Botanical Medicine: How Herbs Represent A Symphony in Harmony Against Cancer

The world of Western conventional medicine is oriented to the ‘magic bullet’ paradigm, where the search for drugs relies on the concept of compounds that bind specifically to a single target and demonstrate a high degree of potency.

Traditional herbal medicine recognized centuries ago that combining many plants delivers far better results than relying on a single plant. This is true both for supporting health and vitality and for treating imbalances and diseases. The multi-component nature inherent in medicinal herbs makes them particularly suitable for managing the multitude of issues that present in complex diseases such as cancer, and offers great potential for synergistic actions, including interactions between botanicals and the relationship of botanicals to conventional cytotoxic drugs such as chemotherapy and targeted agents.

Because botanicals contain a variety of organic chemical complexes, they usually act on multiple targets. A potential advantage of phytochemicals is that they may act through multiple pathways, thus reducing the development of resistance by cancer cells.7 Botanical medicine does not have single effects, nor does it have a high degree of potency, but rather is pleotrophic, having relatively weak (compared to that of drugs) or gentle effects, assisting rather then controlling, and often acting in an amphoteric, symphonic way—able to not only do different things in different situations, but even to have the opposite effect, depending on the circumstances.

Botanical, as well as natural dietary compounds, have drawn a great deal of attention as potential cancer preventive agents because of their wide margin of safety. However, single agent intervention has failed to bring the expected outcome in clinical trials; therefore, combinations of botanicals and natural dietary compounds are gaining increasing popularity.

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Talk at Universiti Teknologi Mara, Penang

This is the recording of my talk at Universiti Teknologi Mara in Penang. Those of you who have “sharp” eyes would know that this talk was given many years ago — 2007! Nevertheless, if I were to give another talk to-day, I would have said the same thing! What I have said some years ago are just as valid today!

1: The Hunt for the Elusive Magic Ingredient

2: Illusion — They Believe They Can Be Cured

3: Common Sense and Cancer Treatment

4: Commonsense and Chemo-drugs

5: CA Care Therapy for Colon cancer

6: CA Care Therapy for Metastatic Colon Liver Cancer

7: CA Care Therapy

Video Presentation: Talk by Chris Teo, 11 May 2013 Kuala Lumpur

1 Title

Pt 1 Get The Best Of Both Worlds

Pt 2 Die of Cancer or Of Treatment

Pt 3 Overblown Statistics and Empty Promise

Pt 4 Doc, Give Me An Honest Answer

Pt 5 Beware Expensive and Dangerous Drug That Does Not Cure

Pt 6 Does Chemo Make Sense? Are Doctors Truly Honest?

Pt 7 Chemo Treats or Promotes Cancer?

Pt 8 Don’t Panic, Heal Yourself

Pt 9 Believe the Diagnosis Not the Prognosis

Pt 10 Chemo Almost Kill, Herbs Kept Him Alive

Pt 11 To Live or Die Is Your Choice

Pt 12 Recovered:  Even After Doctor Said No Chance

Pt 13 Doctor’s Bullying Ways and Self-interest

Pt 14 The CA Care Therapy

Malaysia’s Well Known Oncologist Died of Cancer

Yesterday I got a shock when I received an e-mail informing me that Dr Albert Lim Kok Hooi died of cancer. The first thing that struck my mind was: How could this be? Is it a hoax? I wrote back to the one who sent me the email that I could not believe the information. He then sent me this link:

In the article is the photo of Dr. Lim, the oncologist – this is my first time knowing how he looks like. From the article too I learned that his funeral was held at Trinity Methodist Church, Petaling Jaya. If this was in Penang, this is also the church Im and I worship in every Sunday – Trinity Penang.

I must say I do not know the late Dr. Lim at all, but I suspect we have “heard “of each other through our mutual cancer patients – he, an oncologist and I an alternative medicine practitioner (often referred to as quack or snake oil peddler)  who is on the other side of the great divide. Our patients went to see him for consultation and his patients came to see us after all those “scientific” treatments have failed them.

I also “know” him through his writing in the Star column. Dr. Lim was a prolific writer. And from his writings I learnt that his was an ardent and staunch supporter of “scientific medicine.”  I first learned of Dr. Lim as being the leading oncologist in Malaysia some 16 years ago when patients came to see me after consulting him.

As I surfed the Internet, I also stumbled onto what Dr. V. M. Palaniappan,Ph.D.  (I also do not know him as a person) wrote in

I read a sad news today in The Star (Malaysian, p.16, Saturday, 9 March 2013). This reports the death of Dr. Albert Lim Kok Hooi, a great Consultant Oncologist who was just 60, due to CANCER. It seems he was passionate about many issues, including animal and human rights, the rights of underprivileged, unhealthy lifestyles and habits of people, and the like. Reading all about Dr. Lim, it appears he had been a wonderful human being, and has contributed to the society to the fullest. If he lived for another one or two decades, with this caliber and good soul, he could serve a lot more to humanity. I sincerely regret his loss. May God bless his soul, and to rest in peace!

Likewise, I too felt sad to know that Malaysia has lost one of its outstanding sons “too soon”. At age 60 because of cancer.  Allow me to extend our sincere belated condolence to his beloved family. As children of God, we believe his soul now finds rest and peace with the Lord.

I spent days surfing the Internet trying to find out more details or hints of what had really happened. Unfortunately, I was NOT fortunate. I could not find any information about his illness, although I had access to the articles that he wrote. The link to the 10-page listing of his articles are in:

Dr. Lim also has his own blog: And his most recent posting was on 13 January 2013. And he died on 9 March 2013 – that is, just about two months after that posting?   Sounds like a heart attack rather than cancer.

The questions that strike the mind are: When did he get his cancer? What cancer? What treatment did he undergo?  These, I believe, are fair questions to ask. I went through his articles trying to find out if he ever disclose or give any hint that he had cancer in his writing. I do not seem to find any.

Let me say that even though I have never met Dr. Lim, I found some of what he had written interesting, especially coming from an oncologist! I wish many doctors and oncologists have similar views like him.  Let me highlight what Dr. Lim wrote over the years in his articles in the Star. In fact, he was spot on regarding the issues below – and I hope cancer patients do take note of his advice seriously.  These are good advice!

Cry me a river, 9 December 2012

  • The cancer has been growing in your body for decades. It takes 10 to 20 years for the first cancer cell to transform to a mass of detectable and diagnosable cancer.
  • Take at least two weeks to a month to work things out. Do not embark on any treatment – surgery, radiotherapy, chemotherapy and targeted therapy – until most of your questions are answered. And until your emotions are no longer on a roller-coaster.
  • Never be pushed to see any doctor against your wishes.
  • Choose your surgeon wisely. You should also choose your radiologist and your pathologist.
  • Needless to say, you choose your oncologist. Change your attending oncologist by all means if you are not satisfied with him/her.

A sickly sweet life, 7 October 2012

  • Sugar is as harmful to our health as tobacco and alcohol, and yet, by comparison, so little bad press is given to it. There is much science behind the harm of sugar.
  • All the food we take (even if it does not taste sweet) has sugar in it. Fruit and vegetables contain sugar to a varying degree. Eating fruit (whole, not canned or bottled) and consuming a healthy diet (fruits, vegetables, whole grain, blah blah blah) is more than sufficient for our caloric requirement.
  • The sugar and the sweetened condensed milk we spoon into our coffee and tea are harmful. And so is the sugar in sodas, rose syrup and other sweet drinks. Not to mention the sugar in candy, sweets, chocolates, doughnuts, cakes, nyonya kuih and biscuits encrusted with sugar.
  • All this sugar is refined sugar as opposed to unrefined sugar, which is found naturally in fruit, vegetable and meat. Refined sugar is usually made from cane sugar, but stripped of all its natural goodness.
  • The copious amounts of sugar we consume through all the sweet drinks and food make up another approximately 90 pounds (40.8kg) or more of sugar a year. This 90 to 100 pounds of refined sugar (whether sucrose or fructose) is, to use an accurate term, a poison, i.e. a harmful substance that has no benefit.
  • For starters, we should avoid all processed meats, including bacon (bak kua in our local context) and most sausages.

Fat chance of cancer, 13 July 2008

  • It also advises against eating more than 6 gm of salt per day. I can’t imagine what 6 gm of salt is but I do not add any salt at the table and I would reject all foods that taste perceptibly salty.
  • How do you tell the common folk that their 10 favourite foods are a no-no from the scientific health-wise point of view? Nasi lemak, roti canai, curry mee, wanton mee, burger, doughnuts, fries, char kuay teow, chicken rice and mee goreng are out.

Something about Dr C, 6 January 2013

  • Dr C also taught me a lesson in healthy eating. Whenever we dine together, I notice he attacks fruit and vegetables before all else. I begin with the canapés, he starts with the fruit. I end with the Coeur a la Crème, he ends with fruit.
  • You don’t know how very guilty I feel whenever I dine with Dr C. He tells me that the fruit will fill him up. That would make it difficult for him to consume much else. He drinks water mostly.

Only human, 10 June 21012 

  • My failing as a doctor is my impatience with the pronouncements of alternative and traditional medicine. I feel bad each time I try to explain science to my patients and know that at times I have hurt their feelings.
  • The rights of a patient matter a lot to me. This includes the right of privacy, and the right not to undergo treatment.
  • To me, it was her fundamental human right: to be treated, not to be treated, to map the rest of her life, to die at a time and manner of her choosing.

Of course, I must say you cannot expect me to agree with everything that Dr. Lim wrote. That is understandable. We stood at the opposite, extreme ends of the pole.  Nevertheless, let not our differences of knowledge, training or upbringing divide us. As human beings we are merely travelers on a journey of learning experience as we walk through life on this earth. Once our job is done, we are called HOME. No one lives forever. Doctors also get sick like any other mortals. And CANCER doctors do get cancer too. And they also can die of cancer. This is the reality or irony of life.

I am not a medical doctor. After teaching and researching in the university for 26 years I got involved with the alternative management of cancer. I used my scientific knowledge trying to find truth through a non-conventional view.

Dr. Lim’s death had brought forth one question I often ask myself. If one day I were to be inflicted with cancer – like those thousands who have come and to seek my help – would I keep this illness a secret? My blunt answer is: NO.  This is because I am here on earth for a reason – and I am on a journey to gain experience. I would want to share my trials   and tribulations with my fellow travelers. I believe it is important and fair on my part that I share with you not only my successes but also my bitter experiences. I take the view that my experiences would be useful lessons or examples for others to learn from. If I fail I have to tell you and warn you of the pitfalls of my journey. Some of you may not agree with my personal beliefs. That is perfectly okay with me too.

Recently, I interviewed a cancer patient and at the end of our conversation I asked if he would want me to cover his face for our video presentation. He said NO, there is nothing to be ashamed about if you have cancer. I did not commit any crime!  I have full respect for this patient and am very impressed and proud of such an attitude. To me, failure to win over cancer is not a failure.  I come to this conclusion because I have learned early in my cancer career that there is NO such thing as a (permanent) cure for cancer. You get cancer, you die. You may have a remission but that is not a cure. That seems to be the scenario all over the world today.

President Hugo Chavez died of cancer after four surgeries and lots of chemotherapy.  Jacqueline Kennedy Onassis had non-Hodgkin’s lymphoma and she died after much chemotherapy.  Ted Kennedy died of brain cancer. In this blog, I have written about Tony Snow  who died of colon cancer that had spread to his liver. Then there was a story about Steve Jobs who died of pancreatic cancer. In fact the list goes on.

The world’s most iconic scientist of our time, Nobel laureate James Watson also has (prostate) cancer.  And I was told he refused to undergo the standard medical treatment. In his recent talk, Dr. Watson said: There’s now pretty good research that suggests that if you take a baby aspirin a day, you get less cancer … So every morning, I take an anti-inflammatory, to the laughter from the audience. He joined in with his own distinctive, raspy chuckle and shrugged, asking: Why not?  Watson also takes Metformin. The drug is normally taken by people who have type-2 diabetes, but research shows that fewer of those taking the drug get cancer.  He said: If this is right, this is a bombshell, and all chemotherapy should be done with Metformin.


In his blog, Dr. Palaniappan raised some interesting questions about Dr. Lim’s “secret adventure” with his cancer. This is what he wrote (

  • With all the credentials, Dr. Lim must have been a real … capable radiologist and oncologist…. how can Dr. Lim, a CANCER SPECIALIST, die of CANCER?
  • If a heart specialist, a child specialist, a skin specialist … dies of cancer, he/she can be excused … How can a CANCER specialist die of CANCER? How can a cardiologist die of heart attack?
  • If such best brains do not have the capacity to guard themselves, how are they going to protect the common people? How can we accept them as guardians of our health? Great and disturbing doubts appear to have risen.     

