Tag Archives: bone metastasis

Prostate Cancer: Hormonal therapy did not work. Don’t be fooled by a drop in PSA!

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James (not real name) is a 58-year-old Indonesian. His problem started in early 2016 when he lost his appetite, felt fatigue and lost weight. Blood test showed his PSA was more than 500 and his alkaline phosphatase was 200 plus.

James went to Singapore to consult an urologist at a private hospital. A bone scan showed his prostate cancer had spread to his bones.

James was given Lucrin injection (three months once) and an oral drug, Casodex.

Three months later, the doctor increased the Casodex dosage because his PSA was rising.

With the treatment, James PSA dropped to 0.03, his alkaline phosphatase was at 270 (table below).

Eight months later, (December 2016) his PSA started to increase again from 1.6 to 6.0 and by June 2017 it was at 89.4. The treatment failed (Table 1).

Table 1: The fall and rise of PSA after hormonal treatment

Date PSA Alkaline phosphatase
12 Apr 2016 0.03 270
12 July 16 0.04 102
29 Sept 16 0.19 84
13 Dec 16 1.63 82
7 March 17 6.07 72
5 June 17 89.4 87

Disappointed with the results, James consulted another doctor in The Singapore General Hospital. A PET scan results showed evidence that the cancer had spread to his bones.

James continued to receive his Lucrin injection but Casodex was discontinued. He was asked to take a new oral drug Enzalutamide (or Xtandi). This cost SGD 5,600 per month.

James was also told that if the above treatment is not effective, then there is no other option but to go for chemotherapy.

James found us in the internet and decided to seek our help. During his first visit we prescribed herbs for his problems.

Three months later, September 2017, James came back to see us again. James told us that after seeing us, he went back to his doctor in Singapore and was started on the new oral drug Xtandi. He took 4 tablets of Xtandi per day for the three months while at the same time half-heartedly following our therapy.

Let’s look at his blood test results done in Singapore (Table 2)

Table 2: Blood test results done in Singapore

5 June 2017 11 Sept 2017
PSA 89.4 High 19.8 High
Liver Function
Alkaline phosphatase 87 110 High
Alanine transaminase – ALT 16 23
Aspartate transaminase – AST 35 49 High

When James showed me the two blood test results done in Singapore, my immediate remark was, Good – what else do you expect? Cannot ask for more! His PSA in June was 89.4 and with Xtandi and herbs the PSA dropped to 19.8. Great result! But hang on, James had not finished his explanation yet. Actually I am being fooled by these numbers.

James said, he monitored this PSA level often (Table 3). And if you study the numbers below properly you will note that James is heading for another disaster. That SGD 5,600/month drug and our herbs did not work!

28 June 2017 12  July 2017 2 Aug 2017 30 Aug 2017 6 Sept 2017
PSA 101 High 55.5 H 8.85 H 14.29 H 16.6 H
Liver Function
Alkaline phosphatase 77 n/a 197 H 105 102
Alanine transaminase – ALT 15 n/a 22 41 31
Aspartate transaminase – AST 24 n/a 29 52 H 48 H
GGT 31 n/a 35 52 n/a

After James took Xtandi (+herbs) for about 2 weeks, the result was dramatic fall of PSA from 101 to 55.5. That’s a 50% reduction. You cannot ask for more. Then for another 2 weeks, the PSA dropped further to 8.5. Fantastic results — PSA dropped from 101 to 8.5 after one month on Xtandi.

Hang on! Barely a month later, the PSA on 30 August showed the PSA had gone up to 14.9 from 8.85. That the beginning of disaster. Within a month, between 2 August and 6 September the PSA had doubled from 8.85 to 16.6. This is a clear sign of failure.

Besides the PSA what could be another possible problem is James’ liver function is deteriorating as shown by the increase in AST and GGT. James has to watch out  for this too.

Some notes from the internet

  1. Xtandi: Expensive drug and price merry-go-round

Xtandi is a drug used to treat hormone-resistant prostate cancer that has metastasized, or spread to other areas of the body. Xtandi costs $7,450 per month. The average treatment course is eight months, so the cost of Xtandi is usually about $60,000 for a full course of treatment.

