Tag Archives: Avastin

Can the best of medicine in the world cure brain cancer?

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This week, there are 3 sad stories about brain cancer.

The Brain Tumor That Killed Beau Biden http://www.thedailybeast.com/articles/2015/05/31/the-brain-tumor-that-killed-beau-biden.html

  • On Saturday, Joseph “Beau” Biden, the son of Vice President Joe Biden and former attorney general of Delaware, died following a long battle against brain cancer.
  • The 46-year-old’s death raises new questions about the disease that killed him—one that’s alarmingly common in adults and chronically misunderstood by the public.
  • This past year there were nearly 70,000 new cases and 14,000 deaths from this disease.
  • There are many different types (of brain cancer) that occur in adults—each with a unique set of features. Each types carries with it a separate prognosis—ranging from a life expectancy of eight months to non-life threatening.
  • Glioblastoma is an aggressive and often fatal tumor, with an estimated 2-year survival rate of around 17 percent for patients between 40 and 65 years old. The underlying cause of GBM is unknown.
  • It’s still unclear which specific type of tumor that Biden suffered from, but whether malignant or benign, it’s clear that the treatment to keep it from coming back ultimately failed.
  • Treatment options typically include a combination of radiation, chemotherapy, and surgery. The goal of surgery is usually to reduce the tumor burden, followed by radiation therapy and certain chemotherapeutics. Chemotherapy may delay the disease course in some cases, but most chemotherapeutic agents for GBM have an extremely low response rate, around 10 percent. The prognosis is not particularly good for any age group.

Brain cancers like Beau Biden’s kill about 15,000 adults each year http://www.washingtonpost.com/news/to-your-health/wp/2015/05/31/brain-cancers-like-beau-bidens-kill-about-15000-adults-each-year/

  • A variety of malignant brain and central nervous system tumors kill about 15,000 people in the United States each year, often after difficult courses of surgery, radiation and chemotherapy.
  • Beau Biden was first diagnosed in August 2013 and after surgery, radiation and chemotherapy returned to normal duties in November that year. But his cancer recurred this spring, and he began treatment again at Walter Reed National Military Medical Center.
  • Former Massachusetts senator Edward M. Kennedy died in August 2009, 15 months after he suffered a seizure and was diagnosed with a malignant glioma, the most common form of brain cancer.
  • For most incurable brain tumors, the primary challenge is managing the portions of the tumor that are undetectable by diagnostic imaging, These tumor cells are often the source of recurrence, traveling undetected to other brain regions of the patient and then driving the formation of new areas of growth with little warning. Most malignant brain tumors eventually recur.

Beau Biden fought bravely before losing battle with brain cancer; here are the lessons you should learn  http://www.nydailynews.com/life-style/health/doctor-lessons-beau-biden-death-article-1.2242753

  • Beau Biden had been dealing with health problems since 2010, when he suffered from a stroke.
  • Three years later … after he suddenly felt disorientated and weak during a vacation, he was admitted to M.D. Anderson Cancer Center in Houston. Not long after that, he was diagnosed with brain cancer. He underwent surgery and was free of the cancer; however, it returned this spring.
  • Biden underwent aggressive treatmentat Walter Reed National Military Medical Center in Bethesda, Md.
  • We do not know what causes brain cancer. Most brain tumors are not linked to any known risk factors. While there is no proof that radiation causes cancer, we do know that radiation is not good for you. The use of cell phones has long been led to debate about whether they may increase a person’s risk for brain cancer. Current research shows conflicting results. Regardless, it is probably a good idea to limit cell phone use as much as possible or at least use a hands-free headset to reduce your exposure to radiation.

Beau Biden Dies at 46 From Brain Cancer: Why the Disease Is So Hard to Beat https://www.yahoo.com/health/beau-biden-dies-at-46-from-brain-cancer-why-the-120362278807.html 

  • Details about Biden’s healthprior to his death are scarce. What is known is that he was hospitalized the week up until his death at Walter Reed National Military Medical Center, and that he did have a small lesion removed from his brain in 2013 at University of Texas M.D. Anderson Cancer Center, but was given a clean bill of health after the procedure.
  • …. brain tumor is known to have a high propensity for returning, even after being successfully removed
  • No matter what, almost all the time you’re talking about a kind of tumor that is going to come back and become more resistant to therapies,” Weiss, who specializes in treating adult malignant and benign brain tumors, tells Yahoo Health. “That’s why you hear these patients have a brain tumor, a primary brain tumor, and they’ve been given a clean bill of health. But they’re never really in a position” to have a clean bill of health for the rest of their lives, she says.

Case from Singapore

Someone from Singapore sent me this message:

Dear Doctor Chris,

Thank you for reading this message! I know it is hard for u to make any diagnosis without seeing the patient – but can I just ask before I bring my 32 year old wife over from Singapore if you are able to help her treat Glioblatoma Multiforme Grade 4 brain cancer. She has done surgery to remove 70% of tumor on 28 April and has not started on Chemo/ Radiation. We hope to let her do Immmunotherapy (T cell) before bringing her to u for treatment – do u advise that and know of a reliable hospital/ clinic in Malaysia for recommendation? Please for your kind advice!

Reply: I have bad impression of IT!

Can we seek your treatment for glioblastoma? … can we please seek your help for her glioblastoma?

Reply: Unfortunately … no cure from that ca

Can extend? For how long?

 Reply: Can’t say or predict. 

Case from Penang

May 30, 2015 at 4:20 PM,

Dear Dr Chris Teo,

My sister is a cancer patient with brain tumors, grade 4, high grade glioblastoma.

Sep 2013- She fainted and was sent to hospital, scan showed she had some bleeding in her brain.

Oct 2013- another scan showed that she had a 3cm big tumor.

She had her tumors removed in Oct 2013 by X of General Hospital Penang due to emergency.

Oct 2014-her tumors grew back and scan report found that there’re 5 tumors.

She had undergone 2 sessions of radiotherapy and 3 sessions of chemotherapy since then.

There is no more chemotherapy for her. Her brain swell every week and had to go for dripping and treat with mannitol.

She has strong will to survive as she has a 4 year old daughter. Please save her. We would like to make an appointment with you to see if there’s any advice from you.

I look forward to your reply. Warm regards.

Reply: I am sorry I cannot save her. Her cancer is very, very difficult.

Dear Dr Chris Teo,

Thank you for your reply.

Although it looks like her condition is very critical but she has very good blood test report, all her other organs are functioning very well.

Other than her speech problem and body coordination due to her brain’s tumors, she has clear mind, strong surviving will, she eats very well and pass motions and urine as normal person.

I just feel that if you’ve any herbs that can help to alleviate the swell and cancer cells in her brain, that would be very helpful.

My mother and her husband are there at your clinic now to seek your opinion. Please at least give them some advice.  My mother has been very careful in her diet … It was very surprise to see a glioblastoma cancer patient to survive more than 5 months. My sister has already passed her 1.5 years after diagnosed.