You may wish to ponder what Dr. Palani’s said. You may agree or disagree with him.

To me, Malaysia has lost a good doctor. If Dr. Lim were to leave behind his legacy by writing about his “battle” against cancer it would be a greater help to all of us.  If scientific medicine, which he believed in so ardently, has been so effective against cancer, what is it that went wrong that he had to die of cancer? I am sure this is the question that most, if not all, cancer patients want to know.

I am reminded of what happened in France in the 19th century at the time of Louis Pasteur and Claude Bernard – two great scientists of that period. Pasteur was a chemist and microbiologist, who put forward the germ theory. According to him diseases are caused by infectious microbes, that impair the functioning and structures of different organ systems. This paradigm is the basis for the use of antibiotics today.

Pasteur’s contemporary and friend, an equally great scientist, Claude Bernard was a physiologist. He argued the germs are not as important as the body’s internal environment – what he called le milieu intérieur. According to Bernard, The constancy of the interior environment is the condition for a free and independent life. Bernard thought that the body becomes susceptible to infectious agents only if the internal balance – or homeostasis as we now call it – is disturbed. After all, there are billions of microbes and bacteria inhabiting our guts, our blood, our whole body. Why do we sometimes get sick from them and sometimes not? When a bacterial or viral agent is “going around,” as we say, why do some people fall sick while others remain healthy?

History has it that when Pasteur was on his death-bed, he said:  Bernard is right. The microbe is nothing. The environment is everything.  With that confession, the world is left a bit wiser!


Cancer As a Metabolic Disease

Author: This book is written by Thomas Syefried, Ph.D. He has taught and conducted research in the fields of neurogenetics, neurochemistry and cancer for more than twenty-five years at Yale University and Boston College. He has published more than 150 scientific articles and book chapters and is on the editorial boards of Nutrition & Metabolism, Journal of Lipid Research, Neurochemical Research, and ASN Neuro. Supported by evidence from more than 1,000 scientific and clinical studies, Dr. Syefried provided evidence that cancer is primarily a metabolic disease (NOT a genetic disease).

The author dedicated his 438-page-book to: The millions of people who have suffered and died from toxic cancer therapies.

Do you get his message? The present day cancer therapies are toxic! And millions die – from the cancer or from the toxic treatment? Do you ever wonder why the present day cancer treatment has come (or allowed to come) to such a tragic state of affairs?

Mitochonrdia – the Energy Production  Houses of the Cell

The last time I sat in class (Universiti Malaysia) learning about energy production by mitochondria was in early 1970. That’s a long time ago. When I taught Plant Physiology at USM, I dabbled a bit here and there with energy pathways and that too was many years ago! So to fully comprehend what Dr. Seyfried said and then write this article –  trying to put things in layperson’s language –  did take a rather longer-than-usual-time for me. I have to go back to my textbooks again!

Let’s start from the basics!

Mitochondria are unusual organelles found in the cytoplasm and they are the powerhouses that generate energy for the cell. They have their own genome and they can divide independently of the cell in which they reside.  Mitochondrial division is stimulated by energy demand, so cells with an increased need for energy contain greater numbers of these organelles than cells with lower energy needs.

A typical animal cell may have anything from 1,000 to 2,000 mitochondria. Indeed there are a lot of these structures in a tiny cell.

The mitochondria produce the energy-rich molecule called ATP (adenosine triphosphate). ATP is required to drive all the cellular activities. Indeed ATP is the energy currency of the cells. ATP is like petrol, without it your car cannot move.

The process of energy production in cell is called cellular respiration. It involves a range of metabolic pathways and processes that take place in the mitochondria to convert biochemical energy from nutrients that we eat – sugars, amino acids and fatty acids – into ATP and other waste products.

This energy production (respiration) in cell can take place with or without the presence of oxygen.

If the energy production process occurs in the presence of oxygen it is called aerobic respiration. This process is up to 15 times more efficient than anaerobic metabolism (respiration without oxygen).

This is what happens in aerobic respiration: C6H12O6 (sugar) + 6 O2 (gas) → 6 CO2 (gas) + 6 H2O (water) + heat + ATP

Without oxygen the process of energy production is called fermentation. It is a less efficient way of producing energy because only 2 ATP are produced per glucose molecule (compared to 38 ATP per glucose produced by aerobic respiration).The waste products of fermentation still contains plenty of energy. However, this process creates ATP more quickly. During short bursts of strenuous activity, muscle cells use fermentation to supplement the ATP production from the slower aerobic respiration.

Beside energy production, mitochondria are also involved in the process of cell division and apoptosis (or naturally occurring process of programmed cell death).

In this book, Dr. Seyfried provides us with information saying that mitochondria are also deeply implicated in the initiation, growth and proliferation of cancer.

Energetics of the Healthy Living Cell

In order for cells to remain viable and to perform their functions, they must produce usable energy – and to do so as efficiently and economically (no wastage) as possible.

  • About 88% of total cellular energy is derived from oxidative phosphorylation. This oxidative phosphorylation pathway is probably so pervasive because it is a highly efficient way of energy production than other ways below. In theory oxidative phosphorylation yields 38 ATP molecules per glucose molecule but in reality the current estimate is about 29 to 30 ATP per glucose.

The other remaining 12% of energy is produced about equally by:

  • Substrate-level phosphorylation through glycolysis in the cytoplasm. Substrate-level phosphorylation is the direct transfer of phosphoryl  group (a process called phosphorylation) to ADP to form ATP or GTP. This serves as fast source of ATP. This process takes place in the erythrocytes, which have no mitochondria and in muscles during oxygen depression. In this process only 2 ATP molecules are produced.
  • ATP is also produced through the TCA cycle (tricarboxylic acid cycle or Krebs cycle) in the matrix of the   mitochondria. The net result is production of only 2 ATP molecules.

It is obvious that substrate-level phosphorylation  and TCA  cycle area less efficient method of energy production since only 2 ATP are produced per glucose compared to 38 ATP per glucose by oxidative phosphorylation.

When AT P is  hydrolysed  (hydro =water, lysis = separation) the high energy stored in the ATP is released. The standard free energy change (ΔG) for the hydrolysis of the terminal pyrophosphate bond of ATP under physiological conditions is tightly regulated in cells between -53 to -60 kJ/mole.

The ∆G’ ATP among cells irrespective of how this energy is being produced is similar. For example, the as ∆G’ ATP in heart, liver and erythrocytes are approximately -56 kJ/mol despite of  having very different electrical potentials.

The constancy of the ∆G’ ATP of approximately -56kJ/mol is fundamental to cellular homeostasis. Any disturbance in this energy level will compromise cell function and stability.Cells can die from either too little or too much energy.

Mitochondrial Dysfuction (or Defective Energy Metabolism) May Mean Cancer

Cancer cells produce more energy through substrate-level phosphorylation while normal cells produce most of their energy through oxidative phosphorylation. This goes to say that cancer cells are not efficient energy producers.

A major difference between normal cells and cancer cells is in the origin of the energy produced. Regardless, all cells – normal or cancer cells – require approximately -56 kJ/mol for their survival.

  • A prolonged reliance on substrate-level phosphorylation for energy production produces genome stability, cellular disorder, and increased entropy, i.e. characteristics of cancer.
  • Numerous studies show that tumour mitochondria structure and function is abnormal in cancer cells and they are incapable of generating normal levels of energy.

Against Current Mainstream Thinking

As far back as 1924, Nobel laureate Otto Warburg postulated that cancer was principally a disease of mitochondrial dysfunction. To Warburg, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.

The question which needs to be asked is: Is it genomic instability or is it impaired energy metabolism that is primarily responsible for the origin of cancer?

Metabolic studies in a variety of human cancers showed that the loss of mitochondrial function preceded the appearance of malignancy. However, the general view over the last 50 years has been that gene mutation and chromosomal abnormalities underlie most aspects of tumour initiation and progression.

Gene theory of cancer would argue that mitochondrial dysfunction is an effect rather than a cause of cancer, whereas the metabolic impairment theory would argue the reverse.

It is suggested that genomic abnormalities found in the majority of cancers can arise as a secondary consequence of mitochondrial dysfunction. Impaired mitochondrial function can induce abnormalities in genes and oncogenes.  Once established, somatic genomic instability can contribute to further mitochondrial defects.  For example, impaired mitochondrial function can induce abnormalities in p53 activation, while abnormalities in p53 expression and regulation can further impair mitochondrial function.

Implications for Treatment and Prevention of Cancer

  • Numerous studies show that dietary energy restriction (DER) is a general metabolic therapy that naturally lowers circulating glucose levels and significantly reduces growth and progression of numerous tumour types to include cancers of the mammary, brain, colon, pancreas, lung and prostate.
  • Dietary energy or calorie restriction (DER) can be considered a broad-spectrum, non-toxic metabolic therapy.
  • It is the amount of the diet consumed rather than the composition of the diet that determines blood glucose levels. Many people have difficulty appreciating this fact because they often think that low carbohydrate diets will produce low blood glucose levels. This is clearly not the case here. Our data show that blood glucose levels are influenced more by the amount of calories consumed than by the composition of the calories consumed.
  • Malignant cells use glucose and amino acids like glutamine as their energy source through the process of fermentation even in the presence of oxygen. So cutting off glucose and glutamine should help in starving cancer cells of their fuel.
  • The cancer research field has drifted off course for too long in my opinion. It is now time for all cancer researchers to pause, and to reconsider the foundation upon which their views rest. In light of the compelling counter arguments against the gene-based theories of cancer together with our extensive in vivo studies in brain cancer, it has become clear to me that genetic theories are wanting in their ability to explain the origin of cancer.
  • I do not dispute the overwhelming evidence that defects in DNA, genes, and chromosomes occur in all cancers. The evidence is massive. What I do question, however, is whether these defects actually cause the disease. I will review evidence showing that most of the genomic defects seen in tumor cells can be linked directly or indirectly to insufficient respiration.

 Interview with Thomas Syefried

Dr. Thomas Seyfried believes that cancer is primarily a metabolic disease and so should be tackled as such. Cancer cells have high metabolic needs and so by manipulating the energy balance in the body through diet restriction, Dr. Seyfried is convinced that these malignant cells would suffer more than normal cells and even be killed. 

Pauline Davies: Well let’s go right back to the beginning, tell me why is cancer a metabolic disease?
Thomas Seyfried: Well, all cancers suffer from the same kind of problem; they have inefficient respiration. The inefficiency of respiration forces those cells to use an alternative fuel which is fermentation, and it can happen in cytoplasm or even in the mitochondria. It’s the fermentation that compensates as an alternative source of energy for damaged respiration. This leads to genomic instability, local inflammation and the features that we see as the hallmarks of the disease.

Pauline Davies: Because cancer cells are growing very rapidly, they need a great amount of energy to respire, to actually grow, and that’s where the stress comes from?
Thomas Seyfried: Well actually they need a great amount of energy because they’re not effectively metabolizing all of the energy in the molecules they take in. Cancer cells release significant amounts of un-metabolized molecules … the cancer cells are wasting this, and this is an indication of an inefficient respiratory system. And it’s the fermentation that drives the proliferation of the tumor cells and also it’s the fermentation that makes the cancer cells drug resistant.

Pauline Davies: Can you, in a very simple way, explain why the fermentation actually drives the cancer. Does fermentation give them more energy to do that?
Thomas Seyfried: Well, you know, we have liver regeneration, the division of normal liver cells to regenerate, they’ll actually grow much faster than a cancer cell and they don’t ferment. The cancer cells are locked into a fermentation profile because they have lost their ability to respire. Cells that can respire will stop their fermentation once the cell becomes more differentiated. The differentiation is also controlled by the energy efficiency of the mitochondria, and if that organelle is damaged in any way, it makes it incapable of using respiratory energy, the cells get locked into a primitive form, the way life was on the planet prior to oxygen. All the organisms were highly fermentative and highly proliferative. The cells were highly proliferative cells in a fermentation reduced environment. Oxygen then brought in stabilization and differentiation and this became the result of having mitochondria in our cells. When those organelles become damaged, these cells revert back to a proliferative condition as they were in ancient times before oxygen came onto the planet. And they will continue to do this now even in the presence of oxygen, because the respiration is deficient and cannot stop this fermentation process. So these cells, as long as they have access to the fuels that drive fermentation, which is glucose and glutamine, they will continue to proliferate and it becomes very difficult to kill them.

