Part 2: The Impact of High Cancer Cost on Patient & Family

George T and M. S.Baliga in their paper Generic Anticancer Drugs of the Jan Aushadhi Scheme in India and Their Branded Counterparts: The First Cost Comparison Study. Cureus 13 (11): e19231 (doi:10.7759/cureus.19231) wrote:

  • The costs of cancer drugs are exorbitant and cause significant financial toxicity  to the affected patient and their family members.
  • Considering this, Jan Aushadhi pharmacy stores were established across the country by the government of India with the objective of providing cheap generic medicines to patients.

Indeed it is laudable for the Indian government to take such concrete steps to help the ordinary poor folks of the country.

In an article Unaffordable treatment ( Max Klein and Jörg Schaaber wrote:

  • According to the World Health Organization, medication for a woman with breast cancer costs $ 18,500 a year in India and $ 33,900 in South Africa. In both countries, that amounts to about ten times the average annual income.
  • Though prices are higher in the USA, treatment there only costs 1.7 times more than the average annual income.
  • In Ethiopia, the most widespread form of cancer is breast cancer. It is a death sentence for most of the affected women: about two-thirds die. In Germany, by contrast, two-thirds survive.
  • About half of Tanzania’s people live below the international poverty line of $ 1.90 a day. Sometimes, a cancer drug is even more expensive in poor African countries than in Germany.
  • In high-income countries, over 80 % of children with cancer survive for more than five years, in poorer countries their share is below 30 %.

Van Minh Hoang et al ( analyzed the household financial burden and poverty impacts of cancer treatment in Vietnam. They wrote:

  • As the costs of treatment for cancer are usually substantial, many households and individuals with cancer are facing financial catastrophes or are even pushed into poverty because of the costs.

Wenqi Fu and many fellow researchers  ( studied the Effects of cancer treatment on household impoverishment in China. They wrote:

  • The financial burden of cancer treatment imposes a significant risk of household impoverishment despite wide coverage of social health insurance in China.

Alifah Zainuddin in an article The Real Cost Of Cancer In Malaysia ( wrote:

  • The cost of treatment is also increasing … denying access to treatment to the very people who need them.
  • The estimated cost to treat cancer in Malaysia can go up to as high as RM395,000, though prices may vary based on the type of cancer, with different private hospitals charging different rates.
  • Example: For patient living with metastatic or advanced breast cancer:
  • Targeted therapy drug costs over RM6,000 per month for each cycle.
  • Chemotherapy drug costs more than RM5,500 every three weeks.
  • PET scan –  RM3,000 per scan.

In a paper Financial toxicity in Indonesian cancer patients & survivors: How it affects risk attitude

Stevanus Pangestu & Erwin Bramana Karnadi ( wrote: 

  • In Indonesia, cancer accounted for 13% of mortality in 2014.
  • Financial toxicity is a term used to describe the harmful financial burden faced by patients receiving cancer treatment.
  • The costs of cancer treatment in Indonesia remain high, and this circumstance may lead to financial toxicity. Health insurance does not eliminate financial distress among patients with cancer.
  • There should always be a proper physician-patient communication regarding the costs and affordability of cancer care.

In a paper Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: results from a longitudinal study in eight countries published in MBC Medicine ( the authors wrote:

  • The Association of Southeast Asian Nations (ASEAN) region consists of ten countries – Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam – and is home to over half a billion people.
  • The burden of cancer is increasing in the ASEAN region, due to population ageing and growth and the adoption of cancer-associated lifestyle behaviours.
  • Survival rates for most cancers are poor and quality of life is greatly impaired.
  • Cancer can have a profound economic effect on individuals and their households, especially among the poor and under-insured.
  • A cancer diagnosis in Southeast Asia is potentially disastrous, with over 75 % of patients experiencing death or financial catastrophe within one year.

ASEAN Costs in Oncology study ( discovered that:

  • 12 months after the (cancer) diagnosis, 29% of the patients had died and 48% experienced financial catastrophe.
  • The society has to be educated about the importance of  accomplishing financial security and
  • leading a healthy lifestyle.
  • As always, prevention is better than cure.

Cancer Situation In The United States Of American  – The Richest And Most Advanced Country.

Lastly, let us have a look at what the situation is in the United States – supposedly the most advanced and richest country in the world.


Part1: High Cost of Cancer Treatment

Part 2: The Impact of High Cancer Cost on Patient & Family

When a person is diagnosed with cancer, his/her world is often turned upside down. A cancer diagnosis impacts the patient in various ways:

  • Physically – pain, suffering, unable to walk etc.
  • Emotionally – how much time do I have? I cannot afford to die yet, my children are still small.
  • Financially – generally no one talks about this and the family suffers in silence.

The financial toll of cancer is seldom publicly discussed although it is a very important issue indeed. Is this subject a taboo in our Asian culture?

But let us face reality. Why don’t we discuss this issue and try to understand how to mitigate the impact of this financial burden. So, in the coming weeks/months, I shall be presenting you with a series of articles on this subject.  

Let us examine how cancer impact us financially. There are 4 main costs involved:

1. Consultation and Diagnosis.

Realizing that something is not right, it is important that you go and consult a competent doctor and find out what is exactly wrong with you. So be prepared to pay the following costs:

a. Consultation fee.

b. Blood test.

c. Imaging procedures like ultrasound, mammogram, CT scan, PET scan.

d. Biopsy.

A patient who had breast cancer did the above diagnostic procedures in a private hospital in Penang. It cost her RM 10,817. Take note, this is before any treatment is done yet.

2. Treatment Costs – outpatient and/or hospital stay.

The gold standard of medical treatment for cancer is: Surgery, Radiation and Pharmacological therapy.

Some patients receive all the three treatment modalities, while others receive one or two types.  The cost to the patient vary depending on the type and extent of the treatment.

Some “advanced or modern” hospitals may offer other treatments such as:

  • stem cell transplant,
  • hyperthermia,
  • photodynamic therapy,
  • cryotherapy,
  • immunotherapy,
  • mini-invasive interventional therapy,
  • particle implantation or particle knife,
  • radiofrequency ablation (RFA),
  • photon knife therapy.

The cost of any one of these therapies varies. So it is good to find out your financial obligation. Take note that for treatment in a private hospitals, every item used costs money. Every service provided costs money. Nothing is for free in there. For example:

  • You pay for a cotton bud if that item is used.
  • You pay a fee for the chair you sit on while undergoing chemotherapy.
  • Each time the doctor comes into your room and say “hello”, he/she collects a profession fee.

A patient with prostate cancer was hospitalized for 8.5 days in a private hospital in Kuala Lumpur. The total hospital bills came to RM47,159. Just imagine what the bill would be like if the stay was extended to a month or more? A cool RM200K?

A breast cancer patient underwent a total mastectomy without reconstruction at a private hospital in Hong Kong. The total bill came to HK$257,298 or RM155,139.

So cancer treatment in a private hospital is not cheap!

Drugs for Cancer.

Medication is a very common part of cancer treatment.

  • chemotherapy drug,
  • targeted therapy drug,
  • immunotherapy drug,
  • hormone therapy  drug,  
  • other drugs for pain, anti-nausea and other complications.

Some of these drugs can be taken as pills while some others are administered intravenously (IV) in a doctor’s office, clinic or hospital.

Some drugs appear to be affordable to the ordinary folks but some others may cost a bomb. For example:

  • A lung cancer patient received 24 injections of Imfinzi – an immunotherapy drug. Each injection cost IDR 40 Million or RM12,000. The total cost of 24 injections means IDR 960 Million or RM 288,000. The treatment failed and he came to seek our help.
  • A breast cancer patient was told to receive 17 times of immunotherapy treatment after her surgery. Each treatment is going to cost her RM15,000 or a total of RM255,000. Her son said the family does not have that kind of money and gave up.

Generic Drugs from India.

One aspect on cost of chemo drugs that many of us may not know is that, we are lucky and need to grateful to have India and Bangladesh to supply generic chemo drugs for the world. Without these generic drugs the cost of chemotherapy would have shot up sky high!

What are generic drugs? The US-FDA said:

  • A generic drug is a medication created to be the same as an already marketed brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use.
  • A generic medicine works in the same way and provides the same clinical benefit as the brand-name medicine. In other words, you can take a generic medicine as an equal substitute for its brand-name counterpart.

According to the Pharma Intelligence Center, as of 26 February 2021, there are currently 1,351 generic drugs available in India for the treatment of various cancers.

According to the US-FDA, generic medications can cost, on average, 80 to 85% less than the brand-name equivalents.  That is a great saving indeed and would help the poor folks of the developing countries. Thank you India!

According to the website  (

  • The average cost of chemotherapy in India is INR Rs. 18,000 per session. This is equivalent to RM1,030.
  • The maximum charge for chemotherapy in India is about INR Rs. 50,000. This is equivalent to RM2,862.
  • The total costs of chemotherapy vary between INR 138,974 and INR 208,462. This is RM 7,954 and RM11,931.

A lung cancer patient had chemotherapy in one cancer hospital in Penang. The drugs used were:

  • Krabeva – a generic form of Avastin
  • 5-FU, and
  • Irinotecan – a generic by Intas.

He paid (as of August 2022) RM6,738 per cycle. Compare this to the costs in India!

3. Non-medical Cost. Besides the cost of treatment and hospital stay, there are some “invisible” costs such as:

  1. Transportation and travel costs. Although the cost of transportation may seem trivial compared to treatment, these expenses can add up quickly, especially if you seek treatment away from your hometown. These costs could include gas, tolls, parking, taxis, bus, train, or airplane fares, besides cost of hotel / apartment and food while away from home.
  • Lost wages or income. Some patients must stop working temporarily or permanently, or reduce their work schedules. All these can have serious financial repercussions.

4. Survivorship Care Costs.

We need to know that even when a patient has completed his/her  surgery, radiation and/ or chemotherapy, the costs of care do not end immediately.

Many cancer survivors may have to deal with certain cancer symptoms and the side effects of treatment. That can last for months to years after finishing the treatment – sometimes for the rest of their lives.

The costs may involve:

  • Visit to the doctor for regular check-up.
  • Some patients may suffer various side-effects, such as fatigue, difficulty in movement or many other symptoms and may need assistance such as:
  • supportive or palliative care,
  • rehabilitative therapy,
  • mental health services,
  • nutrition counseling, and
  • cardiology consultations as a result of their cancer or treatments.
  • Some patients may need to pay for helpers to care for themselves or for their children while at home.

Cost of Chemotherapy For Colon-Lung Cancer in Penang

Harry underwent surgery of his Stage 3B colon cancer in Hospital A in Penang. However, after the surgery he underwent 8 cycles of chemotherapy in Hospital B, also in Penang . Harry handed me his the medical bills for two cycles of chemotherapy that he received.

1.The chemo done on 20 January 2022 costs RM 6,624.50

2. The chemo done on 16 February 2022 costs RM 9,856.30

Based on the above, the average cost of a cycle of chemo is RM8,240.40. So we can guess that Harry had to spend a total of RM65,923 for the 8 cycles of chemotherapy to treat his colon cancer.

Unfortunately, the cancer did not go away. Six months after the completion of his chemo treatment, the cancer recurred in his lung. Harry was told to undergo more chemo. This second round of chemo is estimated to cost him RM66,000. Harry refused the treatment.

Let us try to understand what makes chemotherapy such an expensive treatment and why this is being promoted everywhere as the only “proven” treatment modality.

The itemized costs of chemotherapy are as below:

There are many things we can learn from the above table.

1. By wanting to “kill” the cancer, we need medicine to repair the damaged body as well.

There are 3 types of chemo drugs used for treating Harry’s cancer.

  1. Eloxatin or oxaliplain.  This cost RM 1,653 per cycle.
  2. TS-1 (Tegafur + Gimeracil + Oteracil). This cost 1,390 per cycle.
  3. Raltitrexed (Tomudex). This cost RM 4,140.

Since chemo drugs can cause damage to the body, patients are give drugs that can help “repair” that damage. These are not cancer drugs.

