 2 cm in size present in the upper lobe of the right lung.
  • Presence of a small nodule in the left lung in the lower lobe, 6 mm in size. This is suspicious of a possible metastatic lesion.

Cytopatholoogy report of right pleural fluid, 14 April 2014

  • pleural fluid negative for maligancy.
  • pleural fluid is haemorrhagic with few inflammatory cells and an occasional mesothelial cell.

PET/CT Study on 15 April 2014

  • Hypermetabolic mass in the upper lobe of the right lung is consistent with pulmonary malignancy.
  • Mildly hypermetabolic paratracheal and precarinal nodes are suspicious of nodal metastasis. Multiple nodules scattered in both lungs are suspicious of pulmonary metastasis.
  • Hypermetabolic lytic lesions in the thoracic vertebra and left ischium are compatible with metastases.

Cytopathology report – FN lung biopsy, 17 April 2014

Malignant cells present consistent with infiltrative moderately differentiated pulmonary adenocarcinoma.

MRI Brain

No MRI imaging evidence of intracranial metastatic disease is detected.

Liz was not able to walk by herself and had to use the wheel chair. She received 10 sessions of radiation treatment. After radiotherapy, she was able to walk. But she still had cramps and numbness in her legs. Liz told us that this leg numbness and cramp developed after 2 months on the TB medication.

For her lung cancer, the oncologist prescribed Iressa, costing SGD 3,500 per month. 

Meaningless temporary decrease of CEA after taking Iressa

April 2014 Started on Iressa, CEA = 44.3
11 June 2014 X-ray chest: Slight interval improvement. CEA = 18.7 (decrease from 44.3)
13 August 2014 X-ray chest: Stable lobulated opacity seen. CEA = 31.2 (started to increase)
14 October 2014 X-ray chest: No significant change. CEA = 36.0 (slight increase)
20 January 2015 X-ray chest: Right pleural effusion is stable. CEA = 47.6 (increase from initial value)

 

Meaningless improvements of PET scan images after taking Iressa (Study of April 2014 versus October 2014).

April-2014-bad

(Top: April 2014 after Iressa bottom: October 2014)Oct-2014-improve

(Left: April 2014 after Iressa right: October 2014)Meaningless-bone

Iressa did not help Liz. The oncologist offered two options:

  1. Stop taking Iressa and go for chemothrapy.
  2. Or continue taking Iressa for another 2 months and see what happen.

Liz decided to stop further medical treatment and came to seek our help.

 

Scientists find lung cancer can lie hidden for 20 years

On 9 October 2014, Reuters carried this news report: Scientists find lung cancer can lie hidden for 20 years

  • Lung cancer is the world’s deadliest cancer, killing an estimated 4,300 people a day, according to the World Health Organization.
  • The current prognosis for NSCLC is grim, with most patients diagnosed when the disease has already spread and only around 15 percent surviving for at least five years after that.
  • Around 85 percent of patients have non-small cell lung cancer (NSCLC).
  • To get a clearer understanding of the disease, the two groups of British and American scientists looked at genetic variability in different regions of lung tumors removed during surgery and worked out how genetic faults had developed over time.
  • What they found was an extremely long latency period between early mutations and clinical symptoms, which finally appeared after new, additional faults triggered rapid disease growth.
  • (What this means is) Lung cancer can lie dormant for more than 20 years before turning deadly.
  • In the case of some ex-smokers, the initial genetic faults that started their cancer dated back to the time they were smoking cigarettes two decades earlier.
  • On the evolution of lung cancer, scientists in Cancer Research UK reveal how after an initial disease-causing genetic fault — often due to smoking — tumor cells quietly develop numerous new mutations, making different parts of the same tumor genetically unique.
  • (What this means is: Not all cancer cells in a lung tumour are the same). This helps explain why a disease that kills more than 1.5 million a year worldwide is so persistent and difficult to treat.
  • By the time patients are sick enough to be diagnosed with cancer, their tumors will have developed down multiple evolutionary pathways, making it extremely hard for any one targeted medicine to have an effect. (What this means is: ONE drug cannot kill all the different types of cancer cells in the lung).
  • “Previously, we didn’t know how heterogeneous these early-stage lung cancers were.”
  • Currently, doctors use computerized tomography (CT) to detect lung cancer — but by the time a nodule is big enough to be spotted it on a scan it may contain a billion genetically diverse cancer cells.