Pauline Davies: So you came up with some suggestions for actually controlling cancer. What did you say?
Thomas Seyfried: Our approach to managing cancer will be effective against all forms of the disease, because we view the disease as a singular disease of energy metabolism. So they all suffer from the primary inefficiency of respiration. Now knowing that, can we manage the disease? This becomes not an insurmountable problem. The first step you have to do is you have to treat the whole body, not just the tumor. The body has to be brought into a new metabolic state of metabolic stress where the evolutionary programs for our survival have evolved over millions of years, where we can then tap into alternative fuels due to the genomic flexibility that we have in our systems. Once our body gets into one of these metabolically, or I should say, an energy stress condition, which is actually very healthy, it’s not a painful or harmful situation, the cancer cells now become more stressed than the normal cells because they lack the metabolic flexibility. So the first things we do is put the patients in a state of energy stress by restricting the amount of calories they eat. We bring blood glucose down and ketones up. Blood glucose is the major fuel for the cancer cells and most other cells, especially brain cells. But many normal cells will transition to fat ketones, breakdown product of the fat, which cancer cells have great difficulty utilizing. So putting the patient into a global state of energy stress, puts great pressure on the metabolism of the tumor cell while making the normal cells healthy. The mutations that the tumor cells have, makes them restricted in their ability to adapt to this new energy state. Once we hit those fuels, we can manage the disease; patients can live a lot longer.

Pauline Davies: So what does it actually mean for a patient? How much do they have to restrict their diet?
Thomas Seyfried: Well this is an important point and this is one of the reasons it’s a stumbling block. Some patients have to realize they have to stop eating for several days, and get their blood sugar down to 55 to 65 milligrams per deciliter and their ketones up to about 3 to 2 millimolar and then they know they’re in the state. So we have clear biomarkers for patients to get into this particular metabolic state. The problem is a lot of patients are reluctant, they have other thoughts, the issue of cachexia always comes up and they say, “How could you have a patient who’s losing weight stop eating?” And as I said, they’re losing weight because the tumor cells are mobilizing glucose from their tissues of fats and protein. So by lowering the glucose in the patient, you are actually killing tumor cells that are releasing those cachexic factors, so you will lose additional weight at the beginning, but then the body will regain weight and become far more healthy. So it’s a whole systems physiology that has to be used, together with those drugs that target the ability to use glucose and glutamine. 

Pauline Davies: So what should people do … What sort of food should they be eating after starving themselves for three or four days?
Thomas Seyfried: Well it various from one person to the next; people have to know what their own bodies are capable of doing. They just have to measure their blood glucose and ketone levels which gives them an idea as to, you know, does this food help or not help. You know some people just have to stop eating for a week, it sounds terrible but it works, I know it works, we’ve seen many people benefit from this.

The biggest obstacle to this is the medical establishment is clueless as to how this works. It’s totally different than the way people view the disease; the disease is not viewed as a metabolic disease. If you’re not viewing the disease as the nature of what the disease actually is you’re going to be doing things that are irrelevant to the nature of this. I mean there are some people who are cured by the standard of care and current therapies, but they pay a price for that. They have all kinds of other health issues in those who do survive the treatments. And you know, 60 percent of the people treated with cancer do survive. So you have these many survivors but they pay a price for that survival, they’re debilitated in many ways for the rest of their life if they don’t get a recurrent tumor some other time in the future. We want to eliminate that, we want to eliminate the tumor and keep the body healthy, and that’s what our therapy and understanding will do.

Pauline Davies: Why are we not doing this?
Thomas Seyfried: Because the physicians and oncologists are not trained to do this. If they were trained to do this they would be instituting this. This is not part of the medical practice of the field. Cancer is viewed as a very different kind of disease that needs to be treated with toxic chemicals and radiation. No one is talking about the nutritional metabolic approaches to managing the disease because the physicians themselves are not trained in this. If you’re not being trained to do this, how could you institute this, or even understand the principles and concepts? This is a major stumbling block for the improvement of cancer. We’re not going to make any major advances until the physicians in the field understand that this is a metabolic disease.

Pauline Davies: What I don’t understand is why people haven’t looked at cancer as a metabolic disease so much in the past. Why are they focusing on the nuclear problems?
Thomas Seyfried: Well that took place over a many year period, it really kind of exploded with the discovery of DNA in the 1950’s as being the genetic material, and you find broken chromosomes in cancer. It was a natural connection to say, “Oh this is the hottest area in biology; cancer cells have broken DNA; everybody’s looking at gene transcription,” all this kind of stuff. It was only natural course of action to go that route. But Otto Warburg had clearly defined what the nature of the disease was many years ago, and that was kind of considered not important for a variety of reasons, but it was the core issue here.

Pauline Davies: So is there any way of preventing cancer in the first place? What would you suggest, that people starve themselves for a couple weeks a year?                   Thomas Seyfried: Well I don’t like to call it starving because starving is a pathological condition which is very unhealthy. But if you stop eating for three days, two to three days, and see your blood glucose go down and your ketones go up, you already know you’re enhancing the health and vitality of your mitochondrial system. The inefficient mitochondria undergo autophagy, they’re consumed by the cell for the good of the whole. So the body has an internal control system to purge any cell inefficient in its metabolism. The best way would be to one-week fast once a year, would probably be the singular best way to prevent cancer. This is hard for most people, so maybe three days twice a year, something along this. And as I said you dovetail it in with a religious experience for whatever and it makes everybody feel happy. You can do this with whatever culture or whatever religion; it can be worked in for most people. Let’s put it that way. 

In the foreword of the book, Dr. Peter Pedersen, Professor of Biological Chemistry, Johns Hopkins University School of Medicine, Baltimore, USA wrote:

  • I have worked in the cancer metabolism field since the late 1960s and have extensively published works on the metabolic basis and properties of cancer.
  • I am very impressed with the excellent job he (Dr. Thomas Syefried) has done in highlighting abnormal energy metabolism as the central issue of the cancer problem.
  • I recognized long ago the privotal role of mitochondria and of aerobic glycolysis in sustaining and promoting cancer growth.
  • A key point made by Seyfried is that most of the genomic instability seen in cancer is likely arises as a consequence rather than as the cause of the disease. Seyfried’s book provide substantial evidence showing how cancer can be managed using various other drugs and diets that target energy metabolism. The restriction of glucose and glutamine, which drive cancer energy metabolism, cripples the ability of cancer cells to replicate and disseminate.
  • The cancer field went seriously off course during the mid-1970s when many investigators began considering cancer as primarily a genetic disease rather than a metabolic disease.
  • The inconsistencies of the gene “only” theory make it clear why little progress has been made in the cancer war and in the development of effective nontoxic therapies.
  • The gene theory had deceived us into thinking that cancer is more than a single disease … cancer is a singular disease involving aberrant energy metabolism.
  • Cancer has remained incurable for many due largely to a general misunderstanding of its origin, biology, and metabolism.
  • If cancer is primarily a disease of energy metabolism, then rational approaches to cancer management can be found in therapies that specifically target energy metabolism.

From the internet I have obtained the following comments:

  • His book is well-written; it has a lot of technical details which are suitable for biochemists and geneticists but at the same time he does a good job in making things comprehensible to the layperson. He has taken apart the official stand on cancer research – one that uses billions of dollars in research grants ultimately coming out of public money – while producing little if any useful results for the millions of cancer patients who suffer and die more perhaps from the toxicity of treatment rather than the disease itself, hoping for the next miracle drug which the drug companies promise to be just around the corner. His anguish at the state of cancer research as well as clinical management comes out quite clearly in the book ~
  • It’s (cancer) a huge field and it’s an intimidating field because decades of funding and efforts have resulted in perhaps hundreds of thousands of papers, so it’s impossible to grasp what is known. The good news is that unfortunately most of what we learn does not seem to mean much because we still haven’t made much progress in cancer.
  • I believe that they (mitochondria) play an important role in many diseases including cancer… What I think most people will now agree is that they play some kind of role. Because up to ten years ago most people thought mitochondria just damaged, just a result of the cancer process and therefore if you look at them as damaged, they’re not therapeutic targets whereas if you start looking at them as playing a potentially causal role, then all of the sudden they become therapeutic targets. And since the field is in desperate need for new therapeutic targets, mitochondria provide an extraordinary opportunity for new therapeutic options… I think it’s to break down all the existing biases and dogmas and start looking at what the data shows us, what the information about the mitochondria shows us and take a multidisciplinary approach … Keep in mind that there is this new theory for cancer but it hasn’t been based on dramatically new information, it’s just information that was always there, but people looked at it from a different perspective. So now people are just starting to look at it differently and now you have a metabolic theory for cancer being born. So alternate approaches and new ways of looking at the same data is really needed ~ Evangelos Michelakis, a professor at the University of Alberta in Edmonton, Canada.
  • To me it’s what science is all about; the problem is on the table, you attack it in an intellectually honest way, let the chips fall where they ~Erik Schon, Colombia University, trained as a molecular biologist but have spent the last twenty-six or twenty-seven years working on human mitochondrial genetics and human mitochondrial disease. 
  • It’s clear that the strategy to treat cancer as a genetic disease is not working, but this fuels the pharmaceutical industry. Enormous amounts of money are spent on large cancer genome projects, but this has not advanced our understanding or treatment of cancer. The information from these genome projects has actually created more confusion amongst cancer researchers, and this is very clear if one reads the literature. On the other hand, when cancer is viewed as a metabolic disease the strategies to treat and prevent cancer become incredibly simplistic and economical.
  • Why our own medical profession has not looked into this feature of cancer for therapeutic strategies is also odd.
  • The fact that our PET scans show high glucose uptake in almost all types of cancer proves that cancers have a unique metabolic abnormality unlike normal differentiated cells. Simply put cancer cells require large amounts of glucose, or sugar to survival and multiply ~ Dominic D’Agostino. 


Let’s again highlight some of the important messages that Dr. Syefried wants us to know:

  • All cancer cells regardless of tissue origin express a general defect in mitochondrial energy metabolism.
  • Cancer can be effectively managed and prevented once it becomes recognized as a metabolic disease.
  • It … became clear to me why so many people die from the disease.
  1. Many of the current cancer treatments exacerbate tumour cell energy metabolism, thus allowing the disease to progress and eventually become unmanageable.
  2. Most cancer patients do not battle their disease but are offered toxic concoction that can eventually undermine their physiological strength and their will to overcome the disease. Cancer treatments are often feared as much as the disease itself.
  • The view of cancer as a genetic disease is based on flawed notion that somatic mutations cause cancer.
  • Substantial evidence indicates that genomic instability is linked to protracted respiratory insufficiency.
  • Once cancer becomes recognised as a metabolic disease with metabolic solutions, more humane and effective treatment strategies will emerge.

A study of medical history tells us that new ideas will be rewarded with toxic reactions by the Vested Interest. I am glad that Dr. Syefried has the guts to speak out. And he spoke with scientific evidence and data.  Of course many self-serving researchers may label him as yet another quack or charlatan! That is the way most scientists behave anyway.

In reading this work of Dr. Thomas Seyfried, I am particularly disturbed with the following findings:

  • Although radiation therapy can help some cancer patients, radiation therapy will also enhance mitochondrial damage and fusion hybridization, thus potentially making the disease much worse.
  • Malignancy and invasiveness of tumours are directly related to vascularity (blood vessel development or angiogenesis). Reduced availability of glucose has been observed to reduce vascularity and cell proliferation. In light of our findings, it is surprising that the cancer field would persist in treating cancer patients with toxic antiangiogenic drugs such as bevacizumab (Avastin)  and cediranib (Recentin), which show marginal efficacy and appear to enhance the invasive behavior of tumor.
  • Compared to bevacizumab (Avastin), which targets angiogenesis, while producing adverse effects and enhancing tumor cell invasion DER (dietary energy restriction) targets angiogenesis, while improving general health and inhibiting tumor cell invasion. 
  •  Is it better for oncologists to target tumor angiogenesis using toxic drugs with marginal efficacy or is it better to use nontoxic metabolic strategies such as DER with robust efficacy? Oncologists should consider this question.

The question I would like to pose is: In the light of Dr. Seyfried work, can we honestly say that chemotherapy and radiotherapy help cancer patients? Will these treatments do more harm than the cancer itself?

They say, ignorance is bliss but I also learnt from my observation that ignorance kills and it kills mercilessly.

