Breast Cancer: Surgery, Chemo, Radiation and Hormonal Therapy Did Not Cure Her. Xeloda made her miserable! Patient, Only You Should Decide What You Want To Do!

Mdm PG was 59 years old when she was diagnosed with breast cancer in June 2009. She immediately underwent a right mastectomy. Histology report indicated:

  • Three lesions of invasive ductal carcinoma.
  • Focal lympho-vascular invasion is seen at the periphery of the 2 small lesions.
  • Resection margins, skin and nipple are not involved by tumour.
  • 4 out of 13 axillary lymph nodes contain metastatic carcinoma, with focal extracapsular spread.
  • pT2N2aMx, Stage 3A

Prognostic factors:

  • Oestrogen receptor –   Moderate reactivity
  • Progesterone receptor –   Moderate reactivity
  • C-erb-B2 –  No reactivity
  • P53 –  Weak reactivity

PG underwent follow up chemotherapy and radiotherapy. She was also on Fermara (for 5 years). At the same time, she started to take herbs. The following is a brief summary of her treatment progress (extracted from the e-mails from her daughter).

May 2013 – almost 4 years after diagnosis

My mum is doing extremely well and I thank God every day for you and His protection over my mum’s life.  My mum recently went for her blood test and check-up again.  The doc said that her bones are getting brittle due to the regular intake of this hormonal pill that she has been taking every day for the past 3 years to keep her condition under control.  It is one of the side effects of this pill.  He is advising her to go through a kind of treatment to strengthen her bones.

I found out the name of the bone strengthener that the doc recommended to my mum.  It’s called “Zometa.”  It is an injection.  The hormonal pills that she has been taking is called ” Femara.”

October 2013

I would like to update you with regards to my mum’s latest blood test.  Her tumor marker is 5.9.  Her usual is 3.5.

January 2014

I would like to give you an update of my mum’s latest tumor marker result.

CEA 7.1  H
CA 125 29.4  H
CA 15.3 24.1  H

Her CEA is out of the normal range and it has escalated from 5.9  last Oct to 7.1 this week.  Both her CA125 and CA15.3 have also gone up even though it is still within the normal range.

The doc is suggesting for mum to go for a pet scan to find out the problem.

My sis and I are personally not so comfortable with her having to go through another cycle of invasive treatment should we find out if there is another growth elsewhere in her body.  We are really hoping that we can help treat mum’s condition with your herbs and diet advise.

February 2014

I’ve attached my mum’s latest report to show it to you.  The doctor said that there is a relapse and the lymph nodes behind her lungs are affected but there is no spreading to her organs which is a good thing.

The doc has changed her oral medication to Tamoxifen because her Fermara  doesn’t work anymore.  She recently went for a jab to protect her bones from turning brittle.

May 2014

Tumor markers on 7 May 2014
CEA 13.5  H
CA 125 64.5  H
CA 15.3 33.5  H

My mum went for her medical appointment yesterday. Result is negative. ..conditions of marker has worsen. Doc said there is a high chance of relapse but he doesn’t know which spot … could be bone, liver or kidney. If my mum does not wish to find out the cause, the doc can’t prescribe proper medication for treatment but he will change her current medication to see if there is any improvement upon her next visit on 19th June.
The doctor explained that the life span of such case if the patient refuses finding and treatment,  usually won’t pull through. The cancer cells will multiply very fast within a year and she will not make it.

Mum’s tumour marker in January this year comparing to now has escalated from  a marker of 7 to 14 now and another two marker have also increased from positive range now all to negative range. She is  physically very well but result has shown otherwise.

Doc suggested mummy to go for PET scan to at least find out what’s the problem so we can seek early treatment since she is still healthy now. And not wait till she turns fragile and can’t proceed with any more treatment.

March 2015

My mum’s cancer marker has apparently gone up quite a bit recently and the doc said that there are tumours growing quite rapidly in her body that explains why the cancer marker is high. The doc asked if my mum has been taking any other medication that is causing interference with his. And he immediately changed my mum’s medication from tamoxifen to Exemestane Aromasin 25mg per tab and he is trying to see if the new medication can help control her tumour  growth.