Sources: http://www.reuters.com/article/2014/10/09/us-health-cancer-lung-idUSKCN0HY23Q20141009

http://www.sciencedaily.com/releases/2014/10/141009154007.htm

Medically Given Up Lung Cancer: She died after 5 years on CA Care Therapy

NG was a 83-years old lady when she had been coughing. A CT scan done on 19 October 2009 showed a spiculated lesion measuring 1.5 x 2.7 cm in the right lower lobe and an ill defined lesion measuring 1 x 1.5 cm in the left lower lobe of her lung. Solitary mildly enlarged lymph node in the middle mediastinum. At least three lesion in the spleen, the largest measures 1.2 x 2.0 cm.

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Due to her age, the doctor told the family not to proceed with any medical treatment.

Desperate, her son came to seek our help on 23 October 2009. NG was prescribed herbs and told to take care of her diet.

This is her story ….

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We were informed that NG has passed away on 10 August 2014, almost 5 years after being diagnosed with lung cancer. All these years she had been on our therapy. She was 88 years old when she died.

The question we wish to pose is: Did she die of her cancer or of her ripe, old age?

Based on this story, do patients really need to panic and rush to undergo invasive treatments? Do you really need that chemo or radiation? In NG’s case, the doctor had the wisdom to realize that NG would perhaps die sooner if she were to undergo those standard invasive treatments .

We we saddened by NG’s demise. (But, who don’t die? Remember that when we were born we were already destined to die!). We understand that the family had lost a loving mother. However, we are also glad to note that NG had lived to a ripe age without sufferings from her cancer. She is indeed blessed. Glory be to God!

Lung-Bone-Brain Cancer: Pain Gone After 4 days of e-Therapy

Patient, 66-year-old, was diagnosed with lung cancer that had spread to her bones and brain. She had undergone radiotherapy, took Iressa and later switched to Tarceva but the treatments failed her. After 9 months of medical treatment she decided to try out our CA Care Therapy.

Patient led a miserable life. She was constantly in pain and had difficulty sleeping. Patient, her husband and daughter came to CA Care Penang on 8 June 2014. She was started on the e-Therapy. After 4 days, her pains were gone!

Listen to her story.

 

 

Patient was in pain for 2 weeks before coming to see us in Penang.

Nature of her pain:

  • Poking pain in the left rib.
  • Pain radiated from front to the back.
  • Pain comes on and off lasting from 5 minutes to 30 minutes at a time.

After the e-Therapy

The following are notes recorded by her daughter.

Day One

  • Started with Detox #2 on Sunday evening. Felt mild pain at the ribs while undergoing the therapy.
  • Mild pain at 2 am to 4 am.

Day Two

  • Detox # 3 and Insomnia #18 on Monday morning. More pain during the session. Went home felt very, very tired, restless and irritable. Had deep sleep for 30 minutes.
  • Pain at 2 p.m. and then at 9.30 p.m. The pain gradually increased at 11.30 p.m. and 4 a.m. Able to sleep but woke up due to the pains.
  • Overall she had more hours of sleep.
  • The pain now is a bit less than what she experienced while at home before the e-Therapy.
  • Good appetite.

Day Three

  • Pain # 65, 80 and 89. No pain and had good sleep during the therapy. Had mild pain at 1 p.m., 3 p.m. and 4.30 p.m. Duration of pain decreased.
  • At night she was alert, talkative and energy level higher.
  • No pain throughout the night but had coughs with a lot of phlegm.
  • Wake up, sleep, wake up, sleep. Didn’t sleep well.

Day Four

  • Whole day and night NO pain.
  • Before the therapy she had pains every day and night.
  • At night she had pain 2 to 3 times and daytime it was 3 to 4 times per day.
  • After 4 days of the e-Therapy the whole day and night no pain.
  • She felt better, whole day comfortable. She was happy.

Daughter: (The e-Therapy)… It is very good. At night no pain, the whole day no pain. Very good mood. Very good appetite. Happy.

Chris: You can’t ask for more!

The Story of Mom’s Lung-Brain-Bone Cancer

This is the story of a 66-year-old lady who had lung cancer. The cancer has spread to her lymph nodes, bones and brain.

This is what her daughter wrote about her mom.

Mom who cooked and ate meat, dairy, eggs, honey, garlic and onion as part of her diet since young, became a vegan since 3 years ago when she started to follow Master Ching Hai’s teachings.