  1. Netupitant  and palonosetron. This drug in capsule is to be taken by mouth about 1 hour before the start of chemotherapy with or without food. This drug is a combination of netupitant and palonosetron and  is used to prevent nausea and vomiting caused by cancer chemotherapy. This cost RM 630.60 per cycle.
  • Pegfilgrastim or Pelgraz. One common side effect of chemotherapy is neutropenia or low levels of neutrophils (a type of white blood cell). Pelgraz is used to help fight infection following chemotherapy.  This cost  RM 1,210 per cycle.

Other non-cancer drugs administered to Harry were:

  • Chlorpheniramine. This is a antihistamine used to relieve symptoms of allergy, hay fever and the common cold. These symptoms include rash, watery eyes, nose, throat, skin, cough, runny nose and sneezing.
  • Dexamethasone. This is a corticosteroid and is used to treat many different inflammatory conditions such as allergic disorders and skin conditions.
  • Dextrose injection. This is used for nutrition support to treat low blood sugar and to decrease high potassium levels in the blood.
  • Diphenoxylate and atropine. This combination of drugs is used to treat severe diarrhea.
  • Esomeprazole or Nexium. This drug reduces the amount of acid your stomach makes. It’s widely used to treat indigestion, heartburn and acid reflux, and gastro-oesophageal reflux disease.
  • Granisetrom or Kytron. This drug is used to prevent nausea and vomiting caused by chemotherapy and radiotherapy.
  • Itopride or Ganatron. This drug is used  to treat symptoms of functional dyspepsia, i.e. patients having difficulties digesting food. Patients feel full after eating; they have bloating and have stomach pain.
  • Loperamide or Lomodium. This is a drug to treat diarrhoea or runny poo.
  • Pantoprazole.  This drug is used to treat heartburn, acid reflux and gastro-oesophageal reflux. It is also taken to prevent and treat stomach ulcers.

Just ask yourself. Before going into the hospital for chemotherapy, do you have the above 11 conditions that need medication? If no, why do you need them when undergoing chemotherapy?

2. You help me, I help you! That makes everybody happy. Then the project will have the full support of all interested parties.

For each cycle of chemo delivered to a patient the doctor earned about 7.5% to 11.4% of the total cost of the treatment. The more chemo he/she gives to patients the money more he/she earns. Good – the oncologist is well rewarded and should be happy.

On the other hand about 88% to 92% of the treatment cost goes to the hospital. So all parties should be happy.

Total cost of chemo treatmentHospital’s  earningDoctor’s earning
Jan. chemo – RM 6,524.505,779.50 (88.5%)745.00 (11.4%)
Feb. chemo – RM 9,856.309,111.30 (92.4%)745.00 (7.5%)

From the gross earning, the hospital needs to spend on cost of equipment, laboratory charges, room charges for treatment, nursing care , medical supplies and cost of drugs.

Other parties that are happy when you undergo chemotherapy are the companies that make the drugs and medical supplies. They too have a share of the pie.

Hospital charges of each chemo treatmentCost of chemo drugCost damage control drugsCost of other drugs and medical supplies
Jan. chemo – RM 5,779.503,043 (52.6%)102.70 (1.7%)193.00 (3.3%)
Feb. chemo – RM 9,111.305,793 (63.6%)666.50 (11.4%)211.00  (2.3%)

3. Nothing is for free in the private hospital.

For everything that is used in your treatment, know that you need to pay for it. There is no free lunch, except the natural air that your breathe in! Yes, if you need oxygen while in the hospital, you have to pay for it.

In one institution, I learned that you need to pay for the chair that you sit on while undergoing chemotherapy.

A careful look at the medical bills, you will know that the alcohol swab, gloves, face mask, gown, plaster, etc. used during your treatment have to be paid for too.

There is one item that attracted my attention which I was not sure what it means –  Cytotoxic/Chemo Reconstitution. A check in the internet gives this explanation.

  • A process in preparing a ready-to-use form of chemotherapy agent for the patient.
  • Some drugs must be stored in powdered form because they rapidly lose their power once they are mixed into a solution. These drugs will then have to be reconstituted, or mixed with a liquid or diluent, before they can be administered.
  • Before starting reconstitution, ensure that SOPs are adhered to – Hand-washing – Gloving – Gowning – Reconstituting – Disposal of waste products.

For each chemo treatment a patient pays RM 95.00 for this process. So nothing is for free!

Let me come to the last point. Everyone involved in chemotherapy are happy! The oncologist earns good income.  The hospital has a good share of the pie too (88% to 92%). Of course, the drug companies make good profit from the chemo treatment (52% to 63% of hospital’s earning). The important party that is not asked or forgotten, is the patient! Was Harry happy after receiving 8 cycles of chemotherapy? His metastatic lung cancer came back after six months. Do you think he was happy?

Eight & A Half Days In A Private Hospital Cost RM47,159.70 – worth it?

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

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

Vaccination history.

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

Admission to Hospital B in Kuala Lumpur.

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

1. Blood test.

 19 September 202224 September 2022
Platelets502   (High)534   (H)
Alkaline phosphatase208   (High)190   (H)
PSA7,652  (High)7,292 (H)

2. PET scan – 20 September 2022.

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

There are multiple small lung nodules scattered in both lungs,

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

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

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


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

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

3. Multiple bone metastases.


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

The Total Medical Bill

Let us look at the medical bills critically.

1. Doctor Charges

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

  • Doctor made 15 visits.

The first visit was RM230.

Subsequent 12 visits cost RM100 per visit.

Two other visits cost RM150 per visit.               

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

2.  Hospital Charges

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

1. Administration charges  $45

2. Chemo drug

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

3. Equipment charges  RM395.00

4. General medical supplies RM 554.10

5. Imaging procedures

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

6. Laboratory  RM 802

7. Medical record RM18.00

8. Miscellaneous RM 110.00

9. Pharmacy  –  total cost RM5,667.10.

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

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

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

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

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

Lessons We Can Learn From This Case

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Johnny Came To Seek Our Help

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

He was prescribed the following herbal teas for his:

  • prostate cancer
  • bone cancer and
  • lung cancer.

. In addition he was given herbs for his:

  • stomach gas and
  • frequent urination.

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

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

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

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

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

C: Still cannot walk?

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

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

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

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

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

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

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

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

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

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

Up date: My Pa looks better. Leg stronger.

Think hard:

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

The Shockingly Hight Cost of Breast Cancer Treatment

Lian (not her real name) is a 65-year-old lady from one of the  Riau islands of Indonesia. I received an email from her son Henry (not real name):

  • My mother felt something in her breast. It was getting bigger from mid-2021.
  • This is about 2 months after she got vaccinated.
  • I brought her to Jakarta in October 2021 for a check-up. An ultrasound in Jakarta showed the diameter of the  tumour in her right breast is 2 cm.
  • Recently she felt pain and I brought her to Hospital A, a private hospital in Penang, last week to do another check-up.
  1. Blood tests.

Her full blood picture, liver function test and tumour markers were all within normal range.

  • USG.

Ultrasound Right Breast:

  • A solid lesion with irregular margins seen at about 6 o’clock position (above) measuring about 2.9 x 2.7 x 2.7 cm. This is suspicious of a malignancy.
  • There is a solid lobulated lesion measuring about 0.7 x 0.5 x 0.7 cm at about 2 o’clock position, about 1.8 cm from the nipple. this contains some calcifications.
  • An enlarged right axillary node measuring 1.9 x 1.2 x 1.8 cm shows loss of normal fatty hilum (above). A few other smaller right axillary nodes also show loss of normal fatty hilum.
  • Mammogram of right breast.
  • There is a distinct lump in her right breast.
  • PET scan.
  • No focal FDG-avid lesions in the head and neck region,  lung parenchyma lesions, chest wall lesions, mediastnal nodes or hilar masses.
  • An FDG-avid mass measuring 2.9 x 2.7 cm in the right breast.
  • An FDG-avid right axillary node measures 1.8 x 1.3 cm. Small nodes are seen around this. No other FDG-avid axillary nodes seen. 
  • Biopsy.
  • Right breast lump, core biopsy (6 o’clock): Invasive carcinoma of no special type (NST), grade 3.
  • The tumour cells are negative for oestrogen, progesterone and Her2 receptors.

Lian was told that due to the “big” size of the tumour, she had to undergo chemotherapy first before her surgery. The family was unhappy with the idea of undergoing chemo before surgery. So they decided to go home without any further treatment!

Costs Of Diagnostic Procedures

Henry said:

  • I spent around RM 10,817 in Hospital A. This costs include the following:
  • PET scan which is around RM 4,600.
  • RM 3,000 for mammogram, blood test and ultrasound.

Before and after the surgery Lian needs to undergo chemotherapy and immunotherapy.

  • For chemo, it is RM 5.000 each time and she must take 8 times, every 3 weeks. Total cost RM40,000.
  • For Immunotherapy, it is RM 15,000 each time and she needs to receive the treatment about 17 times for a year. Total RM255,000.
  • I was told that this is a triple negative cancer  – so must undergo  immunotherapy (antibody) besides chemotherapy to avoid the cancer’s return.
  • The cost for chemo + immunotherapy is very expensive. We couldn’t afford to do it.

Told About CA Care

Henry wrote:

  • When we were back home from Penang, my cousin told me about you. He heard from his friend named Pak Edy who suffered bowel cancer 12 years ago and he got treatment from you
  • And later, my sister also talked with our neighbour. Coincidentally, her mother is also taking your herbs. Her mother took your herbs since last year.

At this point I received an email from Henry.

Good evening, Doctor,

The biopsy indicated the cancer is a triple negative and it is a Stage 2 cancer.Hopefully you can give us some advice on what we must do to cure her disease.

The reason why we are trying to find other alternative is because we can’t afford to do the chemo and immunotherapy which is very expensive. If we need to see you in Penang, I will try to arrange the time to meet your schedule.

Reply:  Any woman who has breast cancer — had biopsy but refused to remove the whole breast is just STUPID — AMAT BODOH. You must remove the breast now. You cannot just keep it there. Do a total mastectomy i.e., remove the cancerous breast totally.

This is a triple negative cancer type — dangerous! After you remove the breast, come and see me after 2 weeks. I would not see people who do not remove their cancerous breast.

Hi Doctor,

Thank you for the quick response doctor. Do you have any recommendation for the hospital to do the mastectomy? Because if we go back to Hospital A, we would be asked to do chemo and immunotherapy first, then do surgery after that.

Reply: Okay, go to Dr. B in Hospital B and see what he has got to say.

Hi Doctor,

We took action very quickly after we got your advice. I tried searching for some hospitals which are reachable by sea and bus from our hometown.The first option is hospitals in JB. However, there is no breast cancer specialist in JB. Then I found in a breast cancer specialist in Hospital M in Melaka.  We did teleconsultation by video at the beginning. The doctor said that the tumour seems not so big from the report I sent to her.Therefore, she asked us to meet her in Melaka to see whether or not we can do the surgery without chemo first.

The first estimated cost for mastectomy in M Hospital RM 12,000. Since my mom also needs to remove another tumour in her left breast then the cost will come to around RM 15,000.

The estimated cost of surgery in Hospital A in Penang is RM 20,000. This is only the cost for surgery excluding room charges.

Again, thank you so much for your quick response. Really appreciate it.

Oct 19, 2022. Hi Doctor,  Good afternoon.

My mother has done the mastectomy yesterday Oct 19th without chemo in Melaka.

Oct 21, 2022. Hi Doctor,

My mom was discharged from hospital this afternoon and everything seems to be okay. Herewith I attached the hospital bill for your reference.