The nurse warned my mum about all the side effects. My sister advised my mum to stop taking your herbs and see if there is any improvement with the western medication alone because she also believes that there could be that possibility of your herbs clashing with the oncologist’s prescription. I personally am against the idea of my mum stopping your herbs temporarily.

Doc mentioned since last year that cancer has spread to her bones and there are tumours found around her chest outside her lungs and other parts of her body too. He said it was a good thing that it didn’t spread to her organs. I’m a little worried that my mum will eventually feel the adverse side effects of her new medication if she continues with it and not take your herbs. I’m really concerned.. Anyways, no matter what the doctor said and her deteriorating condition, my mum is still in high spirits and her appetite is well and she still goes to church and play mahjong with her friends regularly like a healthy person. Her strong belief in God keeps her in good spirits too.

June 2015

I am wondering if I can bring my mum to come see you on. She has been taking Xeloda for the past one month and the sole of her feet started to turn black since last week.  I am not sure if it is due to Xeloda.  Would love to show you her feet. Blood test also showed that her glucose level is very high.  So I am not sure if she could be diabetic.

Not sure if Xeloda is the culprit? Just read the internet.

Side effects of Xeloda: Hand-Foot Syndrome

Hand-foot syndrome, also called palmar-plantar erythrodysesthesia, is a side effect of some types of chemotherapy.  In mild to moderate hand-foot syndrome, the following symptoms may occur on the palms of the hands and/or the soles of the feet:

  • Redness (similar to a sunburn)
  • Swelling
  • A sensation of tingling or burning
  • Tenderness (sensitive to touch)
  • Tightness of the skin
  • Thick calluses and blisters on the palms and soles

Symptoms of severe hand-foot syndrome include:

  • Cracked, flaking, or peeling skin
  • Blisters, ulcers, or sores on the skin
  • Severe pain
  • Difficulty walking or using the hands

The drugs that may cause hand-foot syndrome include:

  • Axitinib (Inlyta)
  • Cabozantinib (Cometriq)
  • Capecitabine (Xeloda)
  • Cytarabine (Cytosar-U)
  • Docetaxel (Docefrez, Taxotere)
  • Floxuridine (FUDF)
  • Fluorouracil (5-FU, Adrucil)
  • Idarubicin (Idamycin)
  • Liposomal doxorubicin (Doxil)
  • Doxorubicin (Adriamycin)
  • Sunitinib (Sutent)
  • Sorafenib (Nexavar)
  • Pazopanib (Votrient)
  • Paclitaxel (Taxol)
  • Vemurafenib (Zelboraf)
  • Regorafenib (Stivarga)

Not everyone who is treated with these medications develops hand-food syndrome. The severity of hand-foot syndrome can vary from person to person, even among people taking the same medication for the same form of cancer.

Source: http://www.cancer.net/navigating-cancer-care/side-effects/hand-foot-syndrome-or-palmar-plantar-erythrodysesthesia

Lisa Bonchek Adams  was 37 years old when she was diagnosed with breast cancer in 2007. After all the medical treatments in one of the world’s best cancer hospitals (in New York), she died in March 2015.  In her blog, Lisa wrote about her experience with Xeloda:  http://lisabadams.com/2012/11/

… the end of the (chemo) round ended up bringing hand/foot syndrome  from the Xeloda. Hand/foot syndrome is not the same as neuropathy (though it may include some of those symptoms), which many people on chemotherapy experience.Hand/foot syndrome is associated with a few particular drugs, Xeloda is one. The capillaries in your hands and feet leak and/or rupture, causing the chemo to spill into the extremities. This causes them to be extremely red, swollen, painful, sensitive to touch, cracked, peeling, and potentially ulcerating. Numbness and tingling also accompany the condition.For the past month I’ve been trying to keep these effects at bay, but eventually the toxicity builds up. Fine motor activities like tying shoes are hard at the moment, anything that touches/puts pressure on hands and feet. Thankfully I have some shoes with furry insides and cushioning. Socks must be worn 24/7 and slippers at all times. Holding the steering wheel is uncomfortable but doable, thankfully …

Our Meeting and Advice

We got to meet Mdm PG and her daughter in mid-June 2015. GP looked great but she felt miserable inside. She told us that she did not suffer any effects taking Xeloda during the first week. After the second week things started to get worse. She had sores in her mouth, both hands and soles peeled making walking difficult. Then she felt “tired” throughout the day.  She was not able to continue living the “good life” she had earlier on.