To conclude, let me ask you to reflect on the quotations below:

The information in this article are extracted from:
1. Thomas Seyfried & Laura Shelton, Cancer as a metabolic disease

2. Interview with Thomas Seyfried:

New Thinking About Cancer and Its Treatment

We would like to recommend that you visit the website put up by

Professor Gershom Zajicek, The Hubert H. Humphrey Center For Experimental Medicine and Cancer Research, Faculty of Medicine, The Hebrew University of Jerusalem, Israel. (

The following are some salient points raised by this learned professor.   

What is cancer? 

  • Cancer is a systemic disease and its symptom is expressed as a tumor. Removing the tumour is therefore NOT the ultimate solution or cure for cancer. Often the cancer recurs after an apparent “successful medical treatment”. Therefore, there is more to cancer than just its tumor.

Wisdom and the Healing Power of the Body 

  • Our body has its wisdom and unique self-healing power. This self healing instinct lies dormant in us unless it is activated. Modern medicine does not recognize the existence of this Healing Power.

 We Need to Empower Ourselves

  • Health is our responsibility. Do not mortgage this responsibility to our doctors and other specialists. Do you believe they know more about our health better than us? The medical establishment may want us to believe that this is the correct thing to do – to trust them all the way! This may not be the right thing to do when it comes to cancer. Many patients have found out this the hard way – much too late. Professor Zajicek said: doctors’ arguments are wrapped in hypocrisy and double talk. Profound distrust drives patients to alternative medicine.

 Failure of Medicine 

  • Modern medicine fails to cure cancer, signifying the failure of the basic philosophy of medicineitself. Based on the philosophy of Descartes, medicine regards the body as a machine. Disease is a malfunction of the body which has to be corrected. Descartes and his followers, the doctors, did not realize that the human machine differs from man-made machine by its ability to self-heal. The failure of medicine is to ignore the self-healing capacity of our bodies. 
  • Medicine is in a conceptual deadlock that is most pronounced in cancer. It has the best means to treat disease, yet the basic tenets of treatment are false. Medicine fails to deal with the complexity of the organism. It regards our body as a complex linear machine, while in reality it is non-linear and chaotic. Cancer is regarded as a process evolving linearly while in reality it is non-linear

 Mind Disease and the Cancer Mask 

  • Cancer is regarded as an evil disease – by society and also doctors. We must fight this deadly cancer within us, so they say. But on the other hand, arteriosclerosis, which is more dangerous and which kill more patients than cancer, does not carry a similar metaphor. We don’t wage a war on arteriosclerosis. Why?
  • Yesterday, a woman felt healthy. Today, she discovers a small lump in her breast. Suddenly she becomes ill, realizing that she carries an evil disease. The lump is her death sentence. In reality, she is healthy. The lump does not pose an immediate threat to her. Nevertheless she panicked. It is not cancer that causes her misery, but society and medicine that promote thisfatalistic perception.
  • Now this woman is alarmed and rushes to her doctor the next day. She undergoes a mammography and biopsy and is told she has cancer. The doctor tells her that she is very ill. Her world turns upside down.
  • Before detecting the swelling, this woman is otherwise a healthy person not until she is given the cancer mask to wear. Her doctor is now preoccupied with her cancer mask. Fear is generated. Everything needs to be done quickly and urgently to fight and save her life from this evil disease – the tumour! So this woman has to act, to conform to the roles of the mask that she wears. She now acquires a new disease called the mind-cancer. From then on she sinks into the abyss of misery, believing that she will die rather soon.
  • Ask these questions: Before the discovery of the lump, and before consulting her doctor – what was her life like? She was as fit as a fiddle, wasn’t she? The sudden a change of fortune befalls her just because she had discovered a lump in her breast. What is the real cause of her misery? The lump in her breast or the perception of evil being spun by society and the medical establishment?

Cancer is a Chronic Disease

  • Nearly all chronic diseases are essentially incurable. Treatment ought to aim at keeping the patient in remission.
  • Cure is therefore irrelevant.
  • This quest for cancer cure, that generally cannot be attained, causes anxiety in patients that feel as if they have been condemned to death.
  • Oncologists seek to cure cancer. But generally they know that cancer is incurable projecting their helplessness on patients. 

What to Do If You Are Diagnosed With Cancer? 

1.      First find a good doctor with the following qualities:

  • Experienced physician who will find time to listen to your questions.
  • Generalist (take note: not specialist) who understands the newest developments in medicine, particularly cancer.
  • Open minded doctor, ready to consider unconventional medical approaches, like alternative medicine.

2.      Take time to look for the best qualified, and don’t rush to the first one you encounter.

3.      The medical establishment regards your lump as an emergency. You are rushed to the ward, sign consent-papers, and you nearly lose your mind. Remember this ancient Arab saying: haste is from the DevilThis advice is indeed highly appropriate for this situation.

4.      You need time to decide what treatment is best for you.

5. The tumor is only one expression of your chronic condition and its removal does not assure yourcure.

6.      Modern medicine is trying to treat your cancer as if it is an infectious disease and everything must be done to immediately kill the bug. This is a false, panic metaphor that medicine wants you to accept. Cancer does not behave like an infectious disease. A bug is not involved here, and no antibiotics or toxic drugs help. In most patients, cancer is incurable.

7.      Chemotherapy, like antibiotics in infection, is the main treatment in cancer. Yet it has the same drawback as antibiotics. With time the tumor becomes resistant to treatment and the patient dies. Medicine believes that the patient is utterly helpless and depends solely on chemotherapy. Yet our Wisdom of the Body is smarter than academic medicine. 

Blind Spot of Medicine

  • After being diagnosed with cancer your mission is to train yourself to live with cancer in peace and harmony. The message your body is giving you is that your life needs to take a new course, with a new mission. It does not matter whether you were cured by surgery or not.
  •  Start a new life which is devoted to tilt the balance between cancer and your body in your favor.
  • You may turn to your doctor for advice on alternative approaches.  He may just look at you, laugh and say:  Who tell you all this nonsense? Don’t believe in such unscientific and unproven baloney!  For medicine it is inconceivable that other ways are better than their cut, burn and poison approaches.
  • You will have to trot this difficult path on your own. Medicine ignores its limitations and views what are being said here as nonsense.

View Your Misfortune as a Blessing

Very often we take good health for granted – especially when we have never landed in the hospital before! I have seen faces of the sick and shared their pains – I imagined what it was like, though I have not experienced it myself before.

On 9th February 2000, it was my turn to get sick. That morning, I tried to shift a packet of herb, which blocked the door. “Cluck” came a sound from my backbone and I was almost immobilized. The whole of that Wednesday I was confined to the chair, unable to pick things from the floor, could not walk properly, etc. Mentally, I felt frustrated for not being able to do all that I had always taken for granted.  Of course, such problem is nothing compared to the ordeal the cancer patients suffer.

Take painkiller to relief the pain was one advice.  No, thank you. Why cut off the signal that tells me that something was not right with my back?

Rush to the hospital? My past experience with an orthopedic regarding the same problem was enough bad lesson. So, no thanks too!!

Deep down in me, I know, however, that God will help me.  I visualized that I would be well the next morning!  It was not to be. I was unable to bring myself up from bed.

I thought of calling a friend who knows of one person who is good at massaging. At about 11 a.m. this very friend called us instead.  She wanted to drop by our house with her brother-in-law from Singapore who has been taking the herbs.  What a “coincidence”. 

About noon, my cousin dropped by and told us of a chiropractor in town who has done a wonderful job for her friend. She called the chiropractor’s office for appointment but was told that there was no slot free until a week later. Aya!  Mana boleh – can’t wait that long! Anyway, after an explanation my cousin was told that the doctor might be able to squeeze me in the next day. Hai, but what about this very afternoon? Ha, ha, come immediately was the answer! So, by about 3 p.m. I was on his table “for repair”. 

 At home Im boiled the herb we bought earlier which was supposed to be for backache and muscle pain. Then, I applied a wine herbal extract that my Auntie gave us that had proven to be good for my sprained toes.

The morning of Friday, 11 February, I was back on the chiropractor’s table again for another fix. By 3 p.m. I was back at my table in the Cancer Centre for the regular Friday session. By Saturday morning, I felt rather well. I was able to walk up the stairs, bend down, etc, etc. Sunday night was the usual routine and I don’t think anybody noticed that I had a problem.

God does answer prayers but He does so in His own way, that man often cannot understand or see.  Does a miracle happen only when the wind blows and someone gets well for no apparent reason?   In a more subtle way, God works miracles by “opening doors and opportunities” at the correct time and brings you to people whom you need. Some may like to call that coincidence. We call it miracle.

More importantly is that when we call Him in despair, He provides us with the courage to face reality like never before. Deep down in my heart I know that I will be alright. I could sense that feeling – the optimism that is so vital for healing. 

Often we interpret sickness as a misfortune. Why not look at the positive side of things. When I was immobilized, I decided that the best use of my time was to write and I worked on the book: Food & Cancer. By the time I became well, I almost finished writing the whole book. Then, I researched to find herbs to cure my ailing back, I “discovered” two things – the Pain Solution and the Backache Wine. These two helped me tremendously. And that’s besides having the opportunity to know the chiropractor!  So, could my sprained back be a blessing rather than a curse? 

I have no doubt, it was a blessing!

Some Interesting Videos You May Want to Watch

The Perfect ATTITUDE to Heal Cancer Successfully!

There are in general 3 sorts of patients and only one of them is likely to overcome and heal cancer long term. All doctors agree on, that the attitude of the patient is one of the most critical elements in the healing process.


CANCER is curable NOW with Perception

Everything is just as you perceive it. If your subconscious memory tells you this is bad you will believe it and not even question your beliefs. If your subconscious memory tells you that it’s good you like it even though it can be bad for you.


Mind Over Matter. Healing Emotions!

My real passion is to turn anguish, pain and suffering into gratitude. It’s as beautiful as seeing a sun rise in the early morning, when darkness gives way to an awakening consciousness.

Finding The Cause Of Cancer


The Danger In Alternative Cancer Treatment!

The Three Pillars of a Successful Cancer Cure


Are There Doctors Who Can Cure Cancer?


Overdiagnosis and Pseudodisease

What is overdiagnosis? 

Overdiagnosis is the diagnosis of “disease” that will never cause symptoms or death during a patient’s lifetime. It’s a side effect of our relentless desire to find disease early through annual checkups and screening.  Overdiagnosis occurs when a disease is diagnosed correctly, but the diagnosis is irrelevant. A correct diagnosis may be irrelevant because treatment for the disease is not available, not needed, or not wanted.

What’s the problem with wanting to know if there’s a cancer or disease lurking in our bodies?

The problem is, we all harbor abnormalities. Today with our technology we have all sorts of tests that are increasingly able to find our potential health problems, yet most of these abnormalities will not go on to cause disease.

Jennifer Durgin wrote: “Due to the sophisticated scanning technology, like computed tomography (CT) and magnetic resonance imaging (MRI), we’re able see ourselves at a level of detail that has never before been possible. Dartmouth radiologist William Black, M.D, said.”Because we’re now able to see every millimeter of the body, we of course find a lot more abnormalities in the body than we ever knew existed. Oh, there is this ton of tumors out there and other diseases, so disease must really be increasing in frequency.'” But is it?”

But because doctors don’t know which abnormality will and which will not develop into full blown disease, they tend to treat everybody. That means doctors are treating those who cannot benefit because there’s nothing to fix, and these people can be harmed.

What’s the harm?

Overdiagnosed patients cannot benefit from the detection and treatment of their “cancer”, because the nature of the cancer was never destined to cause symptoms or death in the first place. So patients can only be harmed instead due to the following.

  • Overdiagnosis triggers overtreatment or unnecessary treatments.  All medical interventions have side effects. This is particularly true of cancer treatments. Surgery, radiation and chemotherapy all pose varying morbidity and mortality risks.
  • Psychological effects – just being told that you have “cancer” makes your world turns upside down. Unknown to both doctors and patients, this so-called “cancer” may not be harmful after all.
  • Unnecessary expenditure due to the cost of treatment from which the patient cannot benefit, because the disease posed no threat.

Who benefits from overdiagnosis?

 A lot of people: drug companies, device manufacturers, imaging centers, hospitals and of course the doctors. The easiest way to make money is not to make a better drug or build a better device—it’s to expand the market for existing drugs and devices by expanding the indication to include more patients. Similarly, for hospitals, the easiest way to make money isn’t to deliver better care; it’s to recruit new patients—and to make patients to come for regular checkups.