This 29-year-old patient (on wheel chair), her husband and mother came to see us. The following is a letter from her oncologist:

Mdm H is my patient since 2014 with brain cancer, now recurrence with multiple nodules in the brain. This has left her with weakness of her limbs, unsteady gait and double vision. She is therefore dependent and reliant on her carers for mobilising and self-care at home. Her disability is deemed permanent in view of her recurrence of cancer in the brain. She gets agitated and irritated due to her tumour in the brain. Hope you will understand the emotional changes that she is going through due to her illness.

Composite-1

Mdm H underwent surgery on 18 October 2013. This was followed by 30 sessions of radiation and 2 cycles of chemotherapy given as 12 injections. The drug used was Avastin.

By 2 September 2014, H was told that there was NO MORE cancer! Her mother said H was cured!

Unfortunately, about 2 months after this “great news” the cancer came back again. H again underwent chemotherapy. After the 11th injection, the oncologist in a private hospital told her to go and seek further treatment in a government hospital.  As far as he is concerned he could not help H anymore.

At this point, the family decided to come to us for help. I told the family. I cannot cure your cancer. 6 Surgery Tobias Brain ca

It is indeed sad that patients and their families don’t seem to understand that surgery does not cure any cancer (unless it is of a very early stage).  Listen to this: 5 Ssurgery come back again

Over the years, I have come across many cases of brain cancer. Here are some of their stories:

Brain Tumour: Operation, you have an 80 percent chance of cure! Do you believe that?

Brain Cancer: Surgery and Radiotherapy. Died

Brain Cancer: Radiotherapy – Recurrence; Chemo – Recurrence; and Avastin – Dead

Helping a Six-Year-Old with Cancer of the Brain Stem

Brain Tumour: Herbs and e-Therapy Helped Him

Brain Cancer – Marvelous Technology, Dismal Outcome

Brain Cancer – Yet She Lives !

Brain Cancer: She Was in a Coma

Declined Surgery Only On Herbs

Brain Tumour Shrunk With Herbs

 

 

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Dissecting Chemotherapy 15: Couldn’t Afford Avastin, Gave Up Xeloda

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Leo is a 51-year-old man. He was diagnosed with cancer of the rectum. But his cancer had spread to his liver. He underwent 6 cycles of chemotherapy and 25 sessions of radiotherapy. After the treatment he had a surgery to remove the tumour in his rectum. CT scan showed he was not cured, the tumour in his liver was still there. Leo was asked to undergo more chemotherapy.  He declined. He was prescribed Xeloda instead.  He took Xeloda for 3 cycles and gave it up. He turned to herbs.

Listen to what he said:

 

Why he declined the second round of chemotherapy – FOLFOX  + Avastin

Leo was asked to undergo chemotherapy using FOLFOX plus Avastin. The treatment is going to cost him RM 5,200 per cycle and he was to receive a total of 9 to 12 cycles. In total, that means spending around RM 50,000 to RM 60,000 for another round of chemo. To some patients, the response to such proposition is plain and simple. They cannot afford it! Period.

I remember Pak Jam who got his wife into a private hospital and had to spend RM 2,000 per day. After 15 days he was reduced to be a bankrupt!  He came to see us appearing like a “mad man.” His wife had leukemia. Perhaps today he still has to keep working to repay the borrowings from friends and relatives.

CPW was diagnosed with GIST and was asked to take Glivec for her condition. One tablet per day would cost RM 293.00. That is to say the family will have to fork out RM 8,790 per month for the medication. How long does she need to go on this medication? No one can tell.

HS from Indonesia came to see me. He was diagnosed with advanced kidney cancer that had spread extensively to his lungs. Since nothing much could be done, he was asked to take Sutent (sunitineb). According to his  wife, a month of Sutent would cost him 100 million rupiahs. I asked the wife, How much does an ordinary man get paid per month doing a normal job. She replied, Average earning per month in her home town (in Indonesia) is one and a half million rupiahs.

I have a lot more to say about the cost of chemo drugs nowadays. But suffice to say that the price of certain chemo drugs have gone crazy!

Why he stopped taking Xeloda after three cycles

Leo was not convinced that Xeloda would do him any good. He had fevers and diarrhea. In addition he vomit and had pains around the colostomy stoma after taking Xeloda.

Comments

I wonder what Leo would do if he has the money to pay for his FOLFOX + Avastin treatment – would he go ahead with it?

There are three important issues which patients need to bear in mind when deciding whether to undergo treatment or not.

One, don’t ever believe that money can buy your cure! Leo told us of what he saw. A man had spent more than a million ringgit trying to find a cure for his cancer. He went to Singapore for his treatment but found none. He ended up in a Johor government hospital – bed ridden and debt-ridden. He told his son that he had had enough and told his son not to go around and borrow any more money trying to cure him. One night, this frustrated man jumped out of the window of the 6th floor.  This is not the first time I hear such a story. Some time back, I received a similar e-mail from a lady in Singapore telling me that her father just jumped off the flat after failing to cure his cancer.

Two, ask these question: What is the aim of the treatment? Can this treatment cure me? Or is it just to prolong my life for a while more – if so, is it worth it? You should get these answers straight from your doctor. After getting your doctor’s answers, check them out with other experts as well.

Three, ask your doctor about the side effects of the treatment that he is going to give you. List them down. There is no argument about his – all poisonous drugs have side effects! And you know that chemo-drugs are poisonous. . So ask yourself, are you game with that? Some patients can tolerate the side effects but some patients prefer to die than go through it. Only you can decide. But at the same time, educate yourself about the side effects of these drugs.

Unfortunately some doctors are not forthcoming with such information. They would say, Oh, it is nothing. It is just like ant-bite! I remember one funny episode. A patient from India came to our center for help. She underwent chemotherapy and suffered side effects. She went to her oncologist complaining about a certain problem and was told, That is expected because of your chemo. When another problem cropped up, she was again told, That is expect because you had chemotherapy. This woman was clueless about the possible side effects of chemotherapy. Unfortunately for such patients they have to learn the hard way.

Let me end with one final question. What do you think are the benefits of Avastin?

Do you expect Avastin to cure you – after spending a good sum of your life’s saving? Read what the medical literature has got to say. Be ready for a rude shock!  Are you told of this – or do you ever ask your doctor?

The Phase III study involved 820 patients with metastatic, inoperable colorectal cancer who had been treated with standard first-line chemotherapy and Avastin. The results showed that:

In advanced colorectal cancer, continuing bevacizumab (Avastin) without interruption after tumor progression improves survival modestly.

In another report, it says – patients who received chemotherapy and Avastin did better than patients who received chemotherapy alone.