  1. Total hospital charges                                 RM10,039.71
  2. Doctors’ fees                                               RM  6,499.27
  3. Surgeon               RM3,988.00
  4. Anaesthesia               1,490.15
  5. Lab services                  477.12
  6. Radiology services      544.00

                              Total cost of mastectomy + lumpectomy RM 16,538.98

Lessons We Can Learn From This Case

  1. Get your bearing right. I am really glad that Lian took an immediate step to have the cancerous lumps removed from her breasts. If these lumps were allowed to grow in there, they will eventually burst and could give rise to more problems. Over the years, I have seen patients who came to me with “rotten” breasts. They have the mistaken idea that herbs or supplements can make the cancerous tumour in their breast go way. Wrong!
  • Chemo before surgery – different experts have different opinions! Lian was told to undergo chemotherapy before surgery. She refused chemo and went home rather “lost”, that is after spending RM 10,817 for the diagnostic procedures in Penang. My advice to her son was: Go and find another doctor! I am happy that she found one doctor in a Melaka Hospital to do the surgery without having to do chemo first. 
  • Before agreeing to the treatments, know what you are getting into. The standard protocol to treat breast cancer is: surgery, followed by chemotherapy and/or radiotherapy. But now, the latest option being offered to patients is immunotherapy which costs a “bomb”!

You may want to ask: How effective is immunotherapy?  This is answer that I got from the internet:


From the very beginning Lian and her son were given some idea of what the total cost of the treatment is going to be like. Surgery would come to about RM30,000, chemo RM40,000 and immunotherapy would cost her at least RM255,000 or a quarter million ringgit. The family could not afford that. This is indeed sad.

Over the years many patients who came to seek our help told me that they had to sell a house or a piece of land to pay their medical bills. I also had patients who spent RM30K and had no more money. They just packed off and went  home – giving up the idea of receiving medical treatment in Penang.

  • Ask if the treatments like chemo and/or immunotherapy are going to cure your cancer. Spending money is one thing, the most important question we need to ask is – what would be the outcome of the treatment after spending a quarter million ringgit? Is the cancer cured? Unfortunately, no one can guarantee a positive outcome. Unfortunately too, some patients would NOT want to know the answer to this all important question! Over the years, I have seen many failures  — money lost and patient ended up with severe side effects of the treatment.

Dr. Norah Lynn Henry wrote an article Immunotherapy for Breast Cancer Treatment: Is It an Option? ( She said:

  • One challenge of immunotherapy is not knowing who is likely to benefit from the treatment.
  • Second, immunotherapy can cause substantial side effects, including life-threatening ones. The most common side effects are skin reactions, such as redness and blistering, and flu-like symptoms, such as fever, nausea, weakness, and body aches. Different types of immunotherapy can cause different side effects.
  • An important third challenge is the high cost of this treatment.
  • Beware, the cost of treatments differ from hospital to hospital. Lian went to Hospital A in Penang.  She had to spend RM 10,817 on diagnostic procedures! That is before the actual surgery which would cost another RM20,000 plus.

Just a few months ago, one patient had a total mastectomy at Hospital B in Penang. In total she spent only RM15,000. Take note, Hospital B is said to be a non-profit (privately funded) hospital. But be reassured the surgeon who did the mastectomy is just as competent and well known as others in Penang. In fact, this surgeon is one of the two doctors I would recommend that you go to if you have breast cancer. Remember again, expensive does not necessarily mean it is better!

  • Beware of the overuse of diagnostic procedures, overuse of PET scan, over treatment, etc. Take a close look at what Lian had to undergo in preparation of her surgery – she did a blood test, ultrasound, mammogram, PET scan and finally biopsy. All these procedures contributed significantly to the total cost of RM10K. Let me just pose one question – are ALL these procedures absolutely necessary? For some procedures the answer is yes, but not for all of them.  Let me not give my own opinion on this  but quote what other medical experts say …..

Shannon Brownlee et al in an article Evidence for Overuse of Medical Services Around the World ( wrote:

  • We use the term overuse to refer to any services that are unnecessary in any way and for any reason.
  • Overuse (of medication, diagnostic tests, therapeutic procedures) is a global problem that afflicts rich and poor countries alike.
  • In the United States, estimates of spending on overuse … range from 6% to 8% of total health care spending.
  • Around the world, overuse of some individual services may be as high as 80% of cases.

Kelsey Chalmers et al ( wrote:

  • Overuse is defined as the delivery of tests and procedures that provide little or no clinical benefit, are unlikely to have an impact on clinician decisions, increase health care spending without improving health outcomes, or risk patient harm in excess of potential benefits.
  • Although clinicians are responsible for ordering tests and treatments, their practice patterns may be influenced by hospital policies and culture.

A report by AACC – formerly known as the American Association for Clinical Chemistry ( said:

  • Overuse of laboratory tests is a chronic problem.
  • Study finds up to 70% of lab tests in a hospital setting are likely either clinically unimportant or unnecessary.

In an article Understanding over-imaging ( Laura Sussman wrote:

  • The American Society of Clinical Oncology (ASCO) recommended against the use of CT, positron emission tomography (PET), tumor markers and nuclear bone scans in early-stage breast cancers.
  • Carlos Barcenas, M.D., points out that the recommendations of the National Comprehensive Cancer Network — the gold standard for treatment guidelines — clearly state that for women with early disease, the proper procedures for diagnosis only include mammograms, ultrasounds, clinical exams and blood work.
  • “Often doctors think they’re not being good to their patients if they don’t do all they can by way of testing,” explains Giordano, chair of Health Services Research. “But there’s a shift in focus to doing what matters for the patient and what’s proven to improve outcomes, rather than testing for the sake of testing.”

Caroline Helwick in an article PET Scans Not Recommended for Most Patients with Breast Cancer: Potential New Controversy in Breast Cancer Testing (  wrote:

  • According to the updated 2010 practice guidelines of the National Comprehensive Cancer Network (NCCN), the work-up of patients with early breast cancer should not include imaging by positron-emission tomography (PET) or by PET/computed tomography (CT) scanning.  The NCCN Breast Cancer Panel gave a thumbs down for the use of this modality in a number of settings.
  • PET or PET/CT can be helpful in some cases of stage III disease in which standard staging studies are equivocal or suspicious, but it should not be routine in the staging of newly diagnosed stage I, II, or operable stage III breast cancer, the Breast Cancer Panel concluded.
  • The implication of our recommendations is that PET/CT is overused in breast cancer,” said Robert Carlson, MD, of Stanford Cancer Center, Palo Alto, California.
  • “What is fueling the overuse? I don’t really know. It is simple to order, but it is very expensive. So there are financial issues in terms of rewards for physicians who perform them frequently.
  • Our society assumes that any technology with a high price tag has value, but the newest technology is not necessarily the best technology,” Dr Carlson said.

Breast Cancer: A story from China

GT is a 35-year-old single lady from China. About a year ago (in July 2018) she felt a lump in her left breast. She was asked to do a biopsy and probably followed by an operation. She refused.

GT works as a sales assistant in a health food company. She sells health drinks that are said to boost the immune system. Her boss gave her these “health foods” and she took these for about three months. No, the lump in her breast did not shrink.

GT then turned to TCM – Traditional Chinese Medicine. She consulted a TCM doctor in the hospital.

Chris: The TCM doctor did not ask you to operate and remove the lump in your breast?

Translator: The doctor said, “don’t cut.”

C: Did the TCM doctor say he can cure you?

Translator: Yes. This doctor is quite famous.

C: No, he did not know and he gave wrong advice!

GT was on TCM medications for almost a year. And these did not work for her either.

GT went back to the TCM  hospital again. She did a CT scan. The lump in her breast had grown bigger, to 3.8 x 1.8 cm. The cancer had spread to her lungs and bone. Unfortunately, GT did not bring along her CT scan so I am not able to see the extent of her metastasis.

C: What did the doctor say after the CT scan?

T: She was referred to other “bigger” hospital for treatment. But instead of going to the hospital she decided to fly to see you in Penang.

GT presented with breathlessness and severe coughs which make it difficult for her to sleep at night. Otherwise, she looked fine. The lump in the breast is hard and intact, not lacerated.


My advice

  1. If you were to see me earlier when you first discovered the lump, I would have asked you to remove the lump.
    This is the safest way for you. If you keep the lump in your breast it will grow bigger and one day it will burst. Do you like your lump to be like the picture below?

  1. In addition to the painful and ugly wound like above, the cancer will spread. It goes to the lymph nodes, lung, bone, liver and finally brain. So you don’t want to take such risk. The longer the cancerous lump is in your breast the higher is the risk that it will spread elsewhere.
  2. You are only 35 years old. You should not take such risk. Also, my experience showed me that breast cancer in young person tend to be aggressive. So, don’t take any chance.
  3. Now, the cancer has already spread to your lungs and bone. I don’t know how extensive it is because you did not bring along your CT scan.


I felt very sad after hearing her story. I was also upset. She was not given the “right” advice. Now her condition had deteriorated with such an “extensive” metastasis. I am afraid her recovery or survival is very slim. And this poor lady flew all the way from China to see me. What can I do? What did she expect me to do for her? That was exactly the question I asked her that morning.

GT’s reply was rather modest. She wanted me to help her with her coughs. I was glad that she did not ask me to cure her! No, I cannot cure her cancer! To help her, may be but not cure.

I spent time talking to GT trying to find out what could be the underlying problems that could have contributed to her breast cancer.

My advice to her that morning:


  1. Physical stress: Her life is too stressful. GT works from 9 a.m. to up till mid-night sometimes. She stays by herself in the city. GT’s boss suggested that she takes a long leave from her job. Yes, I fully agree with that. GT cannot survive for long under such stress.
  2. Emotional stress: What about emotional stress? GT admitted to having problems with her boy friend and she had broke off that relationship. But, she has a lump in her left breast — could it be due to a female rather than a male? GT admitted that a very close female friend had betrayed her. This had upset her very much but GT said that emotional stress has dissipated with time. I said this to GT: Learn to let go — don’t keep any ill feelings in your heart.
  3. Family support: Her parent’s home is about 4-hour-away by bullet train. Life must be hard for GT having to stay alone in a city without any family support. I suggested that GT go home and stay with her parents. She agreed.
  4. Diet: You can imagine what she eats everyday under the above situation. I can guess it cannot be healthy food every day. Unfortunately, the TCM doctor did not give good advice on this important matter. GT was told not to eat sea food and chilly. After much reading and receiving feed backs from our patients, I came to this conclusion: a) Don’t take anything that walks, including eggs and dairy products. b) No sugar c) No oily or fried foods d) Banana is bad for lung problems.
  5. Herbs bitter and awful taste: Our herbal teas are bitter and have awful taste. She needs to brew each of the teas. It takes time and effort. Will she be able to cope with that? I know most patients cannot!
  6. Monitoring: GT needs constant monitoring. After a month, I need to know how she progresses. Herbs need to adjusted. This means, GT may need to come and see me again. Or she needs to take more herbs after she finishes this first round of teas. Staying in China, how can we overcome this problem? Actually this is the problem facing most patients — even for those who live just a few hour’s drive from us. For such people, I never get to see them again after their first visit. What a waste of time and money.
  7. Financial burden: At CA Care, consultation, no matter how long it takes, is free of charge. However, we request patients to pay for the herbs. Since we started CA Care more than two decades ago, the price of our herbal teas never increase in price (in spite of the inflation). We try to be as charitable and helpful as we can. But, we understand that for GT, even flying to Penang from China cost her a lot of money. How nice if there is such a set up like CA Care in her own hometown! For GT, sad to say that I would probably not be able to see her again.


Not too long ago, I read two news reports about cancer treatment in China that make me feel real sad.

There is a movie, Dying to Survive, which has become a billion-yuan-success after being released in July this year. It is based on a  real-life story of  Lu Yong, a Chinese textile trader and leukemia patient. He imported less expensive generic drug from India and sold it to his fellow Chinese patients. Lu helped thousands of Chinese patients. Sadly, he was arrested and jailed in 2014 for doing such “illegal” activity.

This movie, Dying to Survive tells the same story in a more dramatic way.  It featured an owner of an Indian Miracle Oil Store — Cheng Yong —  who found out  that the Indian-made generic leukemia drug, Gleevec,  was sold at only 500 yuan in India. In China the authentic Gleevec is sold at 40,000 yuan, eighty times more expensive.