Mom had high blood pressure for about a decade now. She used to take medicine to control her blood pressure but has since stopped taking it about 6 months now. Mom is a non-smoker.

Since June 2013, mom started to complain about being tired and she slept a lot. She felt no mood or lazy to do housework. We thought all these were due to aging. She also tended to forget things, like misplacing items.

Sometime in early August 2013, she lost her balance and fell. Mom declined to see the doctor.

Mom started to look very tired. She also had a hard time formulated her speech and stammered. She started to take vitamin B12 pills in the hope of improving her condition. We all thought she might suffer from vitamin B12 deficiency being a vegan. Mom wanted to monitor for 2 weeks before seeing a doctor.

Walking extremely slow, one step at a time, and very tired, we brought mom to see a GP. The doctor advised blood test together with a CT scan at a hospital. The doctor suspected a minor stroke.

Mom Had Cancer

We brought mom to a university hospital. Her CEA was more than 1,000. She was referred to an oncologist who suspected mom had cancer. He prescribed mom Dexamathasone, to reduce swelling of the brain and Omezole – to take care of the side effects of the steroid medication.

CT/PET scan on 3 September 2013, confirmed that mom has Stage 4 lung cancer. The cancer had spread to her brain, mediastinal nodes and bones. The next day, she did a biopsy. The tissue was positive to EGFR.

Radiotherapy and Iressa

From 11 to 23 September 2013, mom had 8 session of radiation treatment to her brain. From 21 September to 11  November 2013 (about 7 weeks) she took Iressa.

Deceptive Positive Results

A second  MRI and PET scan was done on 13 November 2013. The results were great! Mom’s brain metastases reduced tremendously. Also the lesions in her lungs shrunk.

However, liver function test taken on 11 November 2013, indicated liver damage.

Mom had to stop Iressa.

Another blood test on 9 December (i.e. 3 weeks after stopping Iressa), indicated liver got better. Mom started to take Iressa again. This time, a table on alternate days. But in January 2014, mom started to take Iressa daily.

More of Deceptive Positive Results

During the Chinese New Year (February 2014) mom started to lose her voice. A third MRI/PET/CT scan was done on done. The results were:

  • The oncologist was pleased with the MRI result. The oncologist mentioned that in September 2013 MRI there were about 50 lesions in her pain. In this February 2014 MRI showed less than 10 lesions. The oncologist said when he first saw mom’s MRI, he did not think mom was going to make it.
  • However, the PET scan results showed a different story. In the September 2013 PET scan it was a nice result with much reduced lesions (almost not seen). But for this February 2014 PET scan results, some lesions had recurred near her right neck (near vocal chords — therefore loss of voice?).
  • The oncologist mentioned that he was very worried, “it looks like the cancer cells got smarter and tried to overcome the Iressa.” Mom was asked to continue with her Iressa.
  • The oncologist, however, suggested a few options:

1. Start chemotherapy on day 1 and day 8, then rest for 3 weeks. In addition, mom take another oral drug, Tarceva or Afatinib (which was recently approved and is now available for free). We told the oncologist that we preferred not to do chemotherapy. As such the oncologists suggested the following options.

2. Start radiotherapy to the body in addition to taking another type of oral drug similar to Iressa.

3. Take only Tarceva or Afatinib without chemotherapy. But the oncologist said this was not a viable option.

  • For  mom’s voice issue, we brought mom to see an ENT specialist. Endoscopy to the nose/throat showed the left vocal cord was not moving (paralysed?) but the right one was doing fine. The ENT specialist said the problem could be due to the cancer. There is no medicine that he could prescribe for mom.

March 2014 — Iressa failed, switched to Tarceva 

  • Blood test on 5 March 2014, showed the tumor markers were slightly higher. The oncologist said he was worried that the cancer cells were growing and spreading. He suggested chemotherapy. He said he would give mom a lower dosage, perhaps 80 percent strength instead of the normal 100 percent strength. However there will be side effects such as low white blood cell count but the doctor said this can be countered by taking medicines. He also mentioned that patients can get better after going through the “weak” phase.
  • As we were reluctant to undergo chemo, the oncologist suggested radiation treatment to the neck and the left side of the lung. This treatment cost RM 9,100. Mom received 10 sessions of radiation.
  • The oncologist switched mom to Tarceva since Iressa doesn’t seem to be effective anymore. Tarceva cost RM 8,000 per month while Iressa cost RM 7,000 per month.
  • On 24 March 2014, mom received her fist xGeva (denosumab)  injection to protect her bones. This cost RM1,600 per shot and mom is supposed to have it every month.
  • 28 March 2014, mom started to lose her appetite.