  • The patients receiving Avastin were likely to have longer tumor control and live longer than patients who did not receive Avastin. On average, they lived about five months longer (Note: this is probably a mistake found in this posting. It is not five months! Five weeks is probably the right number!).  http://www.medicinenet.com/script/main/art.asp?articlekey=54679

In this article, Avastin prolongs life but drug is too expensive for NHS patients, says Nice, http://www.guardian.co.uk/society/2010/aug/24/avastin-too-expensive-for-patients

  • Avastin (bevacizumab) can help patients with advanced bowel cancer which has spread to other organs, usually the liver and lungs.
  • The National Institute for Health and Clinical Excellence (Nice) said it had considered the drug …, but still considered the price too high for the extra benefit it gives patients.
  • Avastin costs almost £21,000 per patient (Note: This is equivalent to RM 102,302.73).
  • Clinical data submitted by Roche to the watchdog shows it can typically offer patients an extra six weeks of life when added to the chemotherapy drugs  capecitabine and oxaliplatin.

The expected benefit (or you call that benefit at all?) is surely miserable compared to the cost that an ordinary patient in Malaysia or Indonesia has got to pay. But that is not all. What about the side effects of Avastin? Click this link, http://www.avastin.com/patient/overview/side-effects/index.html

The most serious side effects (not common, but sometimes fatal) are: gastrointestinal perforation, i.e. developing a HOLE in your stomach or intestine; wound would not heal, serious bleeding including vomiting or coughing up blood; bleeding in the stomach, brain, or spinal cord; and vaginal bleeding, stroke or heart problems, severe high blood pressure, nervous system and vision problems such as high blood pressure, headache, seizure, sluggishness, confusion, and blindness; kidney problems, etc.

The most common side effects are: nosebleeds, headache, high blood pressure, inflammation of the nose and skin, too much protein in the urine, taste change, dry skin, rectal bleeding and back pain.

Worse of all, researchers have  found that tumors treated with Avastin (also Sutent) developed more cancer stem cells, which fuel a cancer’s growth and spread and are often resistant to standard treatment. https://cancercaremalaysia.com/2013/05/14/chemotherapy-spreads-cancer-and-make-it-more-aggressive-articles-from-the-internet/

Ultimate, you need to make your own decision. Decide wisely!

Brain Cancer: Radiotherapy – Recurrence; Chemo – Recurrence; and Avastin – Dead

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1-Doctor-mistakes-buried-in

It is indeed with a heavy heart that we have to write this story. However, let us pray that similar story like this does not have to be played out all too often in this world of medicine.  May you all find wisdom and learn from this sad experience.

In the month of May, I had this exchange of e-mails.

1 May 2013  Dear Dr. K.H. Teo,

Our family and I migrated to Australia 22 years ago in 1990 from Malaysia as a skilled migrants and live in Australia ever since.

This is very sad to let you know that my young Architect daughter has brain cancer (grade IV Glioblastoma multiforme) which diagnosed six months ago and under chemo treatment by cancer Specialist in … Australia.

I searched the internet and found that your holistic approach towards healing and advocate the use of herbs for all cancer patient. I would like to buy your herbs. We have a strong faith in Nichiren Buddhism (Japanese) and praying hard for my daughter recovery. She has a positive attitude (and looking towards to be better healthy life.

Kindly let me know the cost and instructions so that I can remit money to you.

Sincerely thanks. Please reply. Kind regards.

Reply: I am sorry we cannot help patients from foreign countries, especially from Australia. We may have problems with your quarantine. Also we are not a direct selling outfit. Chris.

1 May 2013   Dear Dr. K.H. Teo,

Thanks for your email reply.

I try very hard to contact you through the phone on +604 – 6595881 and it goes to a fax tone.  Can you please email me your direct phone contact (not mobile) so that we can have a phone conversation and it does not cost me very much.

I can always take a flight back Penang to buy the herbal medicine from you after you have establish which type of herbs are good for my daughter and bring them myself.

I am very well verse of her brain cancer illness conditions and I can explain to you thoroughly every aspect of her cancer condition and her history. I have a medical file which recorded every chemo treatment and western medicine she has taken including chemo drugs – Termozolmide (Temodal) and now on Avastin (bevacizumab) infusion.

I am waiting for your email now and call you, please.

My family and I are in very desperate situation and we have a lot of pain in our mind and hearts. Hope you understand our feeling as parents and we are praying very hard and trying extremely hard to save our daughter’s life.

Sincerely thanks. Regards.

Reply: You can come and see me with all the medical reports and can take back the herbs. Last week I have a 6 year old girl with brain cancer (like your daughter). No surgery, no chemo because it does not work for such cancer. She took herbs and can now go back to school. Read this story, https://cancercaremalaysia.com/2013/05/23/helping-a-six-year-old-with-cancer-of-the-brain-stem/

Avastin — spreads cancer! That’s the drug they gave you!

There is NO need to talk to me over the phone because there is NOTHING I can do. I need to see the scans and medical reports. Unfortunately the herbs are very bitter and have lousy taste and smell. Not many people can drink them. But that 6-year-old could take them without problem.

I do not talk over the phone for obvious reason that everyone on this earth want to talk to me about their problems. I just cannot cope. Actually I would not want to have patients from overseas. ..NO use …but if you want to come, it is okay with me and then you can get your friends and relatives to send the herbs to you. I cannot handle all these chores.

HER MEDICAL HISTORY

1 May 2013  Dear Dr. Teo,

Let me give you a brief medical history of my daughter. She has brain cancer – Grade IV Glioblastoma multiforme on her Brain Stem diagnosed 6 months ago in October 2012.

Very much earlier in September 2009, she had diffused Glioma on her brain stem and was treated with 30 doses of Radiation-Chemotherapy over a period of 6 weeks and the Diffused Glioma shrunk and life was back to normal.

Things started to change end of October 2012, recurrence of diffused low grade brain stem glioma with high grade transformation in the cerebellum. Also, they are aggressive tumours now. Admitted to hospital and neurosurgeon has done a surgery to implant a Brain Shunt to relief the brain pressure built up and at the same time, biopsy taken.

On 9 November 2012, first Termozolomide (Temodal tablets 300mg each day) Chemotherapy for 5 days and rest for 23 days (1cycle) for 5 cycles and blood test was done before each Chemo treatment. After 2 cycles, on 2 January 2013, MRI Head Scan showed the tumours actually shrunk and the family jumped with joy.  Tumours responded to chemo treatment. So continued with Termozolomide Chemo until after the fifth Chemo,

MRI Head Scan on 25 March 2013 was done and sad to say that the tumours had grown back to size   even bigger than before. Her condition deteriorated quickly, Medical Oncologist changed to the use of Avastin (becacizumab) infusion. First Avastin infusion was on 4 April 2013. After 3 weeks, second  Avastin Infusion on 24 April 2013. And at present, her condition seems not improving.

She is bed bound, unable to sit on wheelchair, blur vision, slurred speech, right hand shaking, upper and lower limbs very weak, overall health very weak and unable to eat by herself – feeding needed by mother. Her condition has deteriorated fast just a matter of 4 weeks.

Dr. Teo, I will definitely come over to consult you and show you all the MRI head scans.  I am really working extremely hard to save my daughter. Sincerely thanks, Please reply. Regards.