Early detection of cancer – the cause of overdiagnosis

Overdiagnosis is the side effect of the systematic evaluation of asymptomatic patients to detect early forms of cancer, as in the widely promoted “Early Detection” or “Screening” for cancers (in breast, prostate, etc.). This procedure may detect abnormalities that meet the pathologic definition of cancer as seen under the microscope and interpreted by the pathologists. But these abnormalities will not progress to cause symptoms or death during a patient’s lifetime.

A patient once said this to me, A cancer is a cancer. And like it or not it must be taken out. There is this long-standing assumption that all cancers when found early will inevitably progress to become full blown cancer. This assumption does not hold true all the times. Some pre-clinical cancers will not progress to cause problems for patients.

It has long been known that some people have cancers with short pre-clinical phases (fast growing, aggressive cancers), while others have cancers with long pre-clinical phases (slow growing cancers). Pre-clinical phase is defined as the time period that begins with the onset of an abnormal cell and ends when the patient notices symptoms from the cancer.

The figure below depicts the heterogeneity of cancer progression using 4 arrows to represent 4 categories of cancer progression.

Source: Gilbert Welch, Should I Be Tested for Cancer? pg.55

  1. The arrow labeled “Fast” represents a fast growing cancer, one that quickly leads to symptoms and to death. These are the worst forms of cancer.
  2. The arrow labeled “Slow” represents a slow growing cancer, one that leads to symptoms and death but only after many years.
  3. The arrow labeled “Very Slow” represents a cancer that never causes problems because it is growing very slowly. If a cancer grows slowly enough, then patients will die of some other cause before the cancer gets big enough to produce symptoms.
  4. The arrow labeled “Non-progressive” represents a cancer that never causes problems because it is not growing at all. In other words, they are cellular abnormalities. They meet the pathologic definition of cancer but never grow to cause problem simply because it stops growing or perhaps even shrinks. You may have thought that all cancers progress. That is not the case.

Some cancers outgrow their blood supply and are starved, others are recognized by the host’s immune system and are successfully contained, and some are not that aggressive in the first place. They don’t need to be treated and are harmless.

From the above it is clear that all cancers are not created equal. Some grow rapidly and invade other tissue, others grow slowly and remain noninvasive, and some don’t grow at all or may even recede. So many of the cancers that doctors are finding and treating today are what’s called “pseudodisease”—tumors that will never cause harm, let alone kill you.


Nonprogressive cancers and very slow growing cancers are collectively referred as pseudodisease (meaning “false disease’). Pseudodisease is, therefore, a type of cancer that need not be treated.  Steven H Woolf, MD, MPH, writing in the British Medical Journal, 18 November 2003, said, “Pseudodisease is the portion of the iceberg below the waterline. Modern medicine is too ignorant to know for sure which of the submerged parts are worth detecting. Doctors of the future will know better. Until then, caution is warranted as we probe beneath the water. (

Dr. William Black said, “It should be pointed out that pseudodisease is almost impossible to document in a living individual. When pseudodisease is treated, as it almost always is, long-term survival is attributed to the treatment and is labeled a cure. In the rare instances when it is not treated because of old age or other contraindication, pseudodisease cannot be confirmed as such while the patient is still alive because, by definition, it must remain asymptomatic until the patient dies of other causes. These problems with documentation probably explain why pseudodisease has received relatively little attention.”

The medical community doesn’t know enough about some cancers to predict how they will behave over time. So it’s safer, they reason, to label a questionable abnormality as “cancer” and to treat it, than it is to risk its growing out of control. Only after an untreated person dies from other causes can a cancer be declared pseudodisease. Only then is it clear that treatment of the cancer would have provided no benefit, only potential harm.

Examples of cancers that don’t progress 

1. Neuroblastma:  This is a rare form of cancer that typically affects young children. This cancer generally starts near the kidney. It  can grow to as large as a grapefruit, can invade major blood vessels and can metastatasize to major organs like the liver. They can kill children. In Japan, parents of 11 six-month-old infants declined surgery or chemotherapy for their infants. Instead they opted for watchful waiting.  This decision turned out to be a blessing. The cancers in these 11 children began to grow smaller and eventually regress.

2.  Kidney cancer: Radiologists at New York University Medical Center reported the growth of 40 small kidney tumours (less than 3.5 cm in diameter). The three fastest-growing tumours increased  in diameter by about 1 cm per year. The remaining 37 grew considerably slower – less than 0.6 cm per year. Some did not grow at all. Twenty-six of the tumours grew large enough that they were ultimately removed, but fourteen never grew large enough for the doctors to recommend surgery. More important , no one developed metastases or any symptoms from their cancer and no one died of renal cell carcinoma.

3.  Breast cancer: The incidence of ductal carcinoma in situ (DCIS) rose dramatically in the US after mammography screening became widespread. DCIS now accounts for 1 out of 5 newly diagnosed breast cancers.

More than one half million women have been diagnosed with DCIS in the past 20 years in the US. Virtually all of them were treated with surgery, radiation and chemotherapy as if they had invasive breast cancer.  DCIS is actually quite prevalent in the population and is present in 40% of the findings of autopsies conducted in middle-age women who die of other causes.

Most DCIS is psedodisease. Although rarely done, watchful waiting may be a reasonable strategy for many women with DCIS.

4. Prostate cancer: Autopsy studies had shown that elderly men who died of other causes often had histologic evidence of prostate cancer, latent disease that was clinically silent while these men were alive. Introduction of a screening test (prostate-specific antigen – PSA) in the late 1980s brought an “epidemic” of prostate cancer to the United States in the early 1990s.

“The most compelling evidence that pseudodisease is a real problem comes from the experience with prostate cancer. Prostate cancer is the second-leading cause of cancer-related death in American men, and over the last 30 years, more and more of it has been found. In 1975, about 100,000 new cases were diagnosed; in 2003, about 220,000. At first glance, one might conclude that prostate cancer is on the rise. However, if a cancer is “really increasing,” you’d expect death rates to rise. And that hasn’t happened with prostate cancer. The death rate has remained more or less constant, hovering around 30,000 deaths per year in the U.S.

5. Lung cancer:  Swensen describes the pseudodisease that emerges when computed tomography (CT scan) is used to screen for lung cancer. It detected 56 lung cancers over 4 years at the Mayo Clinic, but also a much larger number of uncalcified chest nodules, 98% of which were benign. He notes that wedge resection carries a 4% mortality rate, raising the prospect of patients’ dying on the operating table in the pursuit of pseudodisease.

Twenty years ago, Yale researchers examined the autopsy reports of patients (generally over age 60) who died at Yale-New Haven Hospital and who were not known to have lung cancer during life. The rate of surprise cases of lung cancer in these autopsies was 10 times the rate of lung cancer diagnosed in the general population. What does this mean?

If pathologists found very few kung cancers in patients not known to have cancer in life, doctors could expect that most small lung cancers they do find will progress to be the type of lung cancer we all fear.

However, if pathologists find a high incidence of lung cancers in patients not known to have cancer in life, doctors need to recognize that many small lung cancers detected by CT scan may be pseudodisease.

6. Thyroid cancer:  Pathologists in Finland examined the thyroid gland in 101 autopsies. Over a third of the autopsied patients had thyroid cancers! But thyroid cancer is rare in Finland as well as in the United States. However, many of the cancers they found were small, some as small as 0.2 mm in diameter. The researchers concluded that virtually everybody would have some evidence of thyroid cancer if examined carefully enough.  Put another way, we might say that the smallest forms of thyroid cancer are so common that they should be regarded as normal.


Let me end this discussion with the following statements by Dr. Gilbert Welch:

  1. Not all cancers should be treated. Some small cellular abnormalities that are called “cancer” will not progress to cause symptoms or death. Others will progress so slowly that people will die of something else before they ever have symptoms of cancer.
  2. It is practically impossible to know for sure whether an individual cancer is, in fact, pseudodisease.
  3. There is a bottomless reservoir of cancer in the general population – the harder you look for it, the more you find but this pseudodisease will never harm the individual anyway.
  4. As  diagnostic methods and equipments become more sophisticated doctors are beginning to find smaller and smaller tumours in such organs as the thyroid gland, kidney, lung and breast.
  5. The fact that pseudodisease exists suggests that the correct approach to cancer is not always treatment. Instead, watchful waiting may be a reasonable strategy.

Points for You to Ponder On

  1. Given that there is such a thing as pseudodisease, do you really need to go “hunting” for cancer every  year  in the forms of mammogram, PSA test, colonoscopy, etc, etc?
  2. The person who determines whether you have cancer or not is really not your doctor but the pathologist. He studies a bit of your tissues under a microscope and decides if you have cancer or not. Do you think he is 100 percent right all the time? Can he be 100 percent sure that the abnormal cells that he observe under the microscope  would grow in you and become a full blown, dangerous cancer?
  3. Given that all cancers are not created equal, is the standard “all-size-fits-all”  recipe of surgery, chemotherapy, radiotherapy (and taking hormones in breast cancer) the only correct solution for every cancer?

Read more:

  1. Gilbert Welch, M.D., M.P.H. Should I Be Tested for Cancer? Maybe not and here’s why, University of California Press.
  2.  Lisa Chedekel,
  4. William Balck,
  5. Jennifer Durgin,


The Cold Hard Facts About the US Cancer Program, Part 2: Misguided and Ineffective

Have you read our earlier write-up: The Cold Hard Facts About the US Cancer Program, Part 1: Misguided and Ineffective?

Townsend Letter, the Examiner of Alternative Medicine, is a magazine published in Washington, USA. It is written by researchers, health practitioners and patients. Its editorial staff is headed by Jonathan Collin, a medical doctor. The aim of this magazine is to provide a forum for discussion on the pros and cons of alternative medicine.

The October 2011 issue of The Townsend Letter has another (continuing) article, The US Cancer Program and Specific Types of Cancer, 1975–2007: A Failure – Part 2. This article is written by Anthony D. Apostolides, PhD, and Ipatia K. Apostolides, BA. (Part 1 and 3 of their papers were published earlier). You can access their papers by clicking this link:

Dr. Anthony D. Apostolides is a researcher and teacher of health-care economics. He received a doctoral degree in economics from the University of Oxford, UK, and a master’s degree from the University of Pittsburgh.  Ipatia K. Apostolides has more than 15 years of experience in the field of cancer (Cleveland Clinic Foundation, and Children’s Hospital, Cincinnati). She has a bachelor’s degree in biology from Case Western Reserve University.

The authors assessed the US cancer program by analyzing the overall incidence and mortality rates of 24 specific types of cancers. The assessment, based on a long time period (1975–2007), provides results that are more comprehensive and thus more reliable than those based on shorter time periods.

The criteria used for assessing the effectiveness  of the National Cancer Institute (NCI) program were:

  1. The incidence rate and the numbers of Americans afflicted by a cancer. A constant or increasing incidence rate over time, along with increased numbers of those afflicted, indicates a failure of the program.
  2. If the incidence rate declines, but the number of people afflicted increases, the program is deemed to be a failure.
  3. A declining incidence rate, along with a declining number of those diagnosed with the cancer, indicates success in the prevention of that cancer.
  4. A constant or increasing mortality rate of a cancer over time, along with increased number of deaths, indicates a failure of the NCI in the treatment of that cancer.
  5. If the mortality rate declines over time but the number of deaths increases, then the program for the treatment side is shown to be a failure.
  6. If the mortality rate declines over time and the number of deaths decline, this indicates success in the treatment of a cancer.

Definition:cancer incidence or mortality rate is the number of newly diagnosed cancers or number of reported cancer deaths of a specific type occurring in a specified population during a year (or group of years), usually expressed as the number of cancers per 100,000 population at risk.

Here are some of the facts that the authors presented regarding some of the common cancers that we hear of in Malaysia (read the authors’ three papers to know more on other types of cancer).

Brain Cancer (Invasive)

  • The overall incidence rate of brain cancer increased from 5.9 (per 100,000)  in 1975 to 6.6 (per 100,000) in 2007. That rate is 12% higher than in 1975.
  • The number of people afflicted by brain cancer surged from 12,634 in 1975 to 20,004 in 2007. From 1975 to 2007, the number of Americans afflicted with this cancer was a marked 558,716.
  • The number of Americans who lost their lives to brain cancer was 8,876 in 1975, and this number rose significantly to 12,732 in 2007.
  • On average 60% of the people who get brain cancer will die from it – a dismal outcome.