April 2014 — 9 months Later 

  • Blood test on 7 April 2014 showed mom’s calcium level had gone down a little due the previous xGeva injection. She was prescribed medicine to bring up mom’s calcium level.
  • Mom was having frequent bowel movements. The oncologist said this might be due to the side effect of Tarceva, which causes minor diarrhoea.
  • Mom still had coughs and still choked when drinking fluid. The throat was dry and her voice hoarse. Her appetite was poor.
  • At this point, we discussed chemotherapy with the oncologist.

1. What after one session, we decided to stop the treatment. Any side effect / problem?

Oncologist: Of course we can stop at anytime, no problem.

2. How does the treatment work in terms of session, timing and rest period?

Oncologist: Do chemo on day 1 and 8 and this is considered as one cycle. Do 3 cycles first.

3. Drugs to use?

Oncologist: Two options. One, Carboplatin + Alimta which is more expensive, costing around RM 8,000 per cycle. Two, Carboplatin + Gemcitabine which cost about RM 1,000 per cycle. This option is much easier on patients but may be less effective (?). It it would be Carboplatin + Gemcintabine, the oncologist suggested that mom go for 4 to 6 cycles.

May 2014 — Tarceva Failed 

  • 5 May 2014, we told the oncologist about mom’s side effects. The oncologist recommended to stop Tarceva for 4 days and we were asked to come and see him again after that. He prescribed medications for insomnia, itchiness, and inflammation.
  • 9 May 2014, after 4 days not taking Tarceva, mom got much better. Acnes on scalp were drying up and there were not more rashes. But there seemed to be a new growth at mom’s neck. Oncologist asked mom to take Tarceva again but on alternate day.
  • MRI on 19 May 2014, showed disease progression. There were about 7 tumours.
  • PET/CT scan on 21 May 2014, showed disease progression:

1. Lymph node at the neck has enlarged.

2. Few new lesions at T9. 

The Final War Plan 

The oncologist laid out the following options.

  1. Tackle the brain first – and fast! He recommended that mom go for Cyberknife and then followed up with chemotherapy. After that mom continue taking the oral drug again after 4 months. If mom’s backache persist then we need to give radiation to that location.
  2. The oncologist also explained that giving mom whole brain radiation again would cause more side effects (e.g. sleepy, headaches) and only low radiation dosage could be give. If mom’s goes for Cyberknife she shouldn’t have such side effects because Cyberknife is more targeted.
  3. Cyberknife cost RM 67,000.
  4. Another option is to go for chemotherapy first. Do MRI after 1 or 2 months and if the tumour is shown to be growing very fast then go for Cyberknife.
  5. The oncologist assured us the mom would be able to tolerate chemotherapy. The only thing we need to really watch out is the white blood cell count.
  6. Mom will have to continue with her monthly xGeva injection to strengthen her bone.

One Final but Most Important Question

Can all these treatment cure mom?

The answer is: No cure. There is no guarantee that the cancer will not recur even after Cyberknife. 

CA Care – the Last Resort, 23 May 2014 

Patient came to seek our help and was prescribed herbs. On 8 June 2014, patient and her husband and daughter came to CA Care Penang and underwent the e-Therapy for her pains.

Comments

As I was about to upload this story, I received an email from Singapore. This is what it says.

Dear Mr Teo, 

My husband, age 61 was diagnosed with lung cancer 2 years ago. He was on Iressa since last year September 2013. Two months ago the oncology asked him to start chemo as he has developed tightness in the chest. We decline. So we just have to carry on with Iressa. Two weeks ago he developed bloatedness  in the stomach with  wind and fluid. Again oncologist scheduled him for chemo this coming Monday. Currently he feels  very fatigue and is too weak to go for chemo cause he lose a lot a weight. 

We are not in favour of chemo because in year 2012 he had gone through that already and we find it is too damaging to the lung and show no result because 10 months later lung had fluid. 

It is indeed sad.

1 Insanity-by-Einstein

Don’t those who are supposed to know, know that Iressa does not cure any cancer? And chemo does not cure lung cancer either? Click this link: https://cancercaremalaysia.com/category/lung-cancer/ and you will see that I have written no less than 70 stories about lung cancer and chemotherapy / Iressa / Tarceva, etc.