Xtandi (enzalutamide) is an expensive prostate cancer drug market by Astellas Pharma, a Japanese pharmaceutical company. The total cost for a one-month supply of Xtandi (120 pills) comes to $8,839.49, or around $73.66 per pill, $294.64 per day, and $107,617.26 per year.

The drug costs much more in America than it does elsewhere, with a U.S. list price of about $129,000 per treatment course, compared with $39,000 in Sweden and in Astellas’ native Japan.

In Singapore, James paid SGD 5,600 for a month supply.

  1. Xtandi increased survival by 4 to 4.8 months

Xtandi is an oral medication that inhibits the androgen receptor, which drives prostate cancer progression.

In a phase III clinical study of patients previously treated with chemotherapy, Xtandi reduced the risk of death by 37 percent and increased median survival by 4.8 months, compared to instances where subjects took a placebo.

In a separate phase III clinical study of patients not previously treated with chemotherapy, Xtandi reduced the risk of death by 23 percent and increased median survival by 4 months.

  1. Side effects of Xtandi include:
  • seizures,
  • back pain,
  • diarrhea,
  • joint or muscle pain,
  • hot flashes,
  • flushing (warmth, redness, or hot feeling),
  • headache,
  • muscle weakness or stiffness,
  • anxiety,
  • dizziness,
  • sleep problems (insomnia),
  • feeling tired,
  • numbness/burning pain/tingling/prickly feeling under your skin,
  • swelling in your hands or feet,
  • cold symptoms (such as stuffy nose, sneezing, and sore throat),
  • high blood pressure,
  • upper respiratory tract infection,
  • blood in the urine,
  • urinary frequency,
  • dry skin,
  • itching, or
  • nosebleeds.
  1. Can Xtandi cure prostate cancer? Try google this question and see what you get. There is NO mention of cure, only delayed deterioration.

In the case of James he is still fine and he is not dying yet. HIs main concern is his PSA is rising in spite of all the drugs taken.

Comments

From our conversation with James and his wife, it appeared that we are wasting our time. I told James and his wife our herbs are not magic bullets and I do not expect his PSA will drop like when he was medical drugs. Healing needs full commitment. James did not show that he has that commitment. He did not take care of his diet. Once a while he ate things that he is not supposed to eat. Did he really take his herbs properly? I am not sure either and I did not ask him about this.

In fact I told James and his wife. If I was told earlier that he wanted to take Xtandi, I would not have prescribed him the herbs. It would be better that he takes the Xtandi first and see what happened. If and  when the doctor’s drugs cannot work anymore then he can come and see us for help.

Although James said he benefited from taking our herbs, I am not sure if this is true or not.

Listen to our conversation that morning.

  1. Lucrin & Casodex

  1. Xtandi & Herbs

 

 

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Cancer – what to do next?

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In early 1995 Larry Burkett, founder and president of a nonprofit ministry — Christian Financial Concepts, was diagnosed with kidney cancer which had spread to his shoulder blade. Larry had surgery – his right kidney and  left shoulder blade were removed. No radiation or chemo was indicated because these treatments would not be helpful for this type of cancer. Larry ventured into alternative therapies. He lived for 8 years. According to the facebook information, Larry died in mid-2003.  In his book, Hope When It Hurts, Larry shared his cancer experiences and provided many helpful and insightful advices. I learned a lot from him! If you have a chance, take time to read this great book!

Hope when it huerts Larry Burkett

In Chapter 12, Time Out! Larry shared his wisdom, as follows:

When people find themselves in a medical crisis … the result is confusion or what I call “systems overload.” There are people to call, doctors to see, decisions to be made — usually under stress and in a short period of time. Add to that the clouds of emotion and shock.  That’s how I felt, and I needed to take a time-out — just to get away by myself, in a attempt to regain my equilibrium and sort out the impact of what I was facing.