Lured by great profit, Cheng smuggled  the unlicensed drug to China and sold to Chinese patients at 2,000 yuan. He made good profit and he was also regarded as a hero by many cancer patients who can’t afford the original version of the expensive Gleevec. Looks like he is a real modern day Robin Hood.

Cheng became rich. He then decided to stop the drug smuggling business. He opened a garment factory. However  a large number of patients became desperate as they were forced to sell their houses or everything they have to pay for the expensive Gleevec. That prompted Cheng to change his heart, and renew his smuggling business. This time he even sold the drug only at just 500 yuan to save lives. Unfortunately, he was arrested and jailed for five years.

Note: Gleevec is developed by Novartis. In the US patients need to pay up to US$100,000 for the drug a year without government or insurance subsidy.


I got hit by another heart-breaking story. Tang is a 26-year-old doctor in Central China. He was diagnosed with oesophageal cancer, three years after graduating and starting to work. He underwent surgery to remove the tumour but declined further medical treatment.

In China, doctors like Tang, earn an average of 63,000 to 77,000 yuan (US$ 10,000 to 12,200) per year. Tang just could not afford to pay for the expensive, follow up medical treatments.

On day, Tang decided to mysteriously disappear from home. He left behind his bank cards and a letter to his parents saying they would end up having to “spend all your savings and even run into debt just for dragging out my miserable existence for a few years at best. If I let you face the financial burdens and the sorrow of losing a child in your late years, it would be a sin for which I should die a thousand times. I also don’t want to live like a near dead person for the rest of my life. So please forgive me … I’m an unworthy son, and I will pay back your love in my next life.”


After the above two stories, here I was sitting  in front of a 35-year-old lady from China who has breast cancer. I felt sad and frustrated. And this propels me to write this article.

What can we learn from these three stories?

  • The movie, Dying to Survive, has stirred discussion on the accessibility of cancer drugs and treatments in China. The original drug imported from the US are extremely expensive. But there are generic (or copy cat) drug from India which is much, much cheaper. But unfortunately smuggling cheaper drugs into China is illegal.
  • The movie has highlighted the exorbitant cost of healthcare. Not only in China, it is the same elsewhere in the developing countries. The cost of cancer drugs are being dictated by the “Cancer Establishment” of the developed nations.
  • The reality about cancer treatment is well understood by Tang, the 26-year-old cancer patient who is himself a medical doctor. After surgery, the next course of action generally is chemotherapy or/and radiotherapy. Based on his note to his parents — these treatments cost a lot of money. But will these treatments cure him? Unfortunately no.
  • Again in his note Tang explained to his parent the need to “spend all your savings and even run into debt just for dragging out my miserable existence for a few years at best. I also don’t want to live like a near dead person for the rest of my life.”
  • How many people understand what Tang wrote or understand the reality of the present day, medical cancer treatment? Cure is elusive — at best for some cancer you extend your life for another few months or years. From the experiences over the past two decades, I come to the conclusion that no one on earth can really CURE cancer. Read more here:

Second, cancer treatment is expensive.

Third, the side effects of treatments are severe and “killing.” Is it worth it?

  • But, what bugs me most is this — does this need to happen in China?

I think there is NO reason to. Why can’t the Chinese develop a much cheaper method of healing cancer? Why is there a need to depend on the expensive medical drugs imported from the US or elsewhere? I believe China can come up with a novel healing method of treating cancer if the Chinese doctors, researchers and entrepreneurs are not obsessed with following what the Western world is doing. Don’t follow others, develop your own way!

  • For more than two decades, I have devoted my life to helping cancer patients by using herbs, diet and lifestyle changes. There is nothing new about this approach. Through the ages, the Chinese sages have been telling us about this.

To the old Chinese, Indian and those who live in east, we are brought up to understand this culture very well. Unfortunately, the younger generations who come after us have failed to learn that heritage. We live like there is no tomorrow and eat “bad, branded food” introduced by the Western world — as a result metabolic diseases like diabetes, heart problem and cancer are on the rise.

  • Yes, China has the wisdom about promoting healthy life. Yes, there is TCM (Traditional Chinese Medicine) in China but I think the way it is practised needs improvement!  The story as related by this 35-year-old breast cancer from China is indeed pathetic. From her story it is clear that she did NOT get the “proper advice” for her breast cancer. This could be the result of ignorance — either of her doctors or herself.
  • Over the past two decades I have helped thousands of cancer patients without having to use those expensive drugs from the Western world. The irony is that I first learned how to help cancer patients by studying TCM on my own. Since I don’t read Chinese, I had to rely on books written in English by non-Chinese authors. Oh, how I wish I can read Chinese! In spite of his handicap, we at CA Care have done extremely well. There are some 1,000 video clips about our work in YouTube. I have written more than 700 articles about cancer healing which you can read in my blog:

Here are a few examples of our work:

  1. Hopeless case of breast cancer  from Hong Kong:
  2. Colon-liver cancer:
  3. Endometrial cancer from Australia:
  4. Melanoma-Lung:
  5. Sarcoma: Don’t do chemo you die, you do chemo also die.
  6. Cancer of the Tonsil: I outlived my two doctors!:
  7. Lymphoma Twenty Years Ago. Still alive and healthy. Is that quackery and scientifically unproven?:
  8. Ovarian-Lung Cancer: Told at most three months to live after surgery & chemo:

If I can do this in Malaysia, why can’t the Chinese do the same in China. After all, my approach to managing cancer is based on the wisdom of the old Chinese healing masters. I started with a blank mind. Then I started to read and read and read about TCM. I used my “scientific mind” to select what are useful and leave out what I thought are dubious. In other words, I develop my own method. I don’t  blindly follow  the “standard procedures.”

If Jack Ma can make Alibaba into such a great success story, I am sure there are many others like him who can also do the same with cancer. I think the real problem is to apply the right knowledge. This unfortunately is not easy  — yes, there are many doctors, sinseh and researchers in China but are they really THINKERS and INNOVATORS who know how to apply their knowledge correctly? Or are they just following “cookbook” protocols when practising their trade?

One last word about working with cancer. Cancer treatment of today is more about making  money and much less about making the patients well. This is what the “Cancer Establishment” of the developed countries is all about. So beware.

Frances M. Visco, the president of the National Breast Cancer Coalition wrote:

  • Breast cancer patients are tired of “breakthrough” therapies that do not extend life for even a day but do bring millions of dollars to industry, medical institutions and the doctors who care for us … The answer is clear, just stop circling the wagons focusing on financial gain and fame.


This is my basic principle I uphold right from the very beginning when I founded CA Care — to succeed we need dedication and compassion. If we go in there just for money — and only money — we would fail miserably. I am afraid in the Western world, cancer is indeed about money and making more money… that is why it fails so badly.

Read more here:

Let us not forget what the Great Chinese Sage and Physician, Sun Simiao said,

  • Whenever eminent physicians treat an illness … they must be free of wants and desires, and they must first develop a heart full of great compassion and empathy. They must pledge to devote themselves completely to relieving the suffering of all sentient beings.

I believe there are enough “kind and generous souls” in China or in this part of the world who want to help their fellow citizens in need. Approach cancer treatment as a noble mission to help others in need.

Some random quick facts about cancer problem in China

  • China has a massive population of 1.37 billion. Cancer is the leading cause of death in China and is a major public health problem.
  • In China in 2015: estimated 4,292,000 new cancer cases and 2,814,000 cancer deaths. Lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death.


  • China has an immense cancer problem. The most common types of cancer in males were those of the lung (21.7%), stomach (19.5%), and liver (18.1%). Source: Cancer Biol Med. 2012 Jun; 9(2): 128–132.
  • In China, cancer rates are exploding … Last year, more than four million people were diagnosed with the disease and nearly three million died from it. Every day, hundreds pour into (hospitals) from all over China. People wait months for a doctor’s appointment, but often it is too late for treatment and the cancer is too advanced.


  • Breast cancer is the most common cancer among women in China … the cancer has increased at a rate of around 3.5% a year from 2000 to 2013, compared with a drop of 0.4% a yearover the same period in the US.
  • Breast cancer rates are higher in urban areas of China than in rural areas. And the higher the population density, the higher the rate.


P/S: It is sad to note that this young lady, GT died about two weeks later.




How Much Longer Will We Put Up With $100,000 Cancer Drugs?

  • Of 91 new therapies approved for solid tumours between 2002 and 2016, the median overall survival benefit was little more than two months. 
  • Yet the annual price tag per patient now regularly exceeds $100,000.

 European School of Oncology

Paul Workman, Giulio Draetta, Jan Scellens and Rene Bernards wrote an article, How Much Longer Will We Put Up With $100,000 Cancer Drugs? DOI:

  • The spiraling cost of new drugs mandates a fundamentally different approach to keep lifesaving therapies affordable for cancer patients.
  • As early as 2012, 12 of the 13 newly-approved cancer drugs were priced above $100,000 annually, and the situation has only gotten worse since (Light and Kantarjian, 2013, Mailankody and Prasad, 2015). For instance, the cost of the combination of nivolumab (anti-PD-1) and ipilimumab (anti-CTLA4) is priced around $252,000, exceeding the median cost of a US home ($240,000 in 2016).
  • With a lifetime risk of developing cancer of close to 40%, the problem is clear.
  • The pharmaceutical industry has traditionally defended these high prices by pointing at the high attrition rate during clinical drug development and the cost of large registration studies.
  • If development cost would be a major factor in the pricing structure, a simple law of economics would have mandated a considerable reduction in price when the eligible patient population increases, but that has hardly happened.
  • This is a recurring theme in pharma. For instance, trastuzumab was first approved for advanced breast cancer and later also for early disease (adjuvant) without a reduction in price. Healthcare payers should not accept this lack of price-volume relationship.
  • Moreover, there is very little relationship between drug price and clinical benefit (Mailankody and Prasad, 2015). This has sparked widespread criticism, alleging that cancer drug pricing is primarily based on “what the market will bear.” 
  • There is a clear and urgent necessity to lower cancer drug prices to keep lifesaving drugs available and affordable for patients. As one patient advocate recently put it: “Innovation is meaningless if nobody can afford it.”
  • Much has been written about the reasons behind the exorbitant drug prices and what to do about it. One recurring theme is the notion that the US federal government is prohibited by law from negotiating drug prices as a result of the 2003 Medicare Prescription Drug, Improvement and Modernization Act.
  • Considering that Medicare and Medicaid spend $ 140 billion on medicines annually, this represents a serious impediment in driving down drug prices. Lack of competition and a general absence of a connection between drug price, sales volume, and clinical performance are other arguments in the drug pricing discussion (Jaffe, 2015).
  • Indeed, lack of competition and bargaining power made US prices of cancer drugs among the highest in the world, increasing by 10% annually between 1995 and 2013, far above the average inflation rate (Howard et al., 2015).
  • While negotiations may bring prices down, a recent cost comparison in EU countries shows that the ability of individual nations to negotiate discounts is limited, most likely due to the modest market sizes of the EU countries (van Harten et al., 2016).


Beware the Medical-Industrial Complex

Stevens CW1Glatstein E.   Oncologist. 1996;1(4):IV-V.

  • “. we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military industrial complex.” Dwight D. Eisenhower, 34th President of the United States (1953-1961). Farewell Address, January 17, 1961.
  • If Ike were with us today, he might well expand his views on power and influence to include modern American medicine. The corporatization of health care in the United States has moved rapidly in recent years.
  • New developments in cancer treatment include expensive technological “bells and whistles” which physicians must ultimately evaluate objectively, despite lush advertisements from companies with obvious vested interests, and authoritative testimonials from biased investigators who presumably believe in their own work to the point of straining credulity and denying common sense.
  • The 3-D image that was created by a computer may look beautiful (and cost accordingly), but it is hard to believe that it can fundamentally change the outcome of patients when it does not add any new data that bear on basic issues.
  • Thus, new equipment will be exploiting issues of convenience, efficiency, and increased throughput (translate: economic improvement, not biological superiority).
  • We must remember that every new therapy costs money ….
  • Improvement in cancer cure rates has been frustratingly slow. We work against a clever, tenacious adversary – both in the clinic and in the corporate board room. It is our responsibility to tout our accomplishments, admit our failures, and provide progressively better basic and clinical research with an eye toward future improvements in outcome. We must not be seen as yet another special interest come to drink at the well of public spending, but as advocates for the public good.