Can we not learn something from these stories? 

More stories about this patient:

Lung-Bone-Brain Cancer: Pain Gone After 4 Days of e-Therapy

Pain Recurred After Eating Rojak

Lung Cancer: Six to 12 Months to Live. Must do chemo, that’s the only way. With herbs still alive after 2 years!

CB (H894) was 74 years old when he was diagnosed with lung cancer.  His daughter came to seek our help on 25 May2012.

CB’s problem started two weeks prior to his daughter’s visit. He had coughs and became breathless. He was brought to a private hospital where fluid was tapped out of his lung.

His CEA on 8 May 2012 showed 13.18 (High). Pleural fluid (fluid from the lung) showed atypical cells suggestive of small cell carcinoma.

Preliminary scanogram on 10 May 2012, showed right pneumothorax of approximately 40 percent and partial collapse of the right upper lobe and total collapse of the right lower lobe.

Bilateral small pleural effusions are seen in the bases.

According to the doctor, the only treatment available for  CB is chemotherapy. There is no other option. There will be no cure, only control the cancer. At best he has 6 to 12 months to live.

Since he was already old the family decided not to do any chemo.

CB’s condition at that time:

1. Breathing difficulty.

2. Cough with white phlegm.

3. Bowel movements, 2 to 3 days once.

4. No appetite.

5. Unable to sleep.

We prescribed Capsule A, Lung 1 and Lung 2, Lung Phlegm, Cough 5, Constipation and Gastric paste.

 

 

Chris: Who asked you to come and see me?

Daughter:  Alice told me about you. She was your student some years ago.

This was what I told CB’s daughter:

  • I can’t cure your father! It all depends on him – whether he wants to take care of himself or not.
  • If he does not believe in what we do, there is no point coming here. You must believe first.
  • If you believe your doctor, then go and see the doctor. But some people refuse medical treatment, then it will be a different story.
  • The herbs are bitter – not nice to the taste, awful smell, etc. Can you father stand that? Some people cannot accept that.
  • He has to take care of his diet. Cannot eat anything he likes. He must understand this first. Only then can he take care of himself.
  • There is no such thing as “magic bullet”.
  • I suggest that you don’t take any herbs first. Go home and discuss with your family. There is no point wasting money and time. He has to be committed. That is the important thing.  Then don’t take meat, sugar, table salt, dairy products and oil.
  • If he cannot take care of his diet, there is nothing I can do to help him.

Up to this day, I did not get to meet CB at all. He did not come to our centre. in fact, CB’s case of out of our “radar”.

However, on 11 June 2014, i.e. two years later,  I happened to “bump” into CB’s daughter when she came to collect herbs for her father.

Chris: How is your father doing.

Daughter: Okay, no problem, no complaints.

C: Amazing – it has been more than 2 years now. He can eat, can sleep and has no complaints? Cannot ask for more!

Pain Gone After e-Therapy

Jane (not real name) was a 47-year old lady from South Africa. She lived with her husband and their dog in a boat that sailed around the world. The happy family had been sailing like this for the past 15 years. Sometime in mid-2013, they landed in Malaysia. Jane developed breathing difficulty and was subsequently diagnosed with lung cancer. CT scan showed a 3.2 x 4.1 x 6.7 cm mass in her lung.

Jane was asked to go for chemotherapy but she refused. She was in severe pain when she came to seek our help. One way to help Jane with her recurrent persisted pains was to put her on the e-Therapy.

Listen to what happened to her.

 

 

Day 1: After detox 1 and detox 2: She went through “hell”. She felt very tired and the pains were more severe.

Day 2: She had nausea, was very tired and the severe pains persisted! She became very irritable, did not feel like eating and it was pain, pain, pain – all the time.

Day 3: In the morning, things seemed to improve a little bit. She became less irritable and less nauseous. However, the pain remained the same.

In the evening, Jane had more of the e-Therapy (almost 2 hours). She had hot flushes, she had a lot of sweat and felt something “moving” inside. The pains did not improve.

Day 4: She awoke at 3 a.m. and felt real good! I jumped out the bed. No pain. I felt absolutely healthy. Jane had more of the e-Therapy in the morning. She walked some distance to an organic shop for lunch. Her pains started to come back.

Day 5: I felt good, rested and it was fantastic.            

Day 6: Jane was better off today than she was on Day 1.