  • Feeling overwhelmed: I felt overwhelmed – I had to make some major decision in a very short period of time, based on a limited amount of information. I knew very little about cancer. Yet, before me stood two highly trained doctors, suggesting that I have my kidney and shoulder blade removed.
  • If I had to do it all over again, I think I would diffuse these feelings by allowing some time to pass before I made any major decisions. I would stand back and say, “Okay, I’ve had this cancer for a while … maybe up to three years or more. What difference would it make if I waited another month? Well, now I know it probably wouldn’t have made any difference.
  • One of the best things any cancer patient could do is to take a time-out, get a medical reference book and read it. I encourage anyone to take the time to thoroughly analyse his or her situation.
  • What, if any, alternative treatments were available for this? You wouldn’t buy an automobile the first time you saw it, so don’t buy an operation the first time you hear of it. Take time to pray about it.
  • The news of a serious illness can throw people into a frantic pace to do things. Emotions become exaggerated. Everything becomes urgent and must be settled immediately — trigger a flurry of activities that tend to minimize, deny or fix the situation. Unfortunately, usually none of our solutions can remedy or change the truth of what we’re really facing.
  • The rush of anxiety: I know people can’t be laughing all the time in the midst of critical health situations, but laughing every once in a while surely can lighten the load, keep things in perspective, and relieve built-up tension. So, I passed the time with one of my favourite activities: watching old movies … and laughed until my sides hurt! But I think laughing helps. We know that it releases endorphins in the body that actually help you to feel better.
  • Rely on others: Many of the decisions I faced were beyond my ability to comprehend. Not only could I not comprehend all the medical data involved in making some decisions, I was not able to concentrate as I normally would. How was I supposed to make a major decision about metastatic kidney cancer when, in fact, I didn’t even know what it was a short time before?
  • So I had to rely on other people. I began by calling friends in medicine and asking their advice …. seek out a second or even third opinion. At the very least buy a good guide to medical terminology.
  • Relinquish matters beyond your control. Don’t worry about things that are beyond your control. Stop worrying about the things you can’t change and concentrate on getting well. I just had to tell myself that over and over again, “Don’t worry about it.” That’s a hard task for someone with my personality, but I had to keep a clear perspective of the things I could control and yield to God the things I couldn’t.
  • Don’t worry about the future. You may be in a situation in which you have several small children and naturally one big concern will always be, How will my children make it without me? Of course that preoccupies your mind because you love them. But God’s not going to abandon them. Will your children face difficulties and sorrows in the time ahead? I’m sure they will. But isn’t that true of life anyway? You can’t spend your time worrying about it because, in the end, you can’t change it. If there is anything within your reasonable ability to do, then do it.
  • Take time to back off. To accommodate the changes taking place with your health, you need to back off and change your priorities. Either you fight change and be miserable, or you can go with the flow an enjoy to the fullest each day God provides. You don’t have to control everything. Take time to face one’s own mortality can really bring the essential issues of life into focus … I resigned as God’s manager of the universe — a position to which I was never appointed anyway.

At CA Care we tell you not to panic after being told that you have cancer. http://www.cacare.com/

CANCER ! Don’t panic !

Haste is from the Devil ~ Arab saying.

Why do you visit this website? We believe you are seeking information to enable you or your loved ones to make certain decisions about his/her cancer. Our advice is: Read as much as possible. Gather information from different sources. Cast your net wider and read what others from different disciplines have to say about the same subject.

Get out of the box and view your problem in a different light. Often, in the face of fear, hopelessness and panic we forget to use our commonsense. Calm down. A decision made in haste or under pressure is never a good decision.

Remember, you don’t get cancer just only yesterday

When helping patients at CA Care, I sometime get a note requesting that I do not tell the patient that he/her has cancer. I am indeed saddened by such attitude but to respect the family’s privacy and wish, I refrained from telling patients the truth! In Chapter 3, Larry wrote about the need to Talk About It.