Cancer of the Female Breast 

  • The overall incidence rate of in situ breast cancer in 1975 was 5.8, and this rate climbed sharply, that in 2007 it had reached 34.8. The rate of this cancer soared 500% over the analysis period, a phenomenal rate of increase.
  • In 1975, the number of women diagnosed with in situ breast cancer was 12,591, while in 2007 an immensely higher number of women, 105,057, received the unpleasant diagnosis. During this period, the total number of women getting this cancer reached a stunning 1.7 million.
  • With regard to invasive breast cancer, the overall incidence rate of that cancer rose substantially from 105 in 1975 to 126 in 2007.
  • The number of women afflicted by invasive breast cancer also grew significantly. In 1975, the number of women diagnosed with that cancer was 226,923. This number climbed steadily over time and reached 381,125 in 2007. The total number of women diagnosed with the cancer between 1975 and 2007 was an astounding 10.6 million.
  • With regard to mortality of invasive breast cancer, the overall mortality rate increased from 31.5 in 1975 to 33.2 in 1990. Subsequently, the rate decreased to 22.8 in 2007.
  • In 1975, there were 67,924 deaths from this cancer, and by 2007 the number had reached 68,911 deaths. This means that the decline in the mortality rate was not large enough to offset increases in the population. The total number of women who died from this disease from 1975 to 2007 was a shocking 2.5 million. 

Cancer of the Colon and Rectum (Invasive)

  • The overall incidence rate of colon cancer declined by 33% over the period of analysis.
  • The number of people diagnosed with colon cancer in 1975 was 128,547, and in 2007, the number reached 136,616, still higher than the number in 1975. During the analysis period, a total of 4.8 million Americans had contracted colon cancer. This is a stunning statistic.
  • The overall mortality rate of colon cancer decreased by 39% over the course of 1975–2007.
  • The annual number of deaths from colon cancer decreased from 60,667 in 1975 to 50,447 in 2007. However, the total number of deaths from this cancer during the period of analysis was 1.9 million. This indicates that of the Americans diagnosed with colon cancer 41% will die from it on the average.


  • The overall incidence rate of leukemia increased from 12.8  in 1975 to 14 in 2007.
  • Even if the incidence rate of leukemia had stayed the same over time, it would still indicate a failing program of prevention. Consequently, even a relatively small increase in the incidence rate is a definitive sign of failure in prevention.
  • The other negative development of this cancer is that the number of Americans afflicted with leukemia increased steadily and significantly over time. In 1975, the number of people diagnosed with leukemia was 27,601 and this climbed markedly to 42,270 in 2007. The total number of people diagnosed with leukemia during the analysis period totaled a significant 1.1 million.

Cancer of the Liver and Intrahepatic Bile Duct (Invasive)

  • Data on liver cancer clearly show a dismally failing program. The overall incidence rate of liver cancer rose significantly from 2.6 in 1975 to 7.2 in 2007.
  • The number of Americans stricken with liver cancer rose rapidly from 5,702 in 1975 to 21,844 in 2007. This represents an amazing 283% increase and proves that the cancer program failed in preventing liver cancer.
  • The total number of Americans afflicted with liver cancer during 1975-2007 was 378,311.
  • The mortality rate grew by 1.3% annually. But the situation worsened in 1988 to 2007, the mortality rate increased by 3.2% annually.
  • The rising mortality rate of liver cancer increased from 6,069 in 1975 to 16,202 in 2007.  This represents a 167% increase.
  • On average, 88% of Americans afflicted with liver cancer die from the disease; that is indeed a horrendous statistic, showing the abysmal failure of the NCI program in treating this cancer.

Cancer of the Lung and Bronchus (Invasive)

  • The overall incidence rate of lung cancer rose from 52 in 1975 to 61 in 2007. This indicates an increase of 17% over the analysis period.
  • In 1975, the number of Americans diagnosed with lung cancer was 112,867. That high number increased rapidly over the years that followed, reaching 183,895 by 2007. As a result of these increases, the number of Americans diagnosed with lung cancer during the period of analysis totaled a shocking 5.4 million.
  • The number of Americans who died annually from lung cancer increased tremendously. In 1975, the number of Americans who died from this cancer was 91,918, and by 2007 that number jumped 66% to reach 152,539. The total number of deaths from this cancer during the period of analysis was a shocking 4.6 million.
  • On average, 85% of Americans diagnosed with the disease, will die from it – a horrible statistic.

Non-Hodgkin’s Lymphoma (NHL)

  • In 1975, the overall incidence rate was 11, and by 2007, it had climbed 91% to 21.
  • The rapidly increasing incidence rate resulted in ever-rising numbers of Americans being afflicted by NHL over the analysis period. The number afflicted with this cancer was 23,887 in 1975 and climbed significantly to 63,028 by 2007. The number of Americans afflicted with NHL during the period of analysis totaled a significant 1.5 million.
  • Data on the mortality rate of NHL also indicate a failing US cancer program in treating this cancer. The overall mortality rate increased from 5.6 in 1975 to 6.5 in 2007.
  • The number of Americans who lost their lives to NHL increased significantly over time. In 1975, 12,000 Americans died from the disease and this number grew by over 100% to reach 24,235 in 1997; it then decreased to 19,672 in 2007. The total number of Americans who lost their lives to NHL during the period of analysis totaled 622,451. This indicates that on average, 42% of Americans diagnosed with NHL will die from it.

Cancer of the Ovary (Invasive) 

  • The overall incidence rate of ovarian cancer declined over the analysis period from 16.3 in 1975 to 13 in 2007. However, the decline in the overall incidence rate of ovarian cancer over time was not large enough to offset the effect of the country’s population increase; consequently, the number of women afflicted by ovarian cancer increased over the period of analysis.
  • In 1975, the number of women afflicted with ovarian cancer was 35,247 and by 2001 the number had reached 41,649. After 2001, the number of diagnoses declined slightly to reach 39,132 in 2007. That number was still markedly higher than in 1975. During the 1975–2007 period, a total of 1.3 million women were diagnosed with ovarian cancer.
  • The overall mortality rate of ovarian cancer declined over the analysis period. In 1975, that rate was 9.8, and it hovered around 9 for over two decades before declining in the last few years of the analysis period to reach 8.2 in 2007.
  • The number of women who lost their lives to ovarian cancer increased over the period of analysis. This is similar to what was observed for the overall mortality rate. The number of women who died from this cancer was 21,252 in 1975, and by 2007, that number had risen to 24,801. The number of women who died from that cancer during the 1975–2007 totaled 770,398. This indicates that on average, 61% of the women diagnosed with ovarian cancer die from their cancer – a dismal statistic. Based on the mortality rates, the majority of these women are from the “65 plus” age group. 

Cancer of the Pancreas (Invasive) 

  • The overall incidence rate of pancreatic cancer increased over 1975–2007, from 11.8 to 12.4. The number of Americans afflicted by pancreatic cancer also increased significantly over time. In 1975, the number of people diagnosed with pancreatic cancer was 25,571 and by 2007 that number jumped to 37,292. The number of Americans afflicted with this cancer during the period of analysis totaled 984,698.
  • The overall mortality rate of pancreatic cancer essentially stayed the same over the period of analysis, at 10.7 in 1975 and 10.8 in 2007.
  • The constant overall mortality rate of pancreatic cancer contributed to increases over time in the number of Americans who lost their lives to that cancer; that number rose from 23,023 in 1975 to 32,525 in 2007.
  • The number of Americans who died from pancreatic cancer during the analysis period totaled 899,943; this was very close to the number of people diagnosed with the disease at 984,698. On average, 91% of the pancreatic cancer patients die from their cancer. This is indeed a most dismal statistic, showing the failing NCI program in treating this cancer. 

Cancer of the Prostate (Invasive) 

  • The incidence rate of prostate cancer show a big failure in the US cancer program in preventing this cancer. The overall incidence rate rose rapidly from 94 in 1975 to a high of 237 in 1992; subsequently, it declined to 171 in 2007, still much higher than in 1975.
  • The number of men diagnosed with prostate cancer in 1975 was quite large, at 203,058. That number increased rapidly over time, reaching a stunning 610,000 in 1992. This was followed by a decline to 515,569 in 2007, which was still much higher than in 1975. The number of those afflicted by prostate cancer over 1975–2007 grew by a remarkable 154%.
    • The total number of men diagnosed with prostate cancer during the period of analysis was the highest number observed of all the cancers – an unprecedented 13 million.
    • The overall mortality rate of prostate cancer increased from 31 in 1975 to 39 in 1993. Thus, during the first 19 years of the analysis period, the US cancer program in treating this cancer was a failure. After 1993, the mortality rate began to decline; and by 2007, the rate had dropped to 23.5. Thus, after 1993, there was some success in the treatment side of this cancer.
    • In 1975, 66,887 men died from prostate cancer, and that number rose to 102,384 in 1993. After 1993, the number of deaths declined, reaching 70,903 in 2007; that number, however, was still higher than in 1975. The number of men who died from prostate cancer during the analysis period totaled 2.8 million. This indicates that on average, 21% men diagnosed with prostate cancer will die from it.

Cancer of the Stomach (Invasive) 

  • The overall incidence rate of stomach cancer decreased over the analysis period, from 11.7 in 1975 to 7.1 in 2007. This indicates that the US cancer program was successful in the prevention side of that cancer.
  • The decline in the incidence rate of stomach cancer also resulted in a decrease in the numbers of Americans afflicted by that cancer over the analysis period. In 1975, the number of people diagnosed with stomach cancer was 25,226 and by 2007, that number had declined to 21,512. The total number of Americans afflicted with this cancer during the analysis period was 794,935.
  • The overall mortality rate of stomach cancer declined, from 8.5 in 1975 to 3.6 in 2007. The declining mortality rate of stomach cancer resulted in a decrease in the number of Americans who lost their lives to that cancer over time. In 1975, that number was 18,379 and by 2007, it had dropped to 10,892. The total number of people who died from that cancer during the analysis period was 481,716. This indicates that on average, 61% of people diagnosed with stomach cancer will die from it – a dismal statistic.


On 23 December 1971, President Nixon declared War on Cancer. He promised the American people and the world that victory against cancer would be achieved within five years. Forty years have passed. That declaration still remains an empty promise, typical of statements made by politicians everywhere.   Billions and billions of dollars have been poured into this War with no victory in sight.

In 1975, Nobel Laureate James Watson said, It produced no promising leads. It‘s a bunch of shit. Linus Pauling, a two-times Nobel Prize winner said, Everyone should know that the War on Cancer is largely a fraud.  An article in the New England Journal of Medicine came to a similar conclusion, Cancer remains undefeated … and the war on cancer is a qualified failure.

Dr. Richard F. Taflinger wrote, “Statistics are a prime source of proof that what you say is true. Statistics are based on studies. There are, of course, problems with using statistics as evidence. Let me remind you of a famous saying: “There are three ways to not tell the truth: lies, damned lies, and statistics.”

In this case, can we ever lie with such hard facts? Actual numbers tell better truth than the manipulated and massaged statistics put out by drug companies and their cohorts.  Ask this question – Is the US War on Cancer a roaring success or a great dismal failure?

Show me the hard facts and numbers please!


Dissecting Chemotherapy 11: No Chemo for Dad’s Liver Cancer – Wisdom of a Daughter

Daughter: My father was diagnosed with liver cancer in August 2011.

The doctor wanted him to do chemotherapy. We did not allow him to do so. I argued with the doctor.

The doctor did not get angry with you? Yes, he was but I did not bother. Since we did not want to go for chemo (injection) he was asked to take an oral drug for his liver. This cost RM 20,000 per month.

Wait, wait. Let’s start from the very beginning. Actually what happened and when? D: My father had winds in his stomach. This was in August 2011. He consulted a doctor who told him that he had a gallstone. His liver had some shadows. The doctor then suggested that my father do a CT scan. He went to do a CT scan and the result showed a Stage 2 liver cancer. The doctor suggested chemotherapy. We told the doctor we wanted to go home first and consult with all the members of the family. After that we went to seek a second opinion from a liver specialist.

The Second Opinion – the Liver Specialist

D: The liver specialist studied the CT scan. He also suggested chemotherapy. This time I accompanied my father to consult with this specialist because I did not want him to undergo the chemotherapy. I told the doctor, “We do not want chemotherapy.” When the doctor saw my father, he encouraged him to get admitted into the hospital. He said, “Uncle get admitted immediately and tomorrow we shall start with the chemo.”