Reply: There is NO hurry to come and see me. She did not get cancer yesterday — she got cancer many years ago yet. No need to rush. Before you come please know that:

a) There is NO cure for cancer. The type of cancer she has cannot be cure by anybody.

b) The most intelligent thing to do is STOP doing the chemo because it does not work and may even spread the cancer more. See what Avastin does to people in the attached file.

c) After that go to www.BookOnCancer.org and read my book on Cancer What Now — there I have explained everything you need to know. This is written specially for people who come and see me and their expectations.

d) Don’t be misled that there is a cure for cancer. THERE IS NONE. Even if you come to me in a hurry there is NOTHING much I can do except to give you the herbs and hope for the best.

e) I see problems like yours everyday — when doctors gave up, they come to me and expect me to cure them. NO way.

Provided you know what you are coming in here for it is okay with me. Don’t be cheated by people who want to make quick bucks from you.Chris

1 May 2013   Hi Dr. Teo,

Very kind of you for your quick reply.

I have my own reason of coming to see you ASAP and I will explain to you when I see you either on this Friday 3 May 2013 or this Sunday 5 May 2013.

We know there is no cure for this brain cancer and we don’t expect very much as well but just to prolong her life and with your herbs so that she can live a few more year with her strong religious faith, positive attitude and thinking which can create her own strong immune system, control diet and then there is a chance for her to live longer.

At present, she is bed bound and can’t eat by herself, terrible to see my own daughter like this and it is very painful for parents.

Tomorrow morning I will ask my son to book a flight to KL and connecting flight to Penang by Air Asia and hopefully to see Friday or Sunday afternoon as stated in the website or please advise. I think the flight will be on this Friday early morning at 5 am. Perth time is the same as Penang time. My son is studying hard for his university exams now.

There will be no more Avastin infusion till 15 May 2013 and we still have time to stop it. Before that Avastin infusion, she needs to have an MRI Head Scan first and see any improvement on the size of tumours. And if no improvement, then treatment with Avastin infusion will also stop.

Looking forward to see you soon, Dr. Chris Teo.I have been reading your website on newsletters and other material and you are a remarkable Doctor. Please reply. Regards.

 

Radiotherapy: Recurrence After three years

 

Temodal shrunk tumour but it grew bigger after that

 

She had Avastin And She died

 

At CA Care I am not god

7 May 2013  Dear Dr. Chris Teo,

Very sad to inform you that when I arrived in Australia early Sunday morning (5/5/13), my daughter has passed away. Terrible news for the family. Sincerely thanks. Regards.

Death by chemo is acceptable

 

Avastin Spreads Cancer and Makes It More Aggressive

Kidney Cancer: An expensive and dangerous drug that does not cure

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KC (E87) is a 50-year-old male. In late January 2013, he had breathing difficulties and had to be hospitalized.  There was fluid in his lung. Pleural tapping was done. KC’s health was restored after 10 days in the hospital where 4 litres of pleural fluid was tapped out.

A CT scan done on 21 February 2013 indicated the following:

  1. Multiple pulmonary nodules in both lower lobes. Right pleural effusion and enhancing right pleural nodules.
  2. Bilaateral heterogeneously enhancing renal masses in upper pole measuring 7.3 x 6.6 cm (right) and 7.0 x 8.1 cm (left).
  3. Right lobe liver with ill defined lesion in segment IV of liver suggestive of local infiltration.
  4. Multiple enhancing peritoneal nodules in right subhepatic space.
  5. Enlarge retrocrural lymphadenopathy and multiple subcentimeter paraaortic and aortocaval nodes. Mild to moderate ascites.

Impression:  Bilateral renal masses likely renal cell carcinoma with local infiltration and lung pleural and peritoneal metastases.

After the CT scan KC was asked to go home and nothing was done. There was no medication either. No satisfied, KC went to consult an oncologist at a private hospital. Another CT scan was done on 26 March 2013. The results indicated:

  1. Multiple mildly enlarged mediastinal nodes.
  2. There is a small-to-moderate right pneumothorax (a collapsed lung – a collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when taking a breath).
  3. Pleural mass at the right anterior costophenic sulcus measuring 8 x 5.6 x 3.8 cm.
  4. Another large right pleural based mass noted anteriorly underlying the right third rib and it measures 6 x 2.7 x 2 cm.
  5. There is also a fairly large pleural based mass medially abutting the left atrium. It measures 5 x 4 x 3 cm.
  6. Bilateral multiple slightly lobulated pulmonary nodules with two nodules at the left lung apex demonstrating cavitation.
  7. There are bilateral large heterogenous masses occupying the upper half of both kidneys. The right renal mass measures 9 x7.4 x 6.7 cm. The left renal mass measures 8.7 x 8 x 6.6 cm.
  8. There is a peritoneal heterogenous lesion invading segment 6 of the liver, measuring 5.6 x 5 x 5 cm.
  9. There are multiple mildly enlarged retroperitoneal nodes measuring up to 17 mm.
  10. There is biconcave appearance of T3 vertebral body due to compression fracture.
  11. There is deformity at the left iliac crest, due to previous bone grafting.

KC was told by the oncologist that since both his kidneys are infected with cancer, surgery is not indicated. The cancer has also spread to his lungs and liver. The oncologist prescribed Sutent. The total cost of his first visit to the oncologist was RM 7,000. Sutent itself cost RM 5,000 for 9 days consumption. The remaining RM 2,000 was for the CT and RM 300 for consulting the oncologist.

KC came to seek our help on 5 April 2013. The following are excerpts of our conversation.

Chris: Did they remove your kidneys?

KC: No, both my kidneys were infected. They could not remove them.

C: Then you saw the oncologist, what did he do?

KC: He prescribed me this drug (showing Sutent box).

C: How much did this cost you?

KC: RM 5,000 for 9 days of consumption.

C: Did you ask if the drug is going to cure you?

KC: Only to control the spread of the cancer.

C: How long do you need to take this drug?

KC: He cannot tell me. I told the doctor. This drug is expensive, I cannot afford it. He said: How much is your life worth? And when I talked too much he got angry at me. I told him I cannot afford to take this medication. I only earn RM 1,000 plus per month – how to afford it.

C: Did he tell you the adverse side effects of his drug?

KC: ?? No, I told him I cannot afford to take the medication. He asked me: How much is your life worth? And why do you come and see me then?

Comments:  This is indeed a sad and tragic story.  Just reflect on this: How long do you expect a patient who earns RM 1,000 plus per month afford to take drug that cost him RM 15,000 per month?  What is the rationale of asking this patient to take the drug? To cure him or is this for any other purpose?  Patient was to take Sutent so as to stop the cancer from spreading. This unfortunately is the line very often sold to patients to make things attractive. But is that an honest answer based on scientific fact? Read below and you will be shocked!

This is something you need to know that oncologists or those with vested interests, will not tell you!