  • It was not easy for me to tell my family and friends that I had cancer. The counsel I had from some friends was NOT to tell anybody about my health condition. If you have an initial resistance to talking about troubling medical news, you’re not alone. I know what that feels like. But let me encourage you that the healthiest thing to do is to talk out the situation you’re facing with those who are closest to you. There are a number of reasons why:
  • Telling others about your predicament helps you peel back layers of denial. It’s easy to think there’s a mistake with the tests, that it’s all a bad dream, or to rationalize it all away. Talking about it … had a powerful, beneficial impact on me: It helped me to face reality. You can have a thousand different thoughts and intentions floating around in your head, but they never seem to become reality unless your vocalize the thoughts. Obviously you can overdo discussion, and some people dwell so much on their problems that’s all they ever want to talk about. I think it’s one thing to talk about your problems and to be honest with people, but it’s quite another thing to make that the centre of all your conversation for the rest of your life.
  • Problems can multiply exponentially if we ignore reality. For instance, it’s not unusual for people to ignore symptoms of poor health — blood in urine, rectal bleeding, etc — hoping that the problems will go away. And rather than talk to their doctors or even their families about the symptoms, a mental wall of denial is constructed, leaving a smoldering fire to erupt into a huge, perhaps life-threatening inferno.
  • If you talk about your health, your family and friends also will feel free to talk about it.. If you clam up, deny it, or act like nothing is wrong, it’s likely others will too.
  • I think sometimes people hold back from talking about the prospect of dying, believing that if they talk about dying, it might make it happen; or if they don’t talk about it, that might prevent it from happening.
  • Pretending that nothing is wrong will not make your circumstances change.
  • I don’t what to talk about cancer. I don’t have cancer. I choose to deny it. I rather suspect that a great many people who have done that in the past have died of their illnesses when, in fact, God had a cure that would have worked for them.
  • When you talk about your real needs, others may know how to help you. I’ve seen people sit around and sulk … because they have needs that are being overlooked. Even though they are desperately lonely or afraid, their pride confines them to silence, thus cutting off the very help they need. Often overtime they become bitter and resentful because their needs are not being met. It that sounds childish, it is. That’s just the way little children act.   
  • If you know what your needs are, then say so. Even if you don’t know what your needs are, voice the fact that you are hurting. That’s why God put other people in the world — to be able to help you when you aren’t functioning at 100 percent.
  • Talking encourages honesty with yourself, with your family and with God. From that day forward, I have tried, to the best of my ability, to be totally honest with everybody …. My goal has been .. “What you see is what you get,” rather than “What you hear is different from who he is.” Talking with others about your situation breeds honesty and I would encourage you to be honest about your thoughts and feelings.
  • One piece of advice I would give anyone: Open up, share with your family and let them help. Make them insiders to what is going on. Don’t make them outsiders. They’ll feel a lot more comfortable, they’ll understand better, and they’ll be there to help.
  • We helped one another to be strong. When one of us got down, others could comfort, console, encourage and pray. The ability to talk openly was the key that allowed us to minister to one another.

Read more:

Larry Burkett’s Cancer Experience: The Undemocratic and Monopolistic  American Medical System for Cancer Treatment

Looking at Cancer From a Christian Perspective by Larry Burkett

 

 

 

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

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

This is what her daughter wrote about her mom.

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

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

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

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

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

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

Mom Had Cancer

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

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

Radiotherapy and Iressa

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

Deceptive Positive Results

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

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

Mom had to stop Iressa.

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

More of Deceptive Positive Results

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

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

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

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

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

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

March 2014 — Iressa failed, switched to Tarceva 

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

April 2014 — 9 months Later 

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

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

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

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

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

3. Drugs to use?

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

May 2014 — Tarceva Failed 

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

1. Lymph node at the neck has enlarged.

2. Few new lesions at T9. 

The Final War Plan 

The oncologist laid out the following options.

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

One Final but Most Important Question

Can all these treatment cure mom?

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

CA Care – the Last Resort, 23 May 2014 

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

Comments

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

Dear Mr Teo, 

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

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

It is indeed sad.

1 Insanity-by-Einstein

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

Can we not learn something from these stories? 

More stories about this patient:

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

Pain Recurred After Eating Rojak

Someone wrote: The Oncologist Had Prostate-Bone-Liver Cancer. And He Died

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After posting the article, Malaysia’s Well Known Oncologist Died of Cancer, some readers wrote to ask what cancer he had and what he did that he died. Unfortunately, I was unable to answer these two important questions. Then out of the blue, someone wrote to fill in the gap. So here it is – the e-mail (reproduced with the kind permission of the writer).

Another question left unanswered. What medical treatments did he receive and he died because of his cancer or his treatment?  We can never know, one day we may get an e-mail from another angel ?

1st April 2013:  Dear Dr Chris Teo,

I am writing this in response to your post (16 March 2013).

It was indeed a shock for me to read in The Star news that Dr Albert Lim Kok Hooi passed away from cancer at age sixty.