The daughter said, “before the Xeloda she was okay. Able to walk about, taking the bus anywhere she wanted to do. She can spend time playing mahjong, etc. Now she can’t do that anymore. She look good and healthy before that. But the doctor said, she was not healthy because the blood test was bad. Now, after the Xeloda her blood result was better, but she was feeling bad.”

PG reminded us that when she was diagnosed with (Stage 3) cancer, the doctor told her that she could last about 3 years if she did all the treatments. Now, it is already 6 years. She believed the herbs did help her. But now living such a miserable life after Xeloda, life has not much meaning anymore.

PG told us that she has 2 daughters – both love her very much and wanted her to live as long as possible. But unfortunately, these  2 daughters  have their own ideas about her treatment. One daughter wanted to strictly the doctor’s treatment while another daughter wanted her to go for herbs and was not happy with all those medical drugs. PG said, they started to “quarrel in front of me and that left me in a limbo — not knowing what to do and who to please!”

Indeed, we have “sensed” this feeling all along when we read the many emails the daughter wrote us. So, this meeting was a good opportunity for us to give our advice frankly and directly. These are what I told PG:

  • You have already understood that nobody on earth can cure cancer. Even with medical treatment the doctor already told you would only last 3 years. Now, it is 6 years. Look at it in a positive way. You have been well blessed. During these years, you did not suffer and have lived a good life (unlike now due to Xeloda). PG responded, I am aware of this. I have been taking your herbs and I felt well. Your herbs helped me a lot.
  • If you can eat, can sleep, can move around and have no pain, please don’t ask for more. Be ever grateful to God for this.
  • No one lives forever, even for those who are supposed to be healthy. One day, I too would return “home.” So let us not fear death because no one can escape this reality. I have read many books of people who have “gone” and saw “heaven” and came back to earth. They said, Up There, it is so beautiful – calm and peaceful, free from all miseries. So why are we so afraid to go there?  Don’t be afraid.
  • We fully understand the dilemma you are in — trying to please both daughters, but each wanting you to take a different path. I am afraid I cannot decide for you and tell you what to do. You will have to make your own decision. Let each of your daughter know what is important for you in life. Tell them how you feel and they must respect your wishes.
  • If you feel that you want to endure all the suffering undergoing more medical treatments, go ahead and tell your daughters you want to do exactly that. If you cannot endure these sufferings and want to just go on herbs, say that out clearly to your daughters. Your daughters should respect and honour your wishes.
  • You need to tell your daughters that what you want to do, is entirely your decision and they should not feel guilty or responsible for whatever the outcome. In this way, there would be “peace.”
  • The last thing — which is a real disaster — to have family members quarrelling among themselves.

23 June 2015

Thank you so much for taking time out to see my mum and I the other night.We are eternally grateful. Words cannot describe how grateful I am. I can never repay your kindness. My sis will still be bringing my mum to see the oncologist the next few days. Hopefully she will make a firm decision and not be swayed by their persuasion. She is recovering well, Dr.

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5 July 2015

Hi Dr Chris,

Guess what?  My mum has decided not to continue with the Chemo treatment anymore.  She told my family and her friends that she will depend solely on your herbs to help stabilise her condition.  Praise The Lord!  She is very diligent in taking your herbs everyday now.

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Breast Cancer: Surgery and Hormonal Therapy Did Not Cure Her

SH (H785) is a 67-year-old lady. She was diagnosed with breast cancer in January 1998. A left mastectomy was performed. The histopathology report of 13 January 1998 indicated two malignant nodes. No residual tumour in her breast. Axillary fat and lymph nodes were free of tumour.

No chemotherapy or radiotherapy was indicated. But SH was put on Tamoxifen. She took this drug for 6 years.

SH said she was well all these years and her progress was monitored by her doctor. About 10 years later, in early 2009, SH developed shortness of breath. She could not lift her left arm. She was tired and lost her appetite.  A chest X-ray indicated large left pleural effusion. SH had the fluid in her lung tapped out. A CT scan on 7 January 2009 indicated several subcentimeter nodules in her left lung. The lymph nodes in the left axilla and aortopulmonary window were enlarged. Impression: left pulmonary and pleural metastasis.