Sutent-spread-cancer 2

Sutent box

Read more: http://www.dailymail.co.uk/health/article-2088032/Cancer-drugs-aim-shrink-tumours-cutting-blood-supply-actually-help-SPREAD.html#ixzz2PwQx0Tun

  • Cancer drugs that shrink tumours by cutting off their blood supply may end up helping them to spread, a study suggests.
  • Tests on mice showed that both Glivec and Sutent depleted pericytes by 70 per cent while metastasis rates tripled.
  • Glivec, the brand name of the drug imatinib, and Sutent (sunitinib) have both been shown in trials to increase patient survival by a significant degree.
  • Drugs such as Glivec and Sutent reduce the size of tumours but could also make them more aggressive and mobile.
  • As a result tumours find it easier to ‘metastasise’, or spread around the body.

If you just looked at tumour growth, the results were good,‘said lead researcher Professor Raghu Kalluri, from Harvard Medical School in Boston. But when you looked at the whole picture, inhibiting tumour vessels was not controlling cancer progression. The cancer was, in fact, spreading. 

Seventy to 80 percent of cells in breast tumour are non-cancer cells. Are they all bad? Some of them are there to protect us and they’re not all bad.

Indeed  Sutent has been approved by the US FDA for treatment of advanced renal cancer, but the reality is it does not cure advanced or metastatic renal cancer or any cancer at all for that matter. Know that!

Below is the Information obtained from the drug company’s website:  http://www.sutent.com/rcc.aspx

The website said, Sutent has been proven effective in the treatment of advanced RCC (renal cell carcinoma).

A clinical study has proven that Sutent is more effective than interferon alfa (IFNα), another approved treatment option for advanced RCC.

SUTENT results:

  1. SUTENT More Than Doubled Median Progression-Free Survival (PFS) vs IFNα – 11 months vs 5 months with IFNα. 
  2. SUTENT Achieved More Than 2 Years’ Median Overall Survival (OS):  26.4 months vs 21.8 months with IFNα.
  3. FIVE TIMES more people saw their tumors shrink. 103 patients taking Sutent compared to 20 taking IFNα. 

Of course, when you read this information it is very impressive (but don’t fall into the trap of sweetened or massage research data!). Why do I say the message is a sweet camouflage?  Let’s look at the data critically.

  1. If you take Sutent, you have TWO TIMES longer progression-free survival.   Progression-free survival means the length of time from the start of treatment that patients remain alive and their disease does not worsen. The question you want to ask is:, what if you don’t take Sutent – can you also have progression free survival? Of course, but it is shorter a bit. According to the Drug Company, with Sutent the progress-free survival was 11 months compared to 5 months without Sutent. So Sutent gave an advantage of 6 months.Progression-free does not mean cure at all. It is just the disease does not worsen and you are still alive.
  2. Those who take Sutent remained alive. The median overall survival was 26.4 months and then they die. But what if you don’t take Sutent? Patients were still alive but died at 21.8 months. That means by taking Sutent you live longer by 4.6 months.

Take note:  you live longer by only 4.6 months. Is that what you want? Let us look at the economics. To live 4.6 months longer you need to take Sutent for at least 27 months, according to this study. This would cost you about RM 15,000 x 27 = RM 405,000. I am sorry, is my calculator playing tricks on me? Is that not a lot of money to you and me? And spending that kind of money to chase after 4.6 months of extended life? Let us hope that the extra 4.6 months of life is blissful, worth every minute of it. Or is it? There is no free lunch – you may have to suffer severe side effects as listed below.Nowhere in medical literature do I ever come across data showing that Sutent cures your cancer.

3. Five times as many people on Sutent saw their tumors shrink – is this a great achievement? Shrinkage of tumour has NO meaning. It is just a lure or camouflage! And what do you make out of the research led by Professor Raghu Kalluri of Harvard Medical School in Boston which said that Sutent may shrink the tumour but ultimately Sutent  may end up helping cancer spread more aggressively and widely.

The following are warnings given by the Drug Company.

SUTENT may cause serious side effects, including:

  • Serious liver problems, including death
  • Heart problems—include heart failure and heart muscle problems (cardiomyopathy) that can lead to death.
  • Abnormal heart rhythm changes— you feel dizzy, faint, or have abnormal heartbeats
  • High blood pressure.
  • Bleeding sometimes leading to death— these symptoms may include:
    • Painful, swollen stomach (abdomen)
    • Bloody urine
    • Vomiting blood
    • Headache or change in your mental status
    • Black, sticky stools
    • Jaw-bone problems (osteonecrosis)—severe jaw bone problems may happen.
    • Tumor lysis syndrome (TLS)— caused by the fast breakdown of cancer cells and may lead to death. TLS may cause nausea, shortness of breath, irregular heartbeat, clouding of urine and tiredness associated with abnormal laboratory test results (high potassium, uric acid and phosphorous levels and low calcium levels in the blood) that can lead to changes in kidney function and acute kidney failure.
    • Hormone problems, including thyroid and adrenal gland problems— as in the  following signs and symptoms:
      • Tiredness that worsens and does not go away
      • Heat intolerance
      • Loss of appetite
      • Feeling nervous or agitated, tremors
      • Nausea or vomiting
      • Sweating
      • Diarrhea
      • Irregular menstrual periods or no menstrual periods
      • Fast heart rate
      • Headache
      • Weight gain or weight loss
      • Hair loss
      • Feeling depressed

Common side effects of SUTENT include:

  • It may make your skin look yellow. Your skin and hair may get lighter in color
  • Tiredness
  • Weakness
  • Fever
  • Gastrointestinal symptoms, including diarrhea, nausea, vomiting, mouth sores, upset stomach, abdominal pain, and constipation.
  • Rash or other skin changes, including drier, thicker, or cracking skin
  • Blisters or a rash on the palms of hands and soles of feet
  • Taste changes
  • Loss of appetite
  • Pain or swelling in arms or legs
  • Cough
  • Shortness of breath
  • Bleeding, such as nosebleeds or bleeding from cuts

How much is your life worth?

Let me ask you to ponder what Rabbi Harold Kushner said:

11-Kushner-Moral-compass

Perhaps we all should read the article below presented by Drs Tito Fojo and Christine Grady. The first author is from the Medical Oncology Branch of the National Cancer Institute, Bethesda, USA, while Dr. Grady is from the Clinical Center, National Institutes of Health, Bethesda, USA.

Sutent-How-much-is-life-wor

Read more: http://jnci.oxfordjournals.org/content/101/15/1044.full.pdf+html

Read also https://cancercaremalaysia.com/2011/05/27/dissecting-chemotherapy-part-4-how-much-is-life-worth-erbitux-for-lung-cancer/

In their paper, Dr. Fojo & Grady wrote:

  • The all too common practice of administrating a new, marginally beneficial drug to a patient with advanced cancer should be strongly discouraged.
  • In cases where there are no further treatment options, emphasis should be first on quality of life and then cost.
  • For therapies with marginal benefits, toxic effects should receive greater scrutiny.
  • We must deal with escalating price of cancer therapy now.
  • The current condition cannot continue … the time to start is now.
  • As oncologists, we cannot go without answering these questions. The moral character of our specialty depends on the answers.