The prince and the pauper. A tale of anticancer targeted agents.

Dueñas-González A1García-López PHerrera LAMedina-Franco JLGonzález-Fierro ACandelaria M.   Mol Cancer. 2008 Oct 23;7:82. doi: 10.1186/1476-4598-7-82.

  • Cancer rates are set to increase at an alarming rate, from 10 million new cases globally in 2000 to 15 million in 2020.
  • Regarding the pharmacological treatment of cancer, we currently are in the interphase of two treatment eras. The so-called pregenomic therapy which names the traditional cancer drugs, mainly cytotoxic drug types, and post-genomic era-type drugs referring to rationally-based designed.
  • Although there are successful examples of this newer drug discovery approach, most target-specific agents only provide small gains in symptom control and/or survival, whereas others have consistently failed in the clinical testing.

There is however, a characteristic shared by these agents: their high cost.


Anticancer Drug Development: The Way Forward.

Connors T1. Oncologist. 1996;1(3):180-181.

  • Cancer chemotherapy celebrated its fiftieth anniversary last year. It was in 1945 that wartime research on the nitrogen mustards, which uncovered their potential use in the treatment of leukaemias and other cancers, was first made public.
  • Fifty years later, more than sixty drugs have been registered in the USA for the treatment of cancer, but there are still lessons to be learnt.
  • One problem, paradoxically, is that many anticancer agents produce a response in several different classes of the disease. This means that once a new agent has been shown to be effective in one cancer, much effort is devoted to further investigations of the same drug in various combinations for different disorders.
  • While this approach has led to advances in the treatment of many childhood cancers and some rare diseases, a plethora of studies on metastatic colon cancer, for example, has yielded little benefit. 5-fluorouracil continues to be used in trials, yet there is no evidence for an increase in survival.
  • The lesson to be learnt is that many common cancers are not adequately treated by present-day chemotherapy, and most trials of this sort are a  waste of time.
  • Significant increases in survival will only occur if the selectivity of present-day anticancer agents can be increased or new classes of more selective agents can be discovered.



Part 3: You should not continue with your medical treatments if you have run out of funds.


SF had already spent around RM 150,000 for her treatment. She said her financial reserve was running low. My advice: You should not continue with your medical treatments if you have run out of funds. It does not make sense to give up half way through the treatment due to lack of funds. Think carefully.



C: We are here not just to sell our herbs. We want to help people. We want to open their minds to new possibilities. We want them to think for themselves and not led by the nose — jumping into a bottomless pit and at the same time leaving a big hole in your bank account.

So let me ask you this — what do you hope to get from rounds and rounds of treatment. I guess you want a cure, right? Unfortunately, from what I read and know, there is no cure for cancer. So first, understand that there is no cure for your cancer. Second, these treatments are going to bring you more sufferings. Third, you will have to spend a lot more money.

So Ibu (mama) even if you undergo another round of treatments, I don’t see how you are going to be able to solve your problem. After the radiation and chemo, you needed an operation if the tumour shrinks. If the tumour does not shrink, you will go for more and more chemo. So your journey does not end yet. It may just be the beginning of another long journey. Please think carefully.

Many Indonesians who came to see me underwent medical treatments without asking any question or much thinking. After undergoing the treatment half-way, they said: I have no more money. So I don’t want to continue with the treatment.  My response was: Why are you so dumb. If you don’t have enough money to go through the entire course of treatment, why did you ever start with the treatment in the first place?

There was this 35-year-old lady from Palembang. She had breast cancer and underwent a mastectomy. After the operation, she was asked to undergo chemotherapy, radiotherapy, and be on oral medication. The total cost of these treatments came to about RM200,000. I asked her: Do you have money to pay for this treatment? Her reply, No.

Yes, I understand a 35-year-old cannot be expected to have RM200,000 in her bank account. So even if she wanted to undergo the recommended treatment, she could not. So, I said to her, It’s okay. No need to do the treatments. There is no point undergoing the treatment half-way and then stop!

Did you understand what I am trying to tell you?

P: I understand.

C:. This is one important point I want you to consider now. In the next 2 days you need to go for chemo. You were told you needed 3 cycles initially. Okay, how much will that cost? Then calculate the cost of your stay in Malaysia. After that you need to go for an operation. What is the cost of that surgery?

Husband: RM 25,000 for the surgery alone.

C: Okay, RM 25,000 plus 3 x RM4,000 for the chemo and previously RM6,700 for the radiation. After the surgery you may need more chemo, and more chemo. Consider all these costs. I don’t know about your financial status. So you need to make a decision after careful consideration.

Is the chemo and surgery going to cure you or bring your more sufferings?

P:  I don’t want any more chemo or surgery. I only want you to help me. The doctor said he would remove my right kidney together with the ureter (tube that carries the urine from the kidney to the bladder).

C: What is going to happen to you after that? They will fix a tube. And one kidney gone.  Do you really want to undergo such treatment?

P: At first I didn’t want.

C: What is the purpose of removing these? Think first! One important question to ask. Will the doctor be able to remove all the cancer inside you? And after the operation it is all clean and the cancer would not come back again? Can surgery do that? What happen if after the surgery the cancer becomes more aggressive and spreads more widely.

Learn from nature — for example the ant’s nest. What happen if you take a parang and cut the nest into two? What if you leave the nest undisturbed?

P: All the ants will spread out.

C: I am not an expert in cancer but I use my head to think. And I also want you to think properly. Now, after you have just received 3 sessions of radiation, you had diarrhea. That bothered you a lot. You have not even started with your third rounds of chemo yet. You have already had 12 cycles of chemo and I don’t know what can happen to you if you have more chemo. You may end up dead?  Again, if the tumour does not shrink this time around, you will need more and more chemo. When will that end?

Do you understand what I am trying to tell you?

P: Before this, I don’t understand. I just accept what I was told to do. I don’t know that there is another way out.

C: No, there is NO way out of this.

P: I know. Everything is in God’s hand.

By all means, sell your house or land to pay for the medical bills if the treatment is going to cure you!

C: There is this young man who came to see me. His mother had lung cancer and had gone to China with a few of her friends for treatment. After the first trip to China, the mother ran out of money. She wanted to sell her house in which 5 of her children were living in. The son came to seek my advice. My answer: If you sell the house and your mother is cured, that’s okay. Worth the gamble. But what happen after all the treatments — money gone, and she is not cured? House gone, mother dead? And the children left out in the street without a home to go to.

My advice was not to go to China for the treatment anymore. She survived 3 years after following our therapy. She had a normal life and was able to help her son in his motor-bike repair shop. Her friends who had money and continued with their treatments in China were ALL dead.

I have no magic potion for your cancer

C: I want you to think carefully. If I just want to sell you my herbs, I would have asked you to buy all that you need and go away. Why talk so much and so long? But the mission of CA Care is to help others. That is why I want you to go home and think carefully first. There is no need to take the herbs now. Why? Because in two days time you want to start with your chemo. Go and do your chemo first.

Our herbs are no magic potion. Healing cancer takes more than just drinking herbs. Cancer is about human being — the need to change your attitude, life style and diet. I am not asking you not to go for chemo. I just want you to give a careful thought to what I have said.

Husband: You have opened our minds. I begin to understand what is happening now.

P: I did not understand all these before.



Blood test: Different lab different result


BS is a 47-year-old male who was diagnosed with colon cancer in December 2014. He underwent a surgery in hospital A in Penang. It was a Stage 2A cancer. No chemo, radiation or medication was recommended.

About a year later,  21 January 2016, BS underwent another procedure to remove 2 polyps in his colon. A CT scan was also done and the results were not good:

  1. There were multiple nodules in both lungs. The largest one measures 1.2 cm. This is not see in the previous scan.
  2. There was a small cyst in segment 3 of his liver, measuring 1.1 x 1.1 cm.

The above findings are consistent with metastases. BS was asked to undergo chemotherapy and also take the oral drug, Xeloda. He refused and decided to take our herbs and take care of his diet. Later, BS also told us that he went to Bali to learn how to meditate (, which I believe did him a lot of good.

To monitor his progress, BS did a full blood test on 14 July 2016 in a private laboratory. The results was good.

Alpha-fetoprotein = 2.1, CEA = 2.7, CA 19.9 = 29.6 and CA 125 = 6.2.

Three months later, 18 October 2016, BS did another full blood test in a private hospital. The results was not good.

Alpha-fetoprotein = 1.38, CEA = 9.1, CA 19.9 = 17.96

His CEA has increased from 2.7 three months ago to 9.1. BS felt upset and disappointed. We discussed what had happened. For the past month, BS had been under extreme stress. His young nephew was robbed and murdered. Apart from that, he slacked on his diet. My advice to BS. Don’t worry so much for now. Try and relax and let’s see what happen in the next three months. We shall repeat the blood test.

But to be sure, I suggested that BS repeat this CEA test with a private lab which we always send our patients to and which he went to earlier. So BS repeated the same CEA test the next day, 19 October 2016.

Lo and behold, CEA from the private lab returned a normal value of 2.5, which is more than 3 times lower than the results obtained by the private hospital. I then suggested that BS repeat this same test in his hometown. The result was CEA = 8.4. So here it goes, three different labs came up with three different numbers!

Now, what has gone wrong? And which result is the correct measure of the situation? What could have been the consequences of such mistake? No doubt about it, BS could have been told to undergo chemotherapy since the cancer has recurred. Or BS would have to do a PET scan to find out what had gone wrong. But, is it true that something had gone wrong?

I have learned not to trust blood test results since years ago. This is because my patients make me see the reality of what happened in the real medical world. One prostate cancer patient went to three labs one morning and made them evaluate his PSA level. The results from the three tests were all different! Here goes the reliability of scientific medicine.

Then, Jennifer regularly monitored her CA 125. The value was around 400 plus which was high. One day, she went to a well known private hospital in Kuala Lumpur and did her blood test. The result was shocking, her CA 125 shot up to 800 plus. Panic, she called me. This was what I told her. I think the result from that private hospital was wrong! Someone must have made a mistake!. To know the truth, repeat the test. Jennifer went to a university hospital. Her CA 125 was back to 400 plus — similar to the previous level.

What can we learn from these episodes? Patients pay for the mistakes that other people in the hospital make! So patients, BEWARE. Just imagine, in panic Jennifer could has been sent for chemotherapy immediately because of the mistake made by someone in the lab.

How serious and how often things like this happen is for anyone to guess! Indeed sad. Ponder the quotations below and always be on guard!






Why do cancer drugs get such an easy ride?

BMJ 2015350 doi: (Published 23 April 2015)Cite this as: BMJ 2015;350:h2068

Donald W Light, professor and Joel Lexchin, professor 

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

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

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

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

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

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

and to READ MORE ….. Article access for 1 day: Purchase this article for £23 $37 €30 *

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

From Highly priced cancer drugs get rushed approvals despite poor trial methodology and little effect on the longevity of patients, cautions York University Professor Dr. Joel Lexchin in the School of Health Policy and Management.

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

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

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

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

From: How Effective Are Newer Chemotherapy Drugs?

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



RM 2,830 lost for not wanting to proceed with radiotherapy

TT was diagnosed with cervical cancer. She underwent an operation to remove her uterus, ovaries and omentum. She was then referred to an oncologist who recommended both chemotherapy and radiotherapy. TT was not at peace at all about undergoing these invasive treatments but she did not have any other choice. She consulted with the oncologist three times and was assured that everything would be okay and that chemo and radiation were her only option — nothing else. During her second meeting with her oncologist, TT was told to pay RM 13,000 as a deposit for her radiation treatment.

Someone told TT about CA Care. TT and her husband decided to forgo further medical treatments. TT went back to hospital and cancelled her appointment for her radiotherapy. What then happened to the RM 13,000 deposit?  Can TT get a refund? Listen to this video.


Gist of what TT and her husband said.