SH sought a second opinion from another oncologist at a university hospital. Another CT scan was performed and it also confirmed a metastatic breast cancer with left pleural effusion with small benign liver cysts.

A bone scan done on 29 January 2009 indicated multiple skeletal metastases in the sternum and two ribs on the left side.

SH was prescribed Arimidex – another oral chemo-drug for breast cancer. She was on this drug for 2 years.

In August 2011 SH developed shortness of breath again.  A CT scan on 4 August 2011 confirmed presence of mild left pleural effusion. Fluid was tapped out of her lung again.

The doctor told SH that Arimidex did not work for her. She was prescribed yet another oral drug – Aromasin. SH was on this drug for about 3 months now. At the same time SH received Zometa injection (for her bone) every 6 weeks. Each Zometa injection cost RM 1,200.

A bone scan done on 18 March 2011 indicated “sclerotic bone metastases in manubrium showing activity.” SH was told that if Aromasin did not work for her, she would have to undergo intravenous chemotherapy.

The following are her CA 15.3 readings throughout the years.

Date CA 15.3
17 January 2009 149.0
4 March 2009 230.0
8 July 2009  30.0

Year 2010 fluctuating values under 30.0

26 April 2011 51.0
22 June 2011 66.0
4 August 2011 67.4
27 October 2011 164.5
24 November 2011 227.0
23 December 2011 231.7
31 January 2012 477.0

SH and her family came to seek our help on 5 February 2012.

Below is her AcuGraph reading on 5 February 2012 which indicated a rather unbalanced internal energy.

Comments

Why did you take tamoxifen? To prevent recurrence, so you are told. Some patients are also often told this – if you survive 5 years, you are cured of your cancer! What a great lie. Did tamoxifen cure cancer in this case? It must have since his patient had survived for 5 years. That, “medically” is defined as a cure. But, you never ask – what if she does not take tamoxifen? She may also survive 5 years! Anyway the cancer came back after 10 years. This time it struck the lungs and the bones. Where then is the so called cure?

Reflect on the quotations below:

Second-Line Treatment: Arimidex

Arimidex (anastrozole) is indicated for the treatment of advanced breast cancer with disease progression following tamoxifen therapy.

Side Effects:  Patients receiving Arimidex had a mean decrease in both lumbar spine and total hip bone mineral density. Patients should be informed that Arimidex lowers the level of estrogen. This may lead to a loss of the mineral content of bones, which might decrease bone strength. A possible consequence of decreased mineral content of bones is an increase in the risk of fractures. Arimidex may also cause heart disease.

Effectiveness:

 Pooled Efficacy Results of Second-line Treatment

Source: http://www.rxlist.com/arimidex-drug/clinical-pharmacology.htm

Final results of the Arimidex, tamoxifen, alone or in combination (ATAC) trial, presented at  the San Antonio Breast Cancer Symposium and published simultaneously in The Lancet, found that, compared with tamoxifen, anastrozole (Arimidex) improved disease-free survival by 13% and increased time to recurrence by 21% ,however, there was no statistically significant improvement in breast cancer survival or overall survival. (Note: be skeptical when reading figures like such percentages – they could be manipulated to bring out only the positive message.)

Some researchers questioned whether use of Arimidex was justified in light of its higher cost ($6.56 per day for Arimidex versus $1.33 per day for generic tamoxifen) and lack of a demonstrated survival benefit (Source: Journal  National Cancer Inst (2005)97 (2): 86-87)

There are 197 comments by women taking Arimidix (as of 27 February 2012) in the website below: http://www.webmd.com/drugs/drugreview-4511-arimidex+oral.aspx?drugid=4511&drugname=arimidex+oral

Below are some examples.

Comment 1: Have not had bothersome side effects from this med so far, but am experiencing hair thinning. Some aches in a hip and knee, lack of sex drive, minor hot flashes …So far this med has not bothered me.