You may wish to read the following related stories:

  1. Kidney-Lung-Brain Cancer: Sutent = Heart Damage https://cancercaremalaysia.com/2011/09/19/kidney-lung-brain-cancer-sutent-heart-damage/
  2. Sutent for Advanced Kidney Cancer  https://cancercaremalaysia.com/2011/09/18/sutent-for-advanced-kidney-cancer/
  3.  Kidney Cancer Part 2: Two Oncologists Two Different Opinions – Is Sutent indicated in this case? https://cancercaremalaysia.com/2011/09/19/kidney-cancer-part-2-two-oncologists-two-different-opinions-%E2%80%93-is-sutent-indicated-in-this-case/
  4. Die of Cancer But Don’t Die A Bankrupt! https://cancercaremalaysia.com/category/kidney-cancer/

 More:

Perilous Approach: Avastin and Sutent Promote Growth of Breast Cancer Stem Cells

Avastin

(Note: Many patients in Malaysia have been treated with this very expensive drug)

http://badscienceblindtruth.wordpress.com/2013/04/19/perilous-approach-avastin-and-sutent-promote-growth-of-breast-cancer-stem-cells/

Dissecting Chemotherapy Part 7: Avastin + Alimta Nearly Killed Me

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Avastin belongs to the group of chemo-agents called the “Smart Bomb” or Targeted Drug. It is used in combination with the conventional chemo-drug for metastatic colorectal, non-small cell lung cancer, metastatic kidney cancer and glioblastoma (brain cancer).

The drug is not only expensive but also comes with a variety of scary side effects. Patients receiving Avastin may suffer from the following:

  1. Serious, and sometimes fatal, side effect called gastrointestinal (GI) perforation. Perforation is the development of a hole in the stomach, small intestine, or large intestine.
  2. Serious and sometimes fatal bleeding, such as coughing up blood, bleeding in the stomach, vomiting blood, bleeding in the brain, nosebleeds, and vaginal bleeding.
  3. Nervous system and vision disturbances. Symptoms may include high blood pressure, headache, seizure, sluggishness, confusion, and blindness.
  4. Stroke or heart problems, which can be fatal. Heart problems include blood clots, mini-stroke, heart attack and chest pain.
  5. Abdominal pain
  6. Nausea,
  7. Vomiting
  8. Constipation
  9. Fever
  10. Slow or incomplete wound healing
  11. Too much protein in the urine, which may lead to serious kidney problems
  12. High blood pressure.

Alimta is used in combination with the conventional chemo-drug for the treatment of non-squamous non-small cell lung cancer and malignant pleural mesothelioma. Alimta is not indicated for squamous cell lung cancer.

Patients may be allergic to Alimta and suffer from hives, difficulty breathing; swelling of face, lips, tongue, throat, pale skin, easy bruising or bleeding and unusual weakness.

The side effects of Alimta include:

  1. Fever, chills, body aches, flu symptoms
  2. White patches or sores inside mouth or on lips
  3. Urinating less than usual, or not at all
  4. Chest pain, trouble breathing
  5. Swelling, rapid weight gain
  6. Skin rash
  7. Numbness or tingling
  8. Depressed mood
  9. Sore throat
  10. Tired feeling
  11. Nausea, vomiting, diarrhea, constipation, indigestion, loss of appetite
  12. Muscle pain.

The most important question which patients want to know:

Can Avastin cure cancer? Try type this question on Google search and see what answer you get? You get nothing. No one is talking about cure at all. They only talk about prolonging life! And that too is amazingly ridiculous.

Q: Does Avastin cure colon cancer?

A: No.

Avastin (Bevacizumab): Good or Bad Cancer Treatment? http://yalepress.typepad.com/fightingcancer/2011/07/avastin-bevacizumab-good-or-bad-cancer-treatment.html

Dr. Richard Frank, M.D. wrote:  “The cost of cancer medicines is breaking the banks of Medicare and patients (private insurers continually raise their rates to cover costs) as well as forcing the closing of many oncology practices across the country. Access to basic cancer care and medicines is being jeopardized because of the exorbitant costs of the new biologic medicines. Unless these medicines can show at least a meager, repeatable improvement in survival for patients battling cancer, then they should not be approved and patients should not be given them in false hope.”

Q: Can Alimta cure lung cancer? This is the answer I got.

A: Alimta does not cure mesothelioma or lung cancer. 

Having understood the risks and the potential benefit (but what benefit are we talking about?) let us watch this video on what Alimta + Avastin did to a patient with lung cancer that had spread to his liver.

 

Note: We received a message on 18 September 2011 that this patient died.

When a lawyer makes a mistake, he loses his case in court; When an engineer makes a mistake, the building collapses; But when a doctor makes a mistake, it gets buried in his patient’s grave  ~ A Cancer Patient

 

Comments

In his website, http://www.utopiaawaits.com/index.php?option=com_content&task=view&id=53&Itemid=2

Dr. Carlos Garcia, M.D. wrote, “Many patients and support individuals … get incensed when I state that chemotherapy has a FAILURE RATE of ninety-seven percent (97%), or a cure rate of a mere three percent (3%).  They are usually shocked and then appalled by this statement.  Their body posture changes, their mood becomes more confrontational, in short this statement touches the very core of their belief structure.  That is if I am correct, as I will attempt to corroborate with the attachments herein, then why were they not told this prior to being told that chemotherapy, along with surgery and radiation are the ONLY ways of treating cancer and furthermore that alternative practitioners are mere quacks.

The FACTS are that after years of trying, and FAILURE and trillions of dollars in research with no improvement in success why is chemotherapy still being used?  Are the oncologists just mindless heartless doctors in it for the buck?  How do they justify just recommending chemotherapy, radiation and surgery, while ignoring dietary changers, and emotional issues?  How do they justify the continued endorsement that was first known to be ineffective in 1985 and remains ineffective with a ninety-seven percent (97%) failure rate today?

Let’s be honest, spontaneous remission, has a higher success rate than chemotherapy.  So potentially one could reach the logical and perhaps factual conclusion that doing nothing when diagnosed with the symptom of cancer is a better medical choice than opting for chemotherapy, with definitely a higher quality of life than that presented by chemotherapy.”

Dissecting Chemotherapy Part 6: Avastin Does NOT Cure Cancer

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The Story of Avastin That You Need to Know

On February 26, 2004, the FDA approved Avastin (or  bevacizumab) as a first-line treatment for patients with metastatic colorectal cancer, i.e., cancer that has spread to other parts of the body. Avastin  was shown to extend patients’ lives by about five months when given  as a combination treatment along with standard chemotherapy drugs for colon cancer (the “Saltz regimen” also known as IFL). IFL treatment includes ironotecan, 5-fluorouracil (5FU) and leucovorin.

Source: http://www.cancer.gov/cancertopics/druginfo/fda-bevacizumab#Anchor-Approva-23287

Take note of this fact carefully and serious ly – nowhere in the medical literature does it say Avastin cures cancer. It does not. When given with IFL, Avastin made patients lived longer by about five months. That was all. And the average time before tumors started regrowing or new tumors appeared was four months longer than patients receiving IFL alone.