  1. They were angry. Why don’t you want to go for radiotherapy? We are still unprepared!
  2. For your RM 13,000 deposit, we could only refund you RM 4,500. The remaining amount is forfeited.
  3. Why must I lose that much money for just not wanting to go for radiotherapy? We have not started with any treatment yet?
  4. Husband started to take pictures of the person. When I go back to Indonesia, I shall report this to the mass media
  5. Okay, okay be patient. Let me consult.
  6. You have to pay for the oncologist’s fee — RM1,700 and the cancer hospital fee is RM 6,000 plus.
  7. The treatment has not even started yet. Why so expensive? It was only the nurse who made some markings. We did not even see the doctor yet.
  8. TT and her husband was referred to the finance department. They demanded to know: Why must I lose so much money just to cancel the treatment? Your hospital comes to Indonesia for publicity. What I can do is to go home and tell the press about this. Okay, you can have your RM 8000 plus, return me my RM 4,500. It is okay. I am not a poor man. I can come to Penang for treatment means I can afford it.
  9. The hospital called up the cancer hospital and after some discussion said: Hang on for 10 minutes. We have miscalculated.
  10. The actual figure: RM 2,830 to be forfeited to cover the following cost:

HospitalBill Tiu Tjin Tjhin

Question: Do you mean that by just asking a patient to go for radiotherapy the oncologist earned RM1,700 up front?  Even when no treatment was given?

When you saw the oncologist three times for consultation, did you pay him any fee? Yes, of course, we paid him RM 60 for each visit. So, this RM1,700 is over and above his consultation fee.

The hospital earned RM 1,130 for putting marks on my tummy!


We have nothing much to say about this episode. Just feeling sad. Reflect on the quotations below and perhaps we all can learn something about the present-day “so-called-noble-profession.”

Medicine a business

As I was writing this story, there is this news report … if there is anything we can learn from this story it this: Before you proceed with any treatment, ask these important questions first:

  1. Can the treatment cure me or not?
  2. What are the risks and side effects?
  3. What will that cost me in total — financially and emotionally?

Don’t get caught up with the idea of wanting to only win. Know that you can lose the “battle” badly as well. In this case below: Imagine, daughter had an operation, (did the parents ask — can cure or not? can win?), then she was paralyzed, hospital bills came to more than RM 2 million !!!, parents declared bankrupt (besides the frustration and heartaches). That is not wining at all. So patients, beware.

Penang Adventist Hospital ordered to pay couple RM6 million

FMT Reporters:  July 15, 2015

See more at:

The couple were earlier declared bankrupt after they could not pay the hospital RM2.35 million in unsettled medical bills.

GEORGE TOWN: The Penang High Court has ordered the Penang Adventist Hospital (PAH), a private centre, to pay RM6,023,802 in damages to the parents of a 18-year-old paralyzed girl.

The victim’s parents, Kee Boon Suan and his wife Ang Mooi Sim from Nibong Tebal, filed the suit three years ago. The High Court had ordered the couple in 2011 to settle RM2,350,013.85 due to the hospital in unpaid bills. The court order led the couple to be declared bankrupt.

In his verdict on the medical negligence suit here on Tuesday, Judicial Commissioner Nordin Hassan said he found PAH and three doctors had committed medical negligence during a spinal surgery performed on Kee Jun Hui on June 4, 2008.

He said the patient’s parents were also not briefed by the doctors-in-charge on the surgery details.

He said the hospital was responsible for the negligence acts by the doctors-in-charge and nurses, who had breached their duties and duty of care to the patient.

Nordin said PAH orthopedic surgeons Dr. Cheok Chee Yew and Dr. Wong Chung Chek neglected their duties after performing the surgery on Jun Hui.

He said the patient had collapsed several times during the post-surgery recovery period while still under the hospital’s custody.

He said anesthetist Dr. Patrick K. S. Tan neglected his duties and failed to instruct hospital nurses to attend to the collapsed patient after being informed of Jun Hui’s inability to move her limbs.

M.S. Dhillon, Rhina Bhar and K.B. Karthi represented the plaintiffs while Mahindra Singh Gill acted for the hospital.

All three doctors were represented by legal counsel J. A. Yeoh.

Mahindra later told newsmen that PAH would appeal against Nordin’s judgment at the Court of Appeal.

In 2011, PAH originally hauled Kee and Ang to court for failure to settle their medical bill for Jun Hui’s surgery.

In 2012, the couple sued the hospital for medical negligence, as their daughter was paralyzed after the surgery.

The hospital was named the first defendant in the suit followed by Cheok, Patrick Tan and Wong.





The cost of cancer drugs

Lesley Stahl discovers the shock and anxiety of a cancer diagnosis can be followed by a second jolt: the astronomical price of cancer drugs

  • And as anyone who’s been through it knows, the shock and anxiety of the diagnosis is followed by a second jolt: the high price of cancer drugs.
  • They are so astronomical that a growing number of patients can’t afford …..

Dr. Leonard Saltz: We’re in a situation where a cancer diagnosis is one of the leading causes of personal bankruptcy… We’re starting to see the term “financial toxicity” being used in the literature. Individual patients are going into bankruptcy trying to deal with these prices.

“I do worry that people’s fear and anxiety’s are being taken advantage of.”

Lesley Stahl: The general price for a new drug is what?

Dr. Leonard Saltz: They’re priced at well over $100,000 a year …  And if you figure one drug costs $120,000 and the next drug’s not going to cost less, you’re at a quarter-million dollars in drug costs just to get started.

Dr. Saltz’s battle against the cost of cancer drugs started in 2012 when the FDA approved Zaltrap for treating advanced colon cancer. Saltz compared the clinical trial results of Zaltrap to those of another drug already on the market, Avastin. He says both target the same patient population, work essentially in the same way. And, when given as part of chemotherapy, deliver the identical result: extending median survival by 1.4 months, or 42 days.

Dr. Leonard Saltz: They looked to be about the same. To me, it looked like a Coke and Pepsi sort of thing.

Then Saltz, as head of the hospital’s pharmacy committee, discovered how much it would cost: roughly $11,000 per month, more than twice that of Avastin.

Another reason drug prices are so expensive is that according to an independent study, the single biggest source of income for private practice oncologists is the commission they make from cancer drugs. They’re the ones who buy them wholesale from the pharmaceutical companies, and sell them retail to their patients.

Dr. Hagop Kantarjian: High cancer drug prices are harming patients because either you come up with the money, or you die.

“They are making prices unreasonable, unsustainable and, in my opinion, immoral.”

When we asked Novartis why they tripled the price of Gleevec, they told us,… When setting the prices of our medicines we consider … the benefits they bring to patients … The price of existing treatments and the investments needed to continue to innovate…”

The challenge, Dr. Saltz at Sloan Kettering says, is knowing where to draw the line between how long a drug extends life and how much it costs.

Lesley Stahl: Where is that line?

Dr. Leonard Saltz: I don’t know where that line is, but we as a society have been unwilling to discuss this topic and, as a result, the only people that are setting the line are the people that are selling the drugs.

Read more:


Articles from the Internet: How Safe Or Unsafe Are Medical Imaging Procedures?

Yeong Sek Yee & Khadijah Shaari 

To understand more about the radiation risks from medical imaging, we recommend that you read the following articles posted in the Internet.  Just Google topics like the dangers of medical/diagnostic tests, etc, etc. There are plenty of materials to read. Here are some examples.

1.       Medical Radiation Soars, With Risks Often Overlooked

Radiation, like alcohol, is a double-edged sword. Radiation can reveal hidden problems, from broken bones and lung lesions to heart defects and tumors. But it also has a potentially serious medical downside: the ability to damage DNA and, 10 to 20 years later, to cause cancer. CT scans alone, which deliver 100 to 500 times the radiation associated with an ordinary X-ray and now provide three-fourths of Americans’ radiation exposure, are believed to account for 1.5 percent of all cancers that occur in the United States.

Although the cancer-causing effects of radiation are cumulative, no one keeps track of how much radiation patients have already been exposed to when a new imaging exam is ordered. Even when patients are asked about earlier exams, the goal is nearly always to compare new findings with old ones, not to estimate the risks of additional radiation.

Read more:

2.       Radiation Risks from Medical Imaging

The FDA has put forward its plan to reduce unnecessary radiation exposure from CT scans, nuclear medicine studies, and fluoroscopy.

An individual’s chance of getting cancer from a single scan is small. But because the scans are so widely used, they cause a considerable amount of harm. One study estimated that the CT scans performed in 2007 are related to some 29,000 future cancers.

What are these tests? What are their risks? When do the tests’ benefits outweigh their risks? Here are WebMD’s answers to these and other questions.

How much radiation does a person get from medical imaging studies?

  • Getting a CT scan gives a patient as much radiation as 100 to 800 chest X-rays.
  • Getting a nuclear medicine study exposes a patient to as much radiation as 10 to 2,050 chest X-rays.
  • Getting a fluoroscopic procedure exposes a patient to as much radiation as 250 to 3,500 chest X-rays.

Moreover, doctors may prescribe scans that aren’t medically justified. And since risk from radiation exposure accumulates over a lifetime, certain scans may not be appropriate for people who’ve already had a lot of scans.

Read more:

3.       Dangers of Medical Imaging Tests and Procedures

Exposure to medical imaging radiation is a concern in both adults and children. However, radiation exposure in children is of a greater concern because they are more sensitive to radiation than adults. In addition, children have longer life expectancy than adults. With repeated exposure or accumulated exposure to radiation, children may be more likely to develop health problems in the future.

Life time risk of developing cancer increases when a patient undergoes more frequent X-ray exams and at larger doses, according to the FDA. Women who are exposed to the radiation may have higher lifetime risk for developing radiation-associated cancer than men after receiving the same exposures at the same ages.

While experts believe that the risk of developing cancer with radiation exposure is relatively small, radiation exposure through these medical imaging tests should never be taken lightly.

Read more:

4.       A Closer Look: The Downside of Diagnostic Imaging

CT and nuclear medicine tests do have a downside, however: they deliver doses of ionizing radiation from 50 to over 500 times that of a standard x-ray, such as a chest x-ray or mammogram. Scientists have raised concerns that such large doses of radiation plus the widespread and increasing use these diagnostic procedures may, in a small but significant way, pose a cancer risk in the general population.

“The use of CT in particular has gone up dramatically, and we’ve drastically lowered the threshold for using it,” said Dr. Rebecca Smith-Bindman, a visiting research scientist with NCI’s Radiation Epidemiology Branch (REB). “There’s a general belief that if you get a CT scan, you must be reasonably sick and must really need it. This is no longer true, and we are increasingly using CT scans in patients who are not that sick. There’s been drift not only in how often we use it but in how we use it.”

“We’ve only talked about the benefits of CT for the past 20 years, without considering any potential harm” she continued.

Research estimated that approximately 29,000 future cancers could be related to CT scans performed in the United States in that year alone, with women being at higher risk than men. About 35 percent of these cancers were projected to be related to scans performed in patients 35 to 54 years old, and 15 percent related to scans performed in children younger than 18. 

The medical community has proposed many ways to reduce radiation exposure from diagnostic medicine without negatively impacting the quality of patient care:

  • Reduce the number of CT exams by using other technologies (such as ultrasound or MRI) in cases where they would provide equal diagnostic quality.
  • Limit the use of CT in healthy patients who would obtain little benefit (such as whole-body CT screening).
  • Limit the use of repeat CT surveillance of patients in whom a diagnosis has already been made, when repeat scanning would lead to little change in their treatment.
  • Track and collect information on radiation exposure for individual patients

Read more:

5.       Ionizing Radiation Exposure with Medical Imaging

Medical diagnostic procedures used to define and diagnose medical conditions are currently the greatest manmade source of ionizing radiation exposure to the general population. The risks and benefits of radiation exposure due to medical imaging and other sources must be clearly defined for clinicians and their patients.

Radiation damages the cell by damaging DNA molecules directly through ionizing effects on DNA molecules or indirectly through free radical formation. A lower dose delivered through a long period of time theoretically allows the body the opportunity to repair itself. Radiation damage may not cause any outward signs of injury in the short term; effects may appear much later in life.