Comment 2: I am 63 and found I had breast cancer at 60. Had lumpectomy, 6 chemos over 7 months (carboplatin, docetaxol, nausea med, Herceptin IV’s, and a Neurlasta shot), followed by 8 more IV’s of Herceptin over 8 months, along with 31 radiation treatments, at last one 1miligram Arimidex  I’m to take for 5 years daily. My complaint is that I was completely bald all over…I had started daily Arimidex  about June 2010. A month ago, I was looking at some old pics made in May2011, and it started to hit me that my hair was thicker with more coverage than NOW (Jan. 2012). It was heartbreaking, it was becoming thinner and patchier on top front where you want it the most. I accidentally happened on a site, read that 40 or more women sharing this experience, and most believed it was the Arimidex. I tried Femara for 2 mo. with no improvement. I have aches and pains and feel “aged from the inside out” … I might just drop the Arimidex, take no “cancer” pill, and pray it won’t come back.

Comment 3: Taking this med for approx. 2 months. Extreme lower back pain 2 weeks after started, brushed it off. At this point just using my arms is very painful. My shoulders are in extreme pain. Talked to oncologist nurse and am changing to another but as of today I just want to cry I am sick of all this pain. Did not have any of this before!! I am in no way a baby, and can handle pain but even I have reached my limits. Hope this helps someone else who is experiencing the same issues with this drug.

Comment 4: I used this drug for 3 years and 4 months thinking I was doing fine on it. Suddenly I felt like my crotch was on fire. It took another 2 months of doctor appointments and medical procedures before I had a doctor that made the connection. Vaginal dryness given as a side effect is a huge under-statement. I’ve been free of this drug for 10 weeks and on estrogen cream for 4 weeks and am still miserable.

Comment 5:  Constipation, depression, lack of motivation,  muscle weakness One plus sleeping 6 hours a night instead of 5.

Comment 6: I thought I had it made …no symptoms except a little weight gain… Now my thumb is locking up and I had no idea it was from the Rx until reading the other reviews. I am achy after sitting for a short time and have really sharp pain in the back of my hand sometimes when I pick something up, even a cup of coffee.

Second-Line Treatment: Aromasin

Aromasin (exemestane) is indicated for the treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy.

There are 99 comments from patients  taking Aromasin http://www.webmd.com/drugs/drugreview-17966-Aromasin+Oral.aspx?drugid=17966&drugname=Aromasin+Oral. The following are some examples:

Comment 1:  I have been on this medicine for 4 1/2 years. The past few months have been the worst. Every joint in my body hurts, night sweats and sleepless nights. It takes all I have to get out of bed in the morning.

Comment 2:  Shortly after starting the drug (04/2010), I developed a cough, which I still have. Had a dose of sinus infection, sore throat, worse coughing just before Christmas. Chose to let my immunity fight it off instead of antibiotics. Took 3-4 weeks to get over it, but I did it on my own. Still have the cough. Tried arimidex first-made my hands, feet and face swell. Satisfied with aromasin except for cough.

Comment 3:  I had a forced menopause after the 2nd cycle of chemo for my stage 2A BC. Never taking tamoxifen, was prescribed Femara for 2 months and then switched over to Aromasin following the chemo and radiation therapies. It has been 6 months since taking Femara and Aromasin. First experienced severe back and knee pains then had hand surgery for my Carpel Tunnel syndrome and now the pains has extended to all bones and joints, mostly in my hands and wrists. Memory loss and attention deficit is getting obvious. Hot flashes and insomnia is concerned. Without having daily walk and exercise and Melatonin Plus for sleep support, I would be miserable with all the side effects from the drugs.

Comment 4: After 20 days on arimidex I was suicidal, had severe bone pain, severe insomnia. I switched to aromasin and have found it easier to tolerate if I take meds for the side effects. I take ambien to sleep, percocet for pain, wellbutrin for depression. It’s either treat the side effects or I have a 70% chance of cancer recurrence. I will give it six months because sometimes the side effects do get better and I don’t want to die at age 63. But there does come a point when quality of life wins out – however short it may be.

Comment 5:  Have had major side affects with it. Tried Arimadex first, then was prescribed this one; a little more manageable, but still have trouble. Joint pain, sweats, muscle cramps and renaud’s syndrome.

Comment 6: I was prescribed aromasin by my doctor after the other 2 AIs had adverse side effects. I took it for 3 yrs and 3 months. I could not tolerate the lack of quality of life.