I was not happy. The first doctor we consulted with told us that my father had to stop all his heart medications before undergoing chemotherapy. My father had a heart by-pass before. But this liver specialist did not even consider this. He was pushing my father to do chemo quickly. But I refused.

Okay, you refused chemo. What did the doctor say? D: I argued with him. Then I requested that he do another CT scan for my father. So, a second scan was done.

Did you ask the live specialist if chemo can cure your father of his liver cancer? D: Cannot. I asked him, “Doctor, you want to give chemo to my father – can you cure him?” The doctor could not give me an answer. He just kept quiet – no answer. Then he said. “It all depends on the patient himself.”

What ? It now depends on the patient? D: I asked the doctor further – “ You give my father the chemo, what can  happen to him after that?” He answered, “The liver may become hard, the patient becomes yellow (jaundice). And his eyes may become yellow.” I countered the doctor, “Okay doctor, my father currently has no pains, can eat, can sleep, can walk and move his bowels – after the chemo, his health is jeopardised  and he may not be able to do all these – what’s the whole idea?

What did he say to that? D: The liver specialist said, “I have found the best oncologist to do the chemo for your father, do you know that? I have already made the necessary arrangements for your father to do the chemo tomorrow. Now you tell me you don’t want to do it.” But I said, “In the first place, we never ever agreed to undergo chemo.”

But he told you, There is no cure and the patient becomes yellow – why do the chemo then?  D: I eventually told the doctor very bluntly, “My father doesn’t want to do chemo.” My mother also said, “The patient refused chemotherapy.”

How did he respond to that? D: Okay, if the patient did not want chemo, there is nothing we can do.

Did you ask him how much the chemo is going to cost you? D: No, we never get into that. He did not tell us about the cost and also how many cycles of chemo he was going to give.

Assistant to the Liver Specialist:  Patients come in healthy, they go out yellow! Why not try the RM 20,000-per-month oral drug for liver cancer?

D: The second CT scan report was ready after two weeks.  I requested to have a copy of the report so that I can bring it to you (CA Care). I went to the hospital and met the assistant of the liver specialist. He is also a medical doctor – a nice person. I asked him, “From your experience giving chemo to so many patients, how many really do well? This nice and friendly doctor answered, “To tell you the truth, patients come in looking healthy, but they go out looking yellow after the chemo.” This is what the assistant told me. Then the assistant said, “If you don’t want to do chemo, why don’t you take the oral drug instead. “ This drug cost RM 20,000 per month. But I told the doctor, “But doc., this drug has so many severe side effects” (Read this post: Benefit and side effects of Nexavar).

My Friend’s Husband Took the Oral Drug for Liver Cancer, He Vomited Blood and Died Within Two Weeks

D: The doctor replied, “ No, no serious side effects – you only feel itchy and have reddish palms.” I told the doctor, “My friend ‘s husband had liver cancer. He took the oral drug that cost RM 200,000 per month.  He vomited blood and within two weeks was dead.” The doctor went silent. He kept his cool and smiled. The he asked, “If you don’t want to do chemo for your father, what do you want to do then?” I replied, “I am going to bring my father to take herbs.”

What was his response? D: He said, “Go ahead and try it.”

He did not get angry with you?  D: No, he was not angry.

Did you know what is the name of that oral drug? Nexavar? D: I did not take note of that. I only know that it can damage the liver and kidney. I read this on the packaging of the medication.

They Just Want You To Do Chemo – That is the way it is

D: Unfortunately, that is the way it is with doctors today. They just want patients to do chemo. After injecting the chemo into you, the poison is already in the body – if you die, you die. That is your business.

Wife: The doctor told us, my husband is still strong. He will be able to withstand the chemo – he can withstand the chemo. D: No, no, I think he will die.

This is the way our world is now. You need to take care of yourself. You have to be responsible for your own health and wellbeing. If not, it may be like “just jumping into the sea.”

Read related story: My friend – business partner – died after chemo for his liver.

Dissecting Chemotherapy 10: No Chemo for Mom’s Breast Cancer – Wisdom of a Son

Patient is a 55-year-old female. She had a lump in her right breast and underwent a lumpectomy in June 2011. Unfortunately the job was not done well. The resected margins were not clean. Patient had to undergo another surgery and this time the whole breast had to be removed. The histopathology report confirmed an infiltrating ductal carcinoma, grade 2 with high grade DCIS (more than 25%) with 1/9 lymph nodes shows metastasis. The tumour is ER +, PR + and C-erb-B2: 2+.

After the surgery, the patient was asked to undergo chemotherapy and radiotherapy. The son persuaded the mother not to go for further medical treatments. Patient came to us and was prescribed Capsule A, Breast M and C-Tea.

On 18 October 2011, I had the opportunity to talk with the patient and her son.

You were asked to do chemo? Patient: Yes, but I didn’t want to do it.

Why? P: (Looking towards her son) He did not want me to do it.

Ha, ha, he did not want to do it, not you didn’t want to do it.

How old are you now? P: Fifty-five years old.

Son: I did not have much confidence (in what they did on her). She went for an operation and after that the doctor asked her to do chemo. Before the surgery, I asked the doctor, “What is the reason my mother has breast cancer?” The doctor replied, “No reason. If it happens, it happens.” I don’t think this was a logical enough answer because any illness must have a cause. This doctor is an expert – so famous yet that was the answer he gave me – if the cancer is going to strike you, it strikes you.

Anyway, after my mother had the mastectomy, we were referred to an oncologist. She was told to undergo six cycles of chemo and fifteen sessions of radiotherapy. The doctor said, “You go ahead and do these treatments first. Later I shall inform you what else to do.” I asked the doctor, “She had just undergone an operation, can you confirm if there are still cancer cells in her?” The reply was, “No need to ask. You must go ahead and do these treatments.”  I asked him back, “If there are no more cancer cells in her, why must my mother do chemo?” The doctor replied, “Patients overseas do the treatments. We must follow what they do. So your mother has to do the same treatments.” (Son shaking his head) I don’t  think we have to follow what others do. It is illogical. As doctors I don’t think they should say such thing – other people do, so we must also follow. After all, all of us are different.

I again asked the doctor, “ If she were to do three cycles only and she is cured – do we still have to continue to do another three?” The answer was, “No, no, you must complete the entire six cycles. We must follow the protocol.”

According to my mind, this is not the right thing to do. I again asked the doctor, “After the chemo and radiation, do we still have to do other treatments.” The doctor answered, “Yes, yes, but let us not discuss that step yet.” I countered the doctor, “Does she need  to go on receiving the treatment, one after another until  she nearly reach the point when she is about to get into the coffin before the treatment ends?”

With such answers, I told my mother the way she is going does not  seem right.

My Friend Died After Chemo for His Liver Cancer

I had a friend – my business partner. He had abdominal pains. A checkup showed liver tumour.  The doctor asked him to go for an operation to remove it. He went for a second opinion. Another doctor told him surgery would be very risky. He might not survive. He should not operate.  My friend went to seek the opinion of a third doctor.  This one said he should undergo chemotherapy. My friend asked the doctor, “But doctor you only see the scan. You did not do a biopsy.” The doctor replied, ”If I do the biopsy, I might break the liver capsule.”

The family finally decided to undergo chemotherapy but they did not have any clue as to what chemo is. After the chemo, my friend’s abdomen bloated up. He could not eat or drink. He died within a few months. I saw with my own eyes what had happened to my friend. So I told my mother, “You don’t know what chemo is and you don’t know about the side effects that the doctor told us. Let us find another path. “

Chemotherapy and Radiation May Not Cure

They asked you to go for chemo and radiation – did you ask if these will cure your mother? Son: No cure. They said the cancer can come back again. They cannot guarantee anything.

Yes, right – no one can give you any guarantee. But I am a bit baffled. Just because others (Westerners) do these, we also must follow – we must do the same thing.

Parents Value Doctor’s Opinion More Than Their Son’s

My father and mother are not well educated. They only depend on the doctors to tell them what to do. As their son, they would not listen to my opinion. They believe the doctors more. There are things I can understand,  but old folks do not understand even if you tell them. Sometimes relatives come – they give their opinions too. That complicates things even more. Uncle, auntie, neighbours come and put pressure on us. Until now, some people still come to me and asked me to send my mother for chemo. They said that so and so had chemo and was cured. But everyone of us is not the same.

I have read – there were people who died after chemo and there were people who were cure with chemo. I have read all these and told my parents about these. They responded, “Why go and read all these.” They do not  have confidence in themselves.

Oh, they don’t want to learn for themselves? They only want to hear “good things” and only think that they can win? Son: Because they only believe in what the doctors tell them. Actually most old folks behave like this.

It is All About Money First

I checked all the information I got to see if they are true or false. It all boils down to money first. Like in my friend’s case, it is all about money when they discussed his case.

CA Care Website

You visited our website and watched the videos of patients telling their stories in Youtube. Can I ask you one question  –  do you believe what they said?  Son: At least there is something in there – the information in there are better than what the doctor provided. These are real stories of people. I also want to find out if the information is true or false.

I put it to you – how sure are you that the videos are not fakes – made up stories with actors posed as patients? Someone wrote me an e-mail asking how much I paid each patient to talk or act like that? Son: That had never crossed my mind at all. No, no, I don’t have that kind of feeling at all. After all, doctors are also telling the same thing – there is no guarantee about anything. You want to do chemo or anything – there is no guarantee but money must come first. But for the side effects – that not their responsibility.

Advice to Patient

(Turning to the patient) What does your heart say Auntie? P: I never think about this at all.

Your friends or relatives may ask you to go for chemo – are you confused? P: No (shaking her head).

No one can help you except you yourself. So please take care of yourself. This is your illness. We can only guide you as what to do but you must be responsible for yourself. What I tell you may be different from what your doctors tell you. It is up to you to believe me or not. I advise you to take care of your diet. They tell you, you can eat anything you like. In addition I advise you to exercise, take the herbs and be happy – don’t think so much. 

Death – The Ultimate Healing

Over the past weeks many things happened that prompted me to write this article about Death. To many people, especially those with loved ones who have cancer, to read or talk about death is probably the last thing that they ever want to do. The subject about death is a taboo – they want to only hear how to cure their incurable cancer.

  • A father wanted us to help his 3-year-old son who had neuroblastoma, Stage 3. After surgery the boy received three cycles of chemotherapy. The side effects were so severe that the father wanted to stop medical treatment altogether.
  • A son from Eastern Europe wrote about his 61-year-old father who had lung cancer that has spread his liver, lymph nodes and bones. He wrote, I was directed to you by a Malaysian colleague of mine whose relatives you have helped. Please don’t turn us away.
  • A lady from Indonesia wrote, I want to ask the best hospital for cancer in Penang. My problem is cancer in my right breast. Record from Dharmais (Cancer Hospital) since 4 July 2011 was to operation. I don’t want. I’m very afraid. What shall I do? Please I’m in trauma because my mother passed away with cancer in 1972. I have one son. Please help me.
  • A young lady wrote, I’m planning to go to your center in Penang regarding my sickness. My leukemia relapsed very recently and my doctor told me I probably have less than six months to live if I choose not to have anymore chemotherapy. And he said further chemotherapy can only buy me some time (probably two additional months) unless I have bone marrow transplant.  

I jokingly tell patients – we are your last one stop. The cases that come to us are usually beyond us to cure. We trust and pray that God will do the miracle – this is His decision not ours. This is our motto – Our hands but God heals. When we first started CA Care, some critics say we are giving the dying false hope.  Over the 16 years that CA Care is around, we are happy to say that many miracles did happen at CA Care. Make no mistake, we are under no illusion. Neither are we a religious fanatic. Over the years we always call a spade a spade and we face reality without any pretence. Death is a reality – it can happen to you or me, anytime – irrespective of whether you get cancer or not. Perhaps with cancer, the journey to the grave seems somewhat shorter!

Our struggle and responsibility is obviously beyond us to bear. We derive much comfort in Reinhold Neibuhr’s often quoted prayer,

God grant us the serenity to accept things we cannot change,

Courage to change the things we can,

And the wisdom to know the difference.

For those who are more conscious, perhaps they might have read the small poster put up at our centre. This is what it says,

“No one lives forever,

Therefore, death is not the issue.

Life is.

Death is not a failure,

Not choosing to take on the challenge of Life is.

Someday, when you’re tired, bored and sore,

And you want to leave your body,

Your death will be a healing ~ Bernie Siegel, 1990.