Medical ionizing radiation has great benefits and should not be feared, especially in urgent situations. Obviously, using the lowest possible dose is desired. In fact, a central principle in radiation protection is “as low as reasonably achievable.” Therefore, the prescribing physician must justify the examination and determine relevant clinical information before referring the patient to a radiologist. Indications and decisions should reflect the possibility of using non-ionizing radiation examinations, such as MRI or ultrasonography.

Repetition of examinations should be avoided at other clinics or sites.

The International Commission on Radiological Protection (ICRP) estimates that the average person has an approximately 4-5% increased relative risk of fatal cancer after a whole-body dose of 1 Sv.

X-rays (including CT scans) should be ordered judiciously. An article in the New England Journal of Medicine notes that the evidence is “convincing” that the radiation dose from CT scans can lead to cancer induction in adults and “very convincing” in the case of children. Clinicians need to realize that doses from a typical CT scan can range from 6-35 times higher than the dose of a standard chest x-ray examination.

Read more:

6.  Doctors Order More Tests when They Benefit Financially: Ask If You Really Need that Test Your Doctor Ordered

Researchers from the Institute for Technology Assessment at the Massachusetts General Hospital Department of Radiology found that there was no mistaking that diagnostic imaging tests were being ordered far more than they deemed necessary. The question that begs to be answered is, “why?”

Many doctors referred their patients to imaging centers that were affiliated with their practice, or were even done by the doctor’s own staff. When a physician has such a close relationship with the provider conducting the imaging study, there is the possibility that the physician will benefit financially from ordering additional imaging studies.

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7.       Radiation Danger from CT and PET Scans

A recent study in the New England Journal of Medicine has found a significant link between radiation exposure and imaging procedures such as CT and PET scans. The use of such technologies has grown from just 3 million in 1980 to 67 million in 2006, and has contributed, some estimate, to upwards of 2% of fatal cancer cases.

Studies have shown that there is little consumer understanding of the risks involved in being subject to such procedures.

Dr. Harlan M. Krumholz proffers that the use of CT scans is increasing because they have become part of our culture. “People use imaging instead of examining a patient; they use imaging instead of talking to the patient,” (New York Times, Study Finds Radiation Risk for Patients, August 27, 2009). For these reasons, imaging technologies have become a common diagnostic tool even when they are not required.

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8.       Study Finds Radiation Risk for Patients

At least four million Americans under age 65 are exposed to high doses of radiation each year from medical imaging tests, according toa new study in The New England Journal of Medicine. About 400,000 of those patients receive very high doses, more than the maximum annual exposure allowed for nuclear power plant employees or anyone else who works with radioactive material.

Dr. Rita Redberg, a cardiologist and researcher at the University of California, San Francisco, who has extensively studied the use of medical imaging, said it would probably result in tens of thousands of additional cancers. It’s certain that there are increased rates of cancer at low levels of radiation, and as you increase the levels of radiation, you increase cancer.

Dr. Reza Fazel, a cardiologist at Emory University, said the use of scans appeared to have increased even from 2005 to 2007, the period covered by the paper. “These procedures have a cost, not just in terms of dollars, but in terms of radiation risk.”

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9.      Radiation Exposure from Medical Diagnostic Imaging Procedures

Ionizing radiation is used daily in hospitals and clinics to perform diagnostic imaging procedures.

Which types of diagnostic imaging procedures use radiation?

•  In x-ray procedures, x rays pass through the body to form pictures on film or on a computer or  television monitor, which are viewed by a radiologist. If you have an x-ray test, it will be performed with a standard x-ray machine or with a more sophisticated x-ray machine called a CT or CAT scan machine.

• In nuclear medicine procedures, a very small amount of radioactive material is inhaled, injected, or swallowed by the patient. If you have a nuclear medicine exam, a special camera will be used to detect energy given off by the radioactive material in your body and form a picture of your organs and their function on a computer monitor. A nuclear medicine physician views these pictures. The radioactive material typically disappears from your body within a few hours or days.

Do magnetic resonance imaging (MRI) and ultrasound use radiation?

MRI and ultrasound procedures do not use ionizing radiation. If you have either of these types of studies, you are not exposed to radiation.

There is no conclusive evidence of radiation causing harm at the levels patients receive from diagnostic xray exams. Although high doses of radiation are linked to an increased risk of cancer, the effects of the low doses of radiation used in diagnostic imaging are not known.

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10.        Radiation Risk of Medical Imaging for Adults and Children

Which kinds of tests are associated with Ionising radiation and which ones are not?

1.  X-rays
X-rays are ionising radiation produced by equipment used in the following types of procedures:

  • Computed tomography (CT)
  • Fluoroscopy (where the image produced by the X-ray beam is made into a moving picture on a TV screen
  • Plain radiology/X-ray film, digital and computed radiography (see  Plain Radiography / X-rays)
  • Mammography (see Diagnostic Mammography)
    • The radiation exposure from having an X-ray, fluoroscopy, mammography or CT examination only occurs while the machine is on.

2.  Magnetic resonance imaging (MRI)
MRI uses strong magnetic fields and radio waves to produce images. It does not use ionising radiation (see Magnetic Resonance Imaging (MRI)).

3.  Ultrasound
Ultrasound uses high frequency sound waves that the human ear cannot detect to obtain imaging information (see Ultrasound).

4.  Nuclear medicine
Nuclear medicine is a medical specialty that involves the administration of a small amount of a radioactive material into the patient. The patient becomes weakly radioactive for a short time and images are made from the radiation given off from the patient (see Nuclear Medicine).

How do I decide whether the risks are outweighed by the benefits of exposure to X-radiation when I have a radiology test or procedure?

  • Ask your doctor about the procedure and how it will help to provide information about your symptom or the presence of disease or injury.
  • Ask your doctor about the risks of the procedure and what the risks would be of not having the procedure, i.e. if your doctor needs the information in order to identify and plan the most appropriate treatment.

While there is a small risk of harm from ionising radiation, there could be a greater risk of not having the information, e.g. failure to detect potentially serious disease that may be easily treated at an early stage but harder to treat or incurable if detected later.

It may also be as beneficial to you to confirm the absence of disease or injury as it is to confirm its diagnosis.

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11.   Radiation in Medical Imaging Has Its Risks

Almost all medical procedures, including imaging procedures that use radiation, have risks associated with them. Physicians and patients should carefully consider the potential benefits and the risks when considering the use of imaging techniques that involve radiation.

Here are some things for healthcare providers to consider when deciding whether or not an imaging procedure that uses medical radiation is the right choice.

  • What is the purpose of the procedure? For example, is it to arrive at a diagnosis, assess treatment response, or is it preventive screening?
  • Are there alternative imaging procedures that could accomplish the same goal without medical radiation, such as ultrasound or magnetic resonance imaging?
  • What are the risks of not having the imaging procedure done?
  • How old is the patient? The risks for pediatric and adolescent patients may be different than for adults.
  • Is the patient pregnant, possibly pregnant, or breastfeeding?
  • What other procedures is the patient likely to undergo during this workup?
  • What is this person’s radiation exposure from previous medical procedures? For example, has the person undergone multiple CT or nuclear medicine scans in the past?
  • What is this person’s occupational exposure to radiation, if any?
  • Will the imaging exam be performed on low-dose equipment?

The standard unit of measure for radiation absorbed by an individual is called the “Sievert,” or Sv (sometimes identified by a smaller unit called the “millisievert,” or mSv). Common medical imaging tests such as X-rays or mammograms generally expose patients to a radiation dose of less than 1 mSv.

Other procedures using CT, nuclear stress tests, or fluoroscopy-guided exams often involve radiation in the range of 5-40 mSv.

single exposure at these diagnostic levels may not pose much risk to the patient. But when a patient has numerous tests over a period of time, the cumulative exposure may raise the level of risk. To minimize cumulative exposure, physicians should determine whether a procedure using medical radiation is necessary to achieve the diagnosis or whether an alternative imaging procedure may offer the same diagnostic benefit.

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12.   How Safe or Unsafe Are Medical Imaging Procedures?

Radiation exposure is a known risk factor for cancer. Recent estimates suggest, for example, that as many as two percent of cancers could be attributed to radiation during CT scans. Although the radiation exposure from a single test is minimal, the frequency of the use of imaging tests that emit radiation continues to grow expansively, and often patients undergo repeated or multiple types of tests, thereby increasing their cumulative exposure to potentially cancer-causing radiation.

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Advice to Patients

Lately, we have noticed that certain medical centres have been urging   cancer patients to perform regular CT or PET scans (some every 3 months)  to “monitor” the progress of their cancer treatment. Sometimes some cancer patients think that such CT/PET scans are “treatment” itself. The medical establishment obviously have a financial benefit in urging you to perform more imaging/diagnostic procedures.

When deciding whether or not to perform further imaging/diagnostic procedures, we would advise you to seek answers to the following:

  • What is the purpose of the procedure? For example, is it to arrive at a diagnosis, assess treatment response, or is it preventive screening?
  • Are there alternative imaging procedures that could accomplish the same goal without medical radiation, such as ultrasound or magnetic resonance imaging?
  • What are the risks of not having the imaging procedure done?
  • What is your radiation exposure from previous medical procedures? For example, have you undergone multiple CT or nuclear medicine scans in the past?

Each time you are asked to do a CT Scan/PET Scan, be aware of the amount of radiation that would be bombarding your body and do remember that the radiation is accumulative i.e. it accumulates in your body, not the doctor’s body (except his wallet gets heavier). The following article is self explanatory:

Medical Bankruptcy in the US

After reading Steven Brill article, Bitter Pill: Why medical bills are killing us (Time magazine, 20 February 2013) I started to surf the Internet and posed some questions. Let me share with you what I found.

Frederick Allen of Forbes wrote an article: The Reason American Health Care Is Out Of Control

This is what he wrote:

Steven Brill’s Time magazine cover story last week on health care got a lot of attention for its tracking of astronomical costs in American health care back to their sources. But why are those costs so high anyway? Is it because an unfettered free market is not allowed to work when it comes to health and medicine? Quite to the contrary.  It’s partly because an unfettered free market cannot work when it comes to health and medicine … a free market can’t control those costs. It can only distort and encourage them. It makes them worse. And it isn’t even really a free market.

As Steve Brill wrote: Everyone along the supply chain—from hospital administrators (who enjoy multimillion-dollar salaries) to the salesmen, executives and shareholders of drug and equipment makers—was reaping a bonanza.

And the only free-market choice I could make at this point to bring way down my own astronomical medical costs would be the choice that was so famously given to Jack Benny: Your money or your life.

Two readers responded to Frederick Allen’s article:

  • Doctors in the US have a very powerful cartel restricting the supply of new doctors – medical school slots and residency positions are not increasing due to the demographic-driven demand. Mid-level providers (Nurse Practitioners and Physician Assistants) help meet the demand; but the barriers to becoming a doctor can’t help control prices.
  • It is very true that people shall pay anything for preserving life! This very compulsion of a patient, is exploited by everyone in the medical sector where there exists nexus between doctors and insurance companies on one hand and on the other hand another nexus exists between pharmaceutical companies and medical clinics/doctors. In their greed to milk a needy patient, every means is employed to make him pay for extremely exorbitant prices for medicines even though cheaper substitutes could be available. There must be some accountability in such matters. Medical profession has turned out to be an extremely lucrative profession in the present times. If patients are left a choice to shop for buying the prescribed medicines from adjoining Canada or Mexico, they would get exactly same named prescribed medicine, manufactured by the same company, at a much cheaper rate over there. The US. Federal government rather should give a choice to those patients who can procure those prescribed medicines at cheaper rates from Canada/Mexico etc.

I typed this question in Google search: Is the US healthcare cost-effective?