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We were glad to be able to help Jane with her pains. The next day, she sailed away with her boat (picture) and we never get to see Jane again. Later we received an e-mail from her husband saying that Jane had passed away on 1 January 2014. The cancer had spread to her brain. It was indeed unfortunate that we were unable to help Jane using herbs because her “Caucasian” stomach would not tolerate them.

 

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!

Lung Cancer: Given Honest Answers Patient May Run Away from Chemotherapy

SS (E345) is a 55-yer-old lady. Her problem started around October 2013 when she started to have coughs with a bit of phlegm. There was no blood. She consulted a GP who gave medication but the problem persisted on and off. At last she requested her GP to do an X-ray of her chest. There was “something” in her lung. SS was referred to a hospital in her hometown for a CT scan.

CT scan done on 18 October 2013 showed a lobulated mass at the right hilar region. It measures 2.9 x 3.2 cm. SS was asked to consult a lung expert in a private hospital in Penang.

Bronchoscopy and Surgery Failed

SS did a bronchoscopy. In this procedure the doctor inserts a bronchoscope into the nose or mouth. This allows him to view the inside of the airways and lungs. Unfortunately for SS, the bronchoscope could not penetrate the passageway deep enough and the doctor saw nothing!  Fluid taken from the lung during the procedure did not show presence of malignant cells.

The doctor suggested a better option would be to do an open surgery. SS agreed but she was asked to do a PET scan first. The PET scan results on 30 October 2013 showed:

  • No intracranial lesion is seen.
  • Few small 5- 7 mildly active hypodense lymph nodes are seen in the right and left side of the neck.
  • A 42 mm metabolic active mass is seen in the middle of the right lung. Multiple smaller 2-7 mm nodules are seen in the rest of the right lung.
  • Few metabolic active lymph nodes measuring 14-26 mm are seen in the right para-trachea, subcarinal and right hilar region of the mediastinum are noted.

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Based on the PET scan results the doctor was optimistic that surgery would provide good “success.” SS proceed with the surgery as recommended by the doctor. Unfortunately it was an open-close job – failed. The doctor took some tissue samples for biopsy.

The result of the biopsy indicated:

  • right pleural node biopsy: no malignancy seen.
  • right lower lobe biopsy: well differentiated adenocarcinoma.
  • right medial lobe: metastatic adenocarcinoma.
  • right paratracheal node: metastatic adenocarcinoma.

The tissue is positive for EGFR (meaning oral drugs such Iressa or Tarceva is indicated).

 

 

Consultation with Oncologist

SS was referred to the in-house oncologist for further management. The following are excerpts of our conversation.

Daughter: The oncologist said it is better to take oral medication than undergoing chemotherapy (infusion). Chemo has more bad side effects. My mother can take either Iressa or Tarceva.

Chris: Did you take the drug?

D: No. I asked the oncologist the following questions:

a) Are there side effects of the oral drug. His answer: Yes, patients may become itchy and have pimples or sores.

b) Can the oral drug cure my mother? His answer: Cannot cure. It is just to control.

c) Control for how long? His answer: It all depends on the patients.

d) From your experience, how long does the control last? His answer: For some patients the control lasted for one year. After one year, the drug was not effective anymore. But for some other patients the control lasted for 2 years before becoming ineffective.

e) After Iressa becomes ineffective, what do we do next? His answer:  Go for chemotherapy (injection).

D: The cost of Iressa is more than RM 200 per tablet. It comes to about RM 8,000 per month. Why take it when it is not going to be effective?

C: After 1 or 2 years on the drug, you will then have to go for chemo. Did you ask if chemo is going to cure your mother?

D: No, chemo cannot cure her. Each chemo costs about RM 2,000 per cycle. Later cycles would cost more – RM4,000 to RM5,000. She needs to do 4 to 6 cycles first and then we will see what happen after that.

Reluctant Q & A Session at RM 100

C: When you ask such questions, did you see if the oncologist was happy to answer you?

D: He seemed very reluctant and uneasy. Appeared like he had the answer and he did not have the answer. Also appeared like wanting to answer and not wanting to answer.

C: How long was your consultation?

D: About an hour and his consultation cost RM 100.