On 6 October 2011, Steve Jobs — the genius of Apple Computer died of pancreatic cancer. I have never heard of his name before, in spite of his fame. My son probably did because he is an iPad and iPhone  fan. This time I was a bit curious why a man so endowed with wealth could ever die of cancer? Is it because of lack of chemo-drug, good oncologist or good hospital? If this happened to a common person, we can always shift the blame to something like no proper medical care, or health care professionals who are not competent enough, etc. etc.  But these excuses do not apply to Jobs.

As I surfed the net, I stumbled onto what Jobs said at the Stanford University commencement speech in 2005. Let me quote what he said that day.

“No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life’s change agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away.”

What Jobs said impressed me indeed. These words came from him a year after being diagnosed with pancreatic cancer – a serious and incurable disease. He did realized from the very beginning how Nature operates. Like a big, growing tree – as new branches and leaves develop, the old branches and leaves will drop off to make way for the new. It is only in this way can the tree grow bigger and bigger.

Dr. Robin Kelly (in Healing ways – a doctor’s guide to healing) wrote, Fear of death is seen as a necessary part of modern medicine. All that can be perceived is loss and failure.

Those who have been spiritually awakened can appreciate the view that death is a natural process and is not a failure. Dr. Bernie Siegel (in Peace, Love & Healing) wrote, It is how we face up to our illnesses and how we take on the challenge of our mortality that determine whether we are successes or failures.


  • Professor Raymond Tallis (in Hippocratic Oaths) wrote, Birth remains a one-way ticket to the grave. If disease does not destroy us, external events – accidents, war, natural disasters – will bring about our demise. The best we can hope for is harmonious decline.
  • Dr. Bernie Siegel (in Peace, Love & Healing) said, It is important that we realize that we can never cure everything. We will never find … cures for all diseases. Dying can be a healing, ending a full, rich life for someone who is tired and sore and in need of rest.

Human Attitude

Some of us live our lives as if life is forever. We hear of others die – relatives, friends and celebrities, but how many of us ever thought or believe that it could be our turn the next time?

  • Writer William Saroyan humourously made this remark during the final hours of his life, I always knew that everyone dies, but I really thought there would be exception in my case.
  • Dr.  David Simon (in The Wisdom of Healing) wrote, As I board airplanes these days, I have the thought that every person who died in an airplane crash did not believe that his or her life is about to end. Although we all know there is the possibility of our dying on any given days, we are fairly certain it is NOT today.
  • Professor Raymond Tallis  (in Hippocratic Oaths) wrote, Death will always be premature – at least for the one who is dying. A late death is never late enough.
  • Dr. Jerome Groopman of Harvard University (in How Doctors Think) wrote, Understandably, people want the home run. But often in oncology what we achieve is less than that. And the risk is, by going for the home run, you can strike out.

What Do We Really Know About Death?

The above question is posed by Dr.  David Simon (in The Wisdom of Healing).  He attempted to give his answers.

  • Hamlet calls death “the undiscovered country” – and  how can we describe a landscape that lies off the edges of our maps and beyond the reaches of our telescopes? For most of us, only one fact is certain about death … someday we will indeed die. Fear is that one certain fact – we know that we’re afraid of death. But again, what do we really fear from something we understand so little about? It’s certainly true that nobody know what’s going to happen. But whatever we may believe … each of us is going to face it alone – and I believe that this utterly solitary quality of the death experience is one of the most important sources of our fear.
  • A second component of our fear of death derives, I think, from a sense of impending powerlessness. At the last moment… what if there are still a lot of things we want to do? Almost all of us live with, “If only I had …” or “ I should have …” or “I could have …”

Just as a blazing fire can burn a log to a fine ash, by really experiencing everyday to the fullest we can eliminate regrets and residual guilt-ridden emotions from our consciousness. If we can fully process the events and relationships of our lives – really digest them – we can leave the table without hunger when the feast is finished.

Personal Life Experience – Do you really want to live?

David Tate (in Health, Hope and Healing) shared his healing journey with Hodgkin’s lymphoma. He wrote,

  • A diagnosis of cancer can be scary, even terrifying … I woke up the next morning. After breakfast I went to my study where I could be alone. There in the quiet, after several minutes of internal silence, a question popped into my mind. “Do you really want to live?” It seemed like a strange question. Of course I wanted to live! I was afraid of dying, that was for sure. Afraid of the pain, the helplessness, the humiliation, the loneliness. “But do you really want to live? “The voice persisted … “Did I like being alive?” “Did I really enjoy living?”
  •  …. If I have to be honest there were a lot of reasons why life was no longer attractive to me. Did I dare admit that some part of me was disappointed? Could I admit that I might shirk my responsibility because, for reasons deep inside, I did not really want to live?
  • So now the truth. I was disappointed with my life. I was disappointed with myself. Sure, I loved my wife and children. I wanted to live for them. But what about wanting to live for myself? Yes. And no. I was ambivalent about life.
  • Depending upon the day, the mood, perhaps even the weather, I would have a different emotional message for my body. One day I would tell it I wanted to live; life was good, fun, enjoyable. Another day I was telling it I wanted to die; life was disappointing.
  • I told myself. Now that you know the truth about yourself, what are you going to do about it? Change, change – I whispered. Reclaim you dreams – I told myself.
  • A final thought – illness can be the catalyst for making deeply needed changes that results in a more meaningful and satisfying life. This has been my experience – illness is a path that can lead to inner riches.

Over these years, this is one lesson we learn – there is no cure of cancer! But there is healing and it is within you. There is no short cut. You have to work for it. Earn it the hard way. The most difficult thing to make patients understand is the need for them to change – change their perspectives about life, change their life style and habits, change their diet, change their attitude, etc. etc.

Many patients come to us with a one-track-mindset of wanting us to cure their cancer with minimal effort on their part and with the minimum of discomfort – never mind if they had chemotherapy before and suffered severely. Some even expect us to offer help via remote control and e-mail, in the comfort of their homes. If the words written by Tate above bring no deep meaning to your heart, your chances of winning over cancer is very remote indeed.

As I have told many patients. By talking to you for five minutes, my intuition will tell me whether I can help you or not. Similarly, by reading your emails to me and they way you write, I could roughly decipher to what extent I could help.

I often ask cancer patients – Do you love yourself? Of course the intelligent brain would say Yes, but I am too sure what your soul has to say. Another question would bring out the truth, Why don’t you drink your herbal tea?  Answer: I have no time to boil it. How could you ever say you love yourself when you don’t even have time to take care of yourself? What do you do with all your time in this world? Of course you may have all your reasons – but where is your priority?

Take another example of a lady who wrote me these words. Her mom has lung cancer that has spread to her bones. She wrote, Per doctor’s advice, the lung cancer had spread to the pelvis in just a couple of weeks which accordingly is very fast. We will hand our mum in your good hands for us. Can we appeal for your help to assist our mum in the best way that you can please?  Please do all possible to help us.

I replied, You are from Penang. If you want to take the herbs and take care of the diet, start now. Come and see me Sunday night and I shall prescribe the herbs.

Her response, By the way, we need not bring our mum over, will it be OK?

The above communication sent a chill into my spine! We can assist patients in need but to “hand over” the sick to us to care is beyond us. It has to be you and your brothers and sisters who should take the lead with our guidance. Then, another  disappointment – she may have whatever reasons for not wanting to bring her mom to our centre. But is that the best thing to do? And she is from Penang. And she could bring her to the Hospital – why not to CA Care? Again, let me say, if patients or their care givers don’t understand that they have to change and work for their healings, our efforts to help others would be futile – a wasted effort.

The Challenge

  • Dr. Bernie Siegel (in Peace, Love & Healing) wrote, No matter how sick we are or how close to death, as long as we are alive we have the chance to make something of our lives. Those who rise to the occasion will find that no matter what the outcome of the struggles, they have created something beautiful. For we die as we live.
  • In another book of his (Love, Medicine & Miracles) Dr. Bernie Siegel wrote, You create your own opportunities out of the same raw materials from which other people create their defeats.

Death is always stalking us, and this is the driving force to live a life of meaning, ever alert to the miraculous opportunities available at every moment.

  • There is an Indian saying, When you are born, you cried and the world rejoiced. Live your life in such a manner that when you die the world cries and you rejoice. To me, this is the secret of how we can triumph and give meaning and beauty to our own death. We leave this world with a sense of pride and accomplishment knowing the we have done our best to make it a slightly better place to live for those we leave behind.

In her 479-page book, Holding Tight, Letting go – living with metastatic breast cancer, Musa Mayer wrote, Many of the people I interviewed:

  • Sought peace of mind through surrender to a will greater than their own. They accepted that death and pain and loss were a part of living. They let go of illusions of immortality and entitlement and found comfort in the contemplation of natural cycles of living and dying.
  • Spoke often of the importance of living in the moment, of how they had learned to savor time with the people they loved and to seek out experiences that had meaning to them. 
  • Kept hope alive by defining their goals and expectations to more closely match the realities of their illness. With mortality no longer a questions – what can you hope for?
  • Became expert in reframing their experiences with illness as challenge. Even in the most dire of circumstances without denying or diminishing the pain and fear, they sought out the benefits that were there to be found. They opened themselves up to new insights. They saw their lives with cancer as both a journey of discovery and a struggle to maintain themselves in difficult circumstances.

One patient wrote, I have been asked how I could achieve such calm while facing death. What is the alternative? The only other choice I can think of is to cry, to scream and yell, and just give up – but all that would be a waste of this precious gift of time.

Where does my strength come from? Nature  –  trees and hills, snow and flowers, the little animals. All these have been a source of solace … As a kid, I often found peace and comfort in the city park … Whenever I have turned to the natural world for guidance, I have not been disappointed … The trees do not mourn their autumn as the leaves fall at the appointed time. New ones are ready to replace them. Death and regeneration exist together everywhere I look in nature. Why should I be different?

Each of us can find meaning in different ways. Have courage and try to find something  that bring most meaning and joy to your life during these last days on earth. When the time comes for you to go, Go in peace. 

Facing Death

Dr. Robin Kelly (in Healing ways – a doctor’s guide to healing) wrote, Working with the dying, has given me more insights into spiritual matters … in dying, healing is at its most profound. Once the dying person has let go, a peaceful calm follows. This late stage can have a wonderfully soothing effect on those privileged enough to be present. I have felt the most relaxed in my life sitting alongside the bed of a dying person – no need to talk or plan, no better place to be.

Guide to visiting the dying:

  • Treat the person exactly as you usually do. Be yourself. Be spontaneous.
  • Talk about the issues of the day. The present is still important to the dying.
  • If he or she is resting, sit quietly and soak up the peace.
  • Respect the dying person’s right to solitude, if this is his or her wish.
  • It is not disrespectful to smile or laugh. This can relax both of you.
  • If near a window, comment on the day and nature. Make sure there are healthy flowers or plants in the room.
  • Value each moment together. Treat each as a precious gift.

Kenneth Caine and Brain Kaufman (in Prayer, Faith and Healing) had another perspective on how to care for  the dying. Someone we love is dying … or confronted with a life-threatening illness. We feel empathy, certainly, but we may also feel awkward with them because we don’t know what to say or do. Do we talk about the situation or do we ignore it?

There is a tendency to treat dying people differently. Voices are often lowered. Don’t do that, says Dr. Miller. This loved one or friend is the same person they have always been. They are as full of life as we are. Treat them as equals. They don’t want pity; they want compassion. They want to be treated as very much alive. They want to live as fully as they are able. Here are other rules of thumb from Dr. Miller.

  1. Don’t go it alone.  We shouldn’t try to be the sole caregiver and do everything ourselves. We won’t be able to. We’ll get frazzled and upset. We need to encourage others to help, and when they offer, take them up on it.
  2. Let the loved one lead.  They have needs, so we should let them make basic decisions about their care and their environment.  The patient, if possible, should decide which doctors, which hospitals and what treatment they want. Those are not our decisions, they are theirs. It’s their life. Let them chose how to live it.
  3. Draw them out. Sometimes the most valuable thing we can do is listen. When someone is dying or on the verge of dying, they usually need to talk to others, but they may not know where to start. We can talk about how they’re feeling, encourage them to relay memories, and let them know that we’re there for them if they need to talk. And when they do need to talk, we should let them. And at times when they do not feel like talking, it’s okay to just be there. Often, a gentle touch is also appreciated. It, too, is a form of communication.
  4. Get advance directives. That’s the proper term for a living will. While the loved one is still able, we should help them draw up instructions for their care should they become so physically disabled that they are unable to communicate. In addition, make sure that their will and other important documents are in order and as they would like them to be.