Avastin Approved As Second-Line Treatment of Metastatic Colorectal Cancer

On June 20, 2006, the FDA granted approval for Avastin for use as second-line treatment of metastatic carcinoma of the colon or rectum. This recommendation is based on the demonstration of improvement in  overall survival  (OS) of patients receiving Avastin plus FOLFOX4 (5-flourouracil, leucovorin, and oxaliplatin) when compared to those receiving FOLFOX4 alone.

Mean overall survival of patients receiving Avastin + FOLFOX4 was 13.0 months while those receiving FOLFOX4 alone was 10.8 months.

Source: Source:  http://www.cancer.gov/cancertopics/druginfo/fda-bevacizumab#Anchor-Approva-51277

Take note again. Patients receiving Avastin + FOLFOX4 lived longer by only 2.2 months. Avastin did not cure. It only extended life by 2.2 months. Is that what patients want? Do oncologists clearly tell this fact to patients before they give them Avastin?

 Each Avastin injection cost a lot of money. It is NOT cheap for most people. Money is one point, Avastin comes with a bunch of devastating side effects. The most serious, and sometimes fatal side effects of Avastin are:

  • gastrointestinal perforation,
  • wound healing complications,
  • hemorrhage,
  • thromboembolic events,
  • hypertensive crisis,
  • nephrotic syndrome and
  • congestive heart failure.

The most common adverse events in patients receiving Avastin are:  asthenia (fatigue or weakness), pain, abdominal pain, headache, hypertension, diarrhea, nausea, vomiting, anorexia, stomatitis, constipation, upper respiratory infection, epistaxis (nose bleed), dyspnea (shortness of breath –SOB), exfoliative dermatitis and proteinuria (excess proteins in the urine).  Source: http://www.avastin.com/avastin/patient/crc/index.html#/crc/treatment/

Avastin for Colon Cancer – Any good?

A posting on 19 September 2010 has this heading:  Second Avastin Trial Shows No Benefit in Early Stage Colon Cancer. Adding Avastin to chemotherapy for early stage colon cancer didn’t reduce the risk that cancer would return. Source: http://fightcolorectalcancer.org/research_news/2010/09/second_avastin_trial_shows

A statement released by the drug company, Roche of Switzerland (http://www.roche.com/investors/ir_update/inv-update-2010-09-18b.htm) stated that:

  • A study known as AVANT evaluated the use of Avastin plus chemotherapy in the adjuvant treatment (immediately after surgery) of early-stage colon cancer. The results did not show that it improved disease-free survival in stage III colon cancer.
  • Evaluation of Avastin in the early-stage setting, the AVANT study shows that standard chemotherapy plus one year of Avastin is NOT effective in reducing the risk of relapses in early-stage colon cancer.

In another posting on 25 Janruary2011,entitled: AVANT Says No Avastin Benefit in Stage III Colon Cancer

Source:  http://fightcolorectalcancer.org/research_news/2011/01/avant_says_no_avastin_benefit_in_stage_iii_colon_cancer

A second randomized clinical trial has confirmed what the first one found — adding Avastin to standard chemotherapy does not reduce recurrences after surgery for stage III colon cancer. In presenting the trial results at the 2011 GI Symposium, Aimery De Gramont, MD, PhD, concluded:

  • The addition of Avastin to FOLFOX4 or XELOX did not improve disease-free survival  (DFS) in the adjuvant treatment of Stage III colon cancer.
  • Immature overall survival data suggest a potential detriment.
  1. In the first year, there was a transient favorable effect.
  2. The treatment effect became unfavorable after one year.

What the Mass Media Said

Avastin Falls Short in Test as Colon Cancer Medicine. Source: http://www.nytimes.com/2009/04/23/health/23avastin.html

Andrew Pollack of the New York Times, wrote on 22 April 2009: In results from a widely watched clinical trial, the drug Avastin failed to show a significant effect on preventing the recurrence of colon cancer.  Avastin had sales of $2.7 billion in the United States alone last year.

Melly Alazrakip of Daily Finance wrote: Roche’s Avastin Fails in Early-Stage Colon Cancer Study

Source:  http://www.dailyfinance.com/2010/09/20/avastin-cancer-drug-roche-fails-colon-study/

The top-selling cancer-fighting drug Avastin, which was once believed to have the potential to help treat many cancers, has hit another roadblock in testing. In a recent Phase III study, Avastin failed to improve disease-free survival in early-stage colon cancer patients when administered immediately after surgery.

Roche, the world’s largest maker of cancer drugs, said data from the study showed that adding Avastin to standard chemotherapy for one year after surgery wasn’t effective in reducing the risk of relapses. Indeed, the data showed better outcomes for standard chemotherapy alone.

As the world’s best-selling cancer drug, Avastin recorded nearly $6 billion in sales last year.
Avastin has experienced other setbacks this year, including Great Britain again refusing to approve Avastin for colorectal cancer on the basis of its poor cost-effectiveness, and another late-stage study showing Avastin failed to extend survival in men with advanced prostate cancer, compared to current treatments.

Take note here: Avastin is not allowed in Great Britain on the basis of poor cost-effectiveness.

In the poor developing countries, Avastin can be used? Is that logical?

Avastin for Other Cancers

In spite of its poor performance, Avastin had and is being used rather commonly for the following cancers:

  1. Metastatic Renal Cell Carcinoma (mRCC)
    Avastin is indicated for the treatment of metastatic renal cell carcinoma in combination with interferon alfa.
  2. Non–Squamous Non–Small Cell Lung Cancer (NSCLC)
    Avastin is indicated for the first-line treatment of unresectable, locally advanced, recurrent or metastatic non–squamous non–small cell lung cancer in combination with carboplatin and paclitaxel.
  3. Brain cancer.
  4. Just not too long ago, Avastin was also approved for the treatment of breast cancer.

Castle Built On Sand – Avastin for Breast Cancer

Andrew Pollack of the New York Times (23 February 2008,http://www.nytimes.com/2008/02/23/business/23drug.html)

reported that the FDA approved Avastin as a treatment for breast cancer – a decision that appeared rather baffling to the common mind.  But as always, we know that a FDA  approval  means an additional hundreds of millions of dollars of annual sales to Avastin.

As a breast cancer treatment, Avastin costs about UD$7,700 a month, or US$92,000 a year.

Let us look at the results of the clinical trial on which the approval was based.

  • Women who received Avastin in combination with the chemo-drug Taxol (or paclitaxel) had a median of 11.3 months before their cancer worsened or they died, in contrast women who received Taxol alone had a median of  5.8 months. This means Avastin only delayed cancer worsening by 5.5 months.
  • Women who received Avastin lived a median of 26.5 months, compared with 24.8 months for those getting Taxol alone — life extension that was not statistically significant. This means Avastin prolonged life by 1.7 months which is meaningless and this difference could just be due to chance and not real.
  • Moreover, the women receiving Avastin suffered more side effects. And 5 or 6 of them out of 363 died from the drug itself.