The US healthcare system is one of the least cost-effective in reducing mortality rates; while the United Kingdom is among the most cost-effective, according to a recent study published in the July issue of Journal of the Royal Society of Medicine Short Reports. The study compared the United States, United Kingdom, and 17 Western countries’ efficiency and effectiveness in reducing mortality over a 25-year period. The greatest cost-effectiveness  was found for Ireland, United Kingdom, and New Zealand  and the  least cost effective, were found for Portugal, Switzerland, and the United States.

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Umair Haque, Director of Havas Media Labs and author of Betterness: Economics for Humans  wrote:

  • Unless you’ve been living under a rock, you’ve heard by now that, where the majority of developed countries spend between 8–10% of GDP on health, America spends ~16%. Per capita healthcare costs in the States have significantly outstripped costs in other countries.
  • Why has healthcare expenditure exploded? Each component of healthcare spending has grown — but the fastest growth has come from prescription drug spending. Where people in other developed countries spend between $400 and $500, Americans spend almost $900 per capita on pharmaceuticals.
  • Americans receive less care than their counterparts in other developed nations. The US has the lowest number of hospital beds per 1,000 people amongst developed countries. And it has the smallest number of doctor consultations per capita — just 3.8, compared to Canada’s 5.8, or Germany’s 7.4.
  •  Americans pay more for healthcare because they trade more expensive products for less service, realizing poorer outcomes. Why? Because that is what maximizes near-term profits along the value chain.


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I typed this question in Google search: Is the US healthcare compassionate?

Rick Nauert, in an article: Compassion Missing in American Health Care wrote: Compassionate care is defined by the following four essential characteristics:

1. Empathy, emotional support, and a desire to relieve a patient’s distress and suffering.
2. Effective communication at all stages of a patient’s illness and treatment.
3. Respecting patients’ and families’ desires to participate in making health care decisions.
4. Knowing and relating to the patient as a whole person, not just a disease.

Compassion is as important in helping patients manage chronic and acute conditions as it is at the end of life. To improve quality and reduce costs, compassion should be present in all aspects of our healthcare system.

The survey found that only 53 percent of patients and 58 percent of doctors rate the U.S. healthcare system as a compassionate one.  Problems with the U.S. health care system include escalating costs, medical errors, inconsistent results and, according to a new national survey, a lack of compassion.

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Gordon Marino, professor of philosophy at St. Olaf College  wroteThe real US healthcare issue: compassion deficiency. Americans suffer from a compassion deficiency.

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I typed this question in Google search: Is the US healthcare money driven?

There is a movie –  Money-Driven Medicine –  produced by Academy Award winner Alex Gibney (Taxi to the Dark Side, etc.) and inspired by Maggie Mahar’s acclaimed book, Money Driven Medicine: The Real Reason Health Care Costs So Much.  The message of this movie:

  • The U.S. spends twice as much per person on healthcare as the average developed nation,  yet our outcomes, especially for chronic diseases, are very often worse.
  • What makes us the exception? The U.S. is the only industrialized nation that has chosen to turn medicine into a largely unregulated, for-profit business.
  • Dr. Donald Berwick, Administrator of the Centers for Medicare and Medicaid Services, explains: We get more care, but not better care.
  • Medical ethicist Larry Churchill doesn’t mince words: The current medical care system is not designed to meet the health needs of the population. It is designed to protect the interests of insurance companies, pharmaceutical firms, and to a certain extent organized medicine. It is designed to turn a profit. It is designed to meet the needs of the people in power.
  • As the eye-opening ads in Money-Driven Medicine reveal, the more new drugs, surgical procedures, diagnostic devices and hospital beds the health industry can produce, the more they can sell – whether we need them or not. It’s called “supply-driven demand” and it’s possible because a sick consumer can’t say no.

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In another article: 50 Signs That The U.S. Health Care System Is A Gigantic Money Making Scam That Is About To Collapse, the author wrote:

  • The U.S. healthcare system is a giant money making scam that is designed to drain as much money as possible out of all of us before we die.
  • In the United States today, the healthcare industry is completely dominated by government bureaucrats, health insurance companies and pharmaceutical corporations.  The pharmaceutical corporations spend billions of dollars to convince all of us to become dependent on their legal drugs, the health insurance companies make billions of dollars by providing as little health care as possible, and they both spend millions of dollars to make sure that our politicians in Washington D.C. keep the gravy train rolling.
  • Healthcare costs continue to go up rapidly, the level of care that we are receiving continues to go down, and every move that our politicians make just seems to make all of our healthcare problems even worse.
  • In America today, a single trip to the emergency room can easily cost you $100,000, and if you happen to get cancer you could end up with medical bills in excess of a million dollars.
  • Even if you do have health insurance, there are usually limits on your coverage, and the truth is that just a single major illness is often enough to push most American families into bankruptcy.  At the same time, hospital administrators, pharmaceutical corporations and health insurance company executives are absolutely swimming in huge mountains of cash.

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 I typed this in Google search:  Are Americans going bankrupt due to medical bill?

David U. Himmelstein, MD; Deborah Thorne, PhD; Elizabeth Warren, JD; and Steffie Woolhandler, MD, MPH are from the Department of Medicine, Cambridge Hospital/Harvard Medical School, Department of Sociology, Ohio University and Harvard Law School. They published their study: Medical bankruptcy in the United States, 2007 in the American Journal of Medicine,


What did they say? In 1981, only 8% of families filed for bankruptcy due to serious medical problem. In 2001, the author’s study showed that at least 46.2% of all bankruptcies were due to medical problems. In 2007, 62.1% of all bankruptcies were because of medical problems.

The shocking discovery: Most medical debtors were well educated, own homes and had middle class occupations. Three quarters had health insurance.

What has gone wrong? High medical bills directly contributed to their bankruptcy. Many families with continuous coverage found themselves under-insured, responsible for thousands of dollars in out-of-pocket costs. Others had private coverage but lost it when they became too sick to work. Nationally, a quarter of firms cancel coverage immediately when an employee suffers a disabling illness; another quarter do so within a year.

The authors concluded: The US healthcare financing system is broken.

CNN carried this report: Medical bills prompt more than 60 percent of U.S. bankruptcies. This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills. Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period,

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Reuters had this report: Medical bills underlie 60 percent of U.S. bankrupts: study. According to this report, medical bills are behind more than 60 percent of U.S. personal bankruptcies … healthcare reform is on the wrong track. More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts.

Dr. David Himmelstein of Harvard University said: Unless you’re Warren Buffett, your family is just one serious illness away from bankruptcy…For middle-class Americans, health insurance offers little protection.

In the New York Times, Medical Bills Cause Most Bankruptcies, Tara Parket-Pope wrote:  Nearly two out of three bankruptcies stem from medical bills, and even people with health insurance face financial disaster if they experience a serious illness. The U.S. health care financing system is broken, and not only for the poor and uninsured,” the study authors wrote. “Middle-class families frequently collapse under the strain of a health care system that treats physical wounds, but often inflicts fiscal ones.

Brennan Keller wrote in his blog: A new study done by Harvard University suggests that more than 62% of all personal bankruptcies are caused by the cost of over-whelming medical expenses. Of the most financially devastating diseases, cancer reigns supreme.

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Professor of Political Science, University of Missouri-St. Louis, Dr. Kenneth Thomas wrote: Medical Costs Help Drive United States to Highest Bankruptcy Rate in OECD.  A study published in the American Journal of Medicine shows that there was a sharp increase in the proportion of bankruptcies with significant medical causes (defined as debts over $5,000, loss of income due to health problems, or mortgaging of the debtor’s home to help meet medical expenses) between 2001 and 2007. According to their study, 46.2% of bankruptcies in 2001 were medically-related, while by 2007 the level had grown to 62.1%.


As expected, in any democratic country, there are always people who would dispute every scientific finding. Sally Pipes in her article: Medical bankruptcy: Fact or fiction?  wrote:

  • This year, a whopping 1.25 million Americans are expected to file for bankruptcy. Ask the president and his allies whom to blame, and they’ll point to healthcare. President Obama has claimed that the cost of healthcare causes a bankruptcy every 30 seconds.
  • But the alleged link between health costs and bankruptcy is about as real as the tooth fairy. The overwhelming body of research shows that medical costs play little or no role in the vast majority of U.S. personal bankruptcies.
  • Proponents of the health-cost-bankruptcy theory tend to cite a Harvard study that blames high medical bills for some 62 percent of American bankruptcies.
  • A study published in the journal Health Affairs reviewed Justice Department data and discovered that among Americans who cited medical debt as a contributing factor in their bankruptcy filing, only 12 to 13 percent of their total debts were medical.
  • The study also found that medical spending was a factor in no more than 17 percent of U.S. bankruptcies.
  • Too many Americans go bankrupt each year. But contrary to the claims … the cost of healthcare is not to blame. 

You can agree or disagree with what Sally Pipes wrote, but let me ask you to read again the article: Are medical bills killing patients?  $83,900 (approx: RM 251,700) the initial cost of a lymphoma treatment, or $902,452  (approx: RM 2.2 million) for treatment of lung cancer for 11 months before the patient died.

With that kind of medical bills, who would not go bankrupt?

As I surfed the internet further, I came across many shocking facts – I asked myself:  How not to go bankrupt with things like this happened?

The tab for medical care can add up quickly. Take a breast cancer diagnosis, for example.

  • A  breast cancer diagnosis bill can easily top $25,000.
  • A bilateral mammogram costs about $270.
  • A biopsy to test a suspicious area costs about $1,070.
  • A total mastectomy would cost about $11,500.
  • If the patient needs chemotherapy, a four-day hospitalization for treatment will run about $13,400.
  • Add another $260 per radiation treatment.

here are two interesting comments  in response to Towering Medical Bills Leave Many Americans Bankrupt:

  • This is written in loving memory of a couple I knew for decades. She suffered a lifetime with bi-polar. To pay for the expensive drugs not covered, he re-mortgaged. After retirement he could no longer keep up. The night before their foreclosure, he shot her and their border collie (dog) and out of grief torched their house. He is now serving life. The collie was killed “because he would have died of a broken heart”. Whenever I think of how inhuman our health care non-system is, my heart breaks again.
  • Our 25 year old son could not afford health insurance and it wasn’t provided at the restaurant where he worked. He had a serious accident which resulted in extensive third degree burns on his right hand, arm and leg. He was in the burn unit in Buffalo, NY for two weeks, underwent skin grafts and physical therapy to regain the use of his right hand and fingers. He ran up over 50K of medical bills but did not declare bankruptcy-because of the stigma. Now he is crippled by medical bills, cannot afford a car, his own apartment, or health insurance on his income. I don’t see how he will be able to recover from this and ever afford to have a family. 

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  • When a Medicine (Revlimid) “Works” It’s Unaffordable: $132,000/year, $534/pill (This is RM 1,650 per pill) :  After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. 
  • While drug companies spend a great deal to develop medications, their costs are inflated and overstated.  Efficiency is simply not on their agenda.  Nor is patient well being, access or for that matter outcomes. It’s the money stupid!  Charging more than twice the median U.S. income for a single drug that patients in life-threatening situation, any single drug, is simple blackmail.  It reflects an industry and economy gone mad. 
  • I had a friend who was on Revlimid for a pre leukemia condition. He was shocked when I told him what the cost was. The drug also has some very nasty side effects. Despite the treatment, he died a few months after starting it. 

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  • Cabozantinib: A Miracle Cancer Drug without Survival Benefit:  The FDA recently approved cabozantinib for use in medullary thyroid cancer that has metastasized.  What’s noteworthy about this drug is that it will likely be very expensive and that it does not, repeat does not improve the patient’s survival – No statistically significant difference in overall survival.
  • Cometriq contains a Boxed Warning, telling doctors and patients about the risks of severe and fatal bleedings and perforations and fistula in the colon.
  • Other new miracle agents often have limited efficacy with say two months median survival improvement.  But this is the first such drug being actively promoted, that I can recall, that has no survival benefit. Maybe this is yet another reason we spend more on healthcare than any other country in the world.  

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Read also: 

  1. The high cost of staying alive in a private hospital
  2. Die of cancer but don’t die a bankrupt
  3. How much life is worth
  4. Money driven medicine
  5. Avastin does not cure cancer