C: Wow, that’s great! One hour! I am indeed very surprised that he gave you so much time. You as patient, need to ask and ask the doctor such questions before undergoing any treatment. Be empowered and don’t be dumb. Now, go home and read this comic book::

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(See https://cancercaremalaysia.com/2014/04/14/info-about-lung-cancer-ignorance-kills/)

I have written many books but many people find reading difficult. Some people don’t want to read. Now, I make comic books instead so that you don’t have to read too much. You can finish reading this book within an hour. So go home and read this. Learn from the stories of these people. Be empowered – be smart. Example, if you take Iressa and this cost you RM 8,000 per month. So, for a year, that would come to about RM 90,000. But can it cure you? No! In addition you have to suffer from itchiness, etc.

Opted for Chemo at Government Hospital

C: Your head – bald? Why?

D: She had chemo at the government hospital in January 2014. She completed 4 cycles – each cycle at 3 weeks interval.

C: Did you suffer?

Patient: Not very bad. I was constipated. My head and some parts of my body became itchy.

C: Did you have to pay for the chemo?

D: Yes, RM 50 per cycle. They used Gemcitabine (Gemzar) + Cisplatin. After the fourth cycle, the CT scan showed stable result.

C: Okay, at least you did it at the GH and did not have to pay so much. If you were to do it at a private hospital, it could cost you anywhere from RM 4,000 to RM5,000 per cycle. (Note: For comparison, a patient from Indonesia has 12 cycles of chemo (same drugs – Gemcitabine + Cisplatin) in a private hospital in Singapore. The total bill came to RM 0.5 million. And the treatment also failed. See: https://cancercaremalaysia.com/2014/04/24/two-billion-rupiah-chemo-and-surgery-failed-oncologist-said-more-chemo-you-just-have-to-trust-me/ ).

Do more chemo, and more chemo – until you die?

Patient: The tumour did not grow bigger. It did not get small either.

D: The doctor said my mother had to take Iressa or Tarceva as a follow up. I again asked how long must my mother need to be on this oral drug. The answer: It all depends on the patient. When Iressa becomes ineffective, she will go for chemo again. So we decided not to take the drug.

C: It seems that you are going round and round the same road.

D: You do the chemo.  Then you take oral medication. Then go for chemo again. Then take oral drug again.

C: Did you ask when can you stop the treatment?

D: No, no idea.

C: Oh, see how long can you stand the treatment? Then until you die?

D: Exactly.

C: So they are being honest with you. You need to know that there is no cure for lung cancer – even with chemo!

Take Home Lessons From This Case

1. There is no cure of lung cancer. The oncologist acknowledged that.

2. But of course, there is treatment (provided you have the money to pay for it, or are willing to endure the side effects).

3. According to the oncologist, take oral drug – Iressa or Tarceva. You will suffer less side effects.

4. Iressa or Tarceva does not cure. It may cost you RM 8,000 per month. And it may be effective for one or 2 years only.

5. When you have reached the dead end with oral drug, go for i/v (injection) chemo which also cannot cure.

6. Then, if you are still alive and still have the money to spend, go for oral drug again.

Have plenty of money to splurge?

You have an option to go to Singapore  — go to the best and the famous. There they may also give the same stuff, chemo with Gemcitabine (Gamzar)  + Cisplatin. That seems to be the gold standard.

A patient from Indonesia paid about RM 500,000 (half a million ringgit!) for 12 cycles of that stuff. Result: miserable failure. https://cancercaremalaysia.com/2014/04/24/two-billion-rupiah-chemo-and-surgery-failed-patient-said-ill-die-not-because-of-my-cancer-its-because-of-the-chemo/

Another Indonesian, was treated with one oral drug after another interspersed with chemo, over a period of about 3 years. He spent about half a million ringgit as well. Result: just the same failure and the cancer got worse. https://cancercaremalaysia.com/2013/11/29/lung-cancer-chemo-experiments-that-failed-and-failed/

Yet another Indonesia had chemo after chemo and spent about one million Singapore dollars and he died after about 2 years of treatment.

I have learned something interesting from this case study. If you wish to try your luck with chemotherapy but do not have the money to splurge, you still have a chance! Go to the (Malaysian) government hospital. This patient (SS) paid only RM 50 for a cycle of chemo with Gemcitabine + Cisplatin. For 4 cycles she only paid RM 200 — compared to half a million ringgit in Singapore! After all they use the same toxic drugs anyway! And the result is just the same,  FAILURE – wherever you go!

If you want to opt for less hefty medical bills, then go local.  Only that  you don’t get to become the patient of the best and the famous.  The husband of one lung cancer told me he spent about RM 300,000 over 2 years on his wife’s treatment. HIs wife took Iressa and had chemo after chemo. She died just after her husband came to see us.