In spite of such miserable performance, Avastin was approved for breast cancer treatment. And many patients in this part of the world, including Malaysia, were given Avastin by their oncologists.

A castle built on sand would not last! 

Matthew Perone of the Associated Press, on 15 December 2010 wrote:  http://www.msnbc.msn.com/id/40702735/ns/health-cancer/t/avastin-shouldnt-be-used-breast-cancer-fda-says/

Federal health authorities recommended Thursday that the blockbuster drug Avastin no longer be used to treat breast cancer, saying recent studies failed to show the drug’s original promise to help slow the disease and extend patients’ lives.

The ruling is a significant setback for the world’s best-selling cancer drug and will likely cost Swiss drugmaker Roche hundreds of millions of dollars in lost revenue.

The FDA approved Avastin for breast cancer in 2008 based on one study suggesting it halted the spread of breast cancer for more than five months when combined with chemotherapy. But follow-up studies showed that the delay lasted no more than three months, and patients suffered dangerous side effects.

Roche sells the drug at a wholesale price of $7,700 a month. When infusion charges are included, a year’s treatment with Avastin can run to more than $100,000.

Comment 

Avastin – it is all about big money but the results of Avastin are just miserable. It falls far short of the patients’ expectation. They expect the chemo drug to cure their cancers or at least prolong their lives for many more years! The truth is, Avastin does not and cannot do that!

Dissecting Chemotherapy Part 5: Contribution of Chemotherapy to Survival of Colon Cancer Patients

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L M Carethers wrote the following in the International Journal of Gastroenterology & Hepatology,  Gut 2006;55:759-761 doi:10.1136/gut.2005.085274:

  • The current gold standard for treating patients with advanced colon cancer is chemotherapy with 5-fluorouracil (5-FU) based regimens. This standard is based on compelling clinical trials utilising 5-FU and levamisole, and demonstrating a survival benefit for patients with stage III (Dukes C) colon cancer.
  • Although there is no set standard for treating stage II patients, some stage II patients do receive 5-FU chemotherapy.
  • Stage I patients with colorectal cancer do not receive 5-FU as their prognosis is excellent with removal of the tumour.
  • Stage IV patients may receive 5-FU for palliation (note: this is not cure).

Dissecting the Gold Standard of Colon Cancer Treatment

In 1975, Dr. Charles Moetel, a renowned oncologist of the famed Mayo Clinic in Minnesota, USA, found that the lives of Duke’s C colon cancer patients could be prolonged when treated with a combination of 5-FU and levamisole (a drug used in sheep, swine and cattle to control stomach and intestinal worms and nematode parasite infections). 

In this study, 971 patients with Duke’s C colon cancer who had undergone surgery were divided into three groups and given one of the three treatments. The actual median follow-up time is 6.5 years.

Treatment

Number of patients

Number with recurrence

Number died
Surgery only

315

177   (56.19%)

168  (53.33%)
Levamisole

310

  172   (55.48%)

158   (50.96%)
Levamisole +  5-FU

304

   119   (39.14%)

121   (39.80%)
Benefit of Levamisole + 5-FU over  surgery only (no chemotherapy)

Less recurrence by 17.05%

Less death by 13.53%

Source:  Moertel, C. G. et al. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma. Annals of Internal Medicine. March 1995. Vol: 122: 321-326. http://www.annals.org/content/122/5/321.full.pdf

The authors concluded that Fluorouracil plus levamisole is tolerable adjuvant therapy to surgery; it has been confirmed to substantially increase cure rates for patients with high risk (stage III) colon cancer. It should be considered standard treatment for all such patients.

The therapy with 5-FU + levamisole: caused nausea, infrequent vomiting, stomatitis, diarrhea, dermatitis, fatigue and mild alopecia. Approximately half of the patients had leucopenia (lowering of the white blood cells).

The unanticipated toxic reaction to 5-FU + levamisole: 40% of the patients had abnormal liver function test results during the course of the therapy. Their toxicity were reflected in elevated alkaline phosphatase levels (which peaked approximately 7 months after onset of therapy), elevated aminotransferase (AST) levels, and elevated serum bilirubin besides causing fatty liver.

Questions:

  1. Does the result show that if you don’t undergo chemotherapy after surgery, you will die?
  2. Does it not show that without chemotherapy 53.3% of patients were dead but even if you have undergone chemotherapy almost 40% died anyway?
  3. Does it not show too that even with chemotherapy 39% of the patients still suffered recurrence?
  4. Would it not be prudent to weigh this advantage against quality of life issues, taking into account the acknowledged side effects of chemotherapy?

From the above data it is clear that chemotherapy reduced recurrence by 17 % and reduced death by 13.5 % but not without side effects which are often brushed off as insignificant.

Chemotherapy is proven to be beneficial by only a slim margin (13% to 17%). Indeed, from the academic point of view, the result is statistically significant. This would please the statisticians and the scientists, but I am not sure if it pleases cancer patients at all. I believe this is not what patients (especially those in the poor developing country) are looking for. They are seeking for a REAL cure (not a MEDISAL CURE either!). If this is not possible, at least they expect a much greater chance of achieving it. I wonder if anything less than 20% benefit is good enough?

Chemotherapy causes severe side effects in most patients. It is not like an “ant-bite” as one oncologist would tell some patients. With less than 20% benefit, is it worth the gamble?

One question comes to mind: Can this slim margin of benefit of chemotherapy not be achieved by some other non-invasive or non-toxic means? For example, does it ever occur to people that by just a change of diet or taking of herbs, perhaps we can also increase our chances of healing colorectal cancer and the result could be better than chemotherapy? At CA Care we have presented many case studies showing that indeed this hypothesis is valid and has merit — herbs and change of diet and lifestyle can prolong meaningful survival better than chemotherapy!

Gold Standard Plus Targeted Therapy

Today, oncologists have a good number of chemo-drug mixes for patients with advanced stage colon cancer. A new generation of “smart bomb” or targeted-therapy drugs can also be added to the mix to help control (ah, not cure?) the cancer. Examples of these regimens are:

  • FOLFOX (leucovorin [folinic acid], 5-FU, and oxaliplatin)
  • FOLFIRI (leucovorin, 5-FU, and irinotecan)
  • CapeOX (capecitabine and oxaliplatin)
  • Any of the above combinations plus either (not both) Avastin (bevacizumab) or Erbitux (cetuximab)
  • 5-FU and leucovorin, with or without Avastin
  • Capecitabine, with or without Avastin
  • FOLFOXIRI (leucovorin, 5-FU, oxaliplatin, and irinotecan)
  • Irinotecan, with or without Avastin
  • Erbitux alone
  • Vectibix (panitumumab) alone

Avastin and Ertibux are now being commonly offered to cancer patients in Malaysia. Vetibix is still unknown here … but soon it will hit our shore. But what do they say about Avastin and Ertibux? Two things are clear: They are expensive. And they don’t cure colon cancer !