Many questions ran through my mind.

  • What cancer did he die from?
  • When did he find out that he had cancer?
  • How did he treat his own cancer?
  • Why did he discover his cancer at such a late stage? 

I surfed the Internet to try to find more details. When I could not find any information, I contacted friends who knew him and his family.

I was informed that Dr Albert Lim had prostate cancer which spread to the bone and liver. Apparently his cancer was diagnosed a year ago. However he kept it from the public. No one in the hospital was allowed talk about it.

If The Star did not publish the cause of his death, we would not have known that Dr Albert Lim passed away from cancer.

Recently, I came across an online article and confirmed that Dr Albert Lim learnt he had cancer a year ago. http://thestar.com.my/health/story.asp?file=/2013/3/17/health/12844733&sec=health

To quote from the article

He also kept his cancer a secret from acquaintances and friends.

He was a private person in many ways. His cancer was something to be dealt with within the family

Now this brings up some interesting issues.

Why did Dr Albert Lim choose to keep his disease a secret?

As a prolific writer in the papers, he shared his knowledge, medical training and experience to raise the level of public awareness on how to prevent cancer, treat cancer and how to cope with cancer.

Was he doing a social service or was he merely writing to boost his image after his six months suspension from the Malaysian Medical Council?

http://thestar.com.my/news/story.asp?file=/2007/2/23/nation/16951173&sec=nation

What had he hoped to achieve by keeping his cancer a secret?

Normally it is the patient’s prerogative whether to keep the disease secret or make it public. However Dr Albert Lim is no ordinary patient. He is a leading oncologist and a respectable authority on cancer locally and internationally. He was actively running a thriving oncology practice. He had cancer patients who made decisions based on trust and confidence in his prescriptions. Had he disclosed his condition, would some of the patients choose different courses of treatment?

It would seem that there is some implied moral duty or fiduciary duty to disclose his cancer as he is an involved party. Steve Jobs was chided for trying to conceal his pancreatic cancer from the Apple Board and investors. Under stock exchange rules, it was material disclosure as the information would have caused some investors to make their decisions differently.

Here, how do you think his patients would feel? Having faith in a doctor and having spent thousands of ringgit on chemo and other treatments, he read in the newspapers that his oncologist passed away from cancer! And the patient had no inkling that his oncologist had cancer!

It would not be unreasonable to conclude that Dr Albert Lim kept his cancer a secret as it is sheer bad publicity for the medical industry. If the Physician Heal Thyself  maxim, does not work, what faith can the patient have in the doctor? Was Dr Albert Lim worried that his business would be affected?

I am not saying that doctors are not human and that they are immune from diseases. Of course an oncologist can also be afflicted by cancer like anyone else. However, when an oncologist dispenses How To advice, we would expect that the probability of him diagnosing himself at an early treatable stage is higher than anyone else. And if he did get cancer, share the journey with others so as to benefit all.

I read a New Straits Time article dated 26 November 2012 that Dr Albert Lim gave media statements endorsing a new chemo drug which offered hope for late stage prostate cancer patients.

http://www.nst.com.my/latest/hope-for-prostate-cancer-patients-1.176963

It would now seem ironical that four months later, Dr Albert Lim died from prostate cancer. At the launch of the new drug, he knew that he was suffering from late stage prostate cancer. Unless he had tested it himself and it worked, it would seem so inappropriate to endorse a highly toxic drug. Chemo drugs are very expensive. It is unfair to sell hope to poor patients, while not proving its efficacy on oneself. Would the drug company have asked him to endorse the launch of the drug had they known the facts?

I got to know Dr Albert Lim nineteen years ago. He was Head Oncologist at KLGH. He treated my father for terminal lung cancer for six months. During that time I got to know him fairly well on a social basis.

Well, when one meets with an oncologist in a social setting and he is not wearing his professional mask, one gets some interesting insight into the medical industry.

Perhaps in those days, chemo drugs were not as advanced as today.

In the course of conversations, I found that oncologists viewed cancer patients, especially late staged ones as quite hopeless cases. The majority of cancer patients who came to seek treatment would die anyway. Whatever the oncologists do will not make much of a difference. It is a matter of time but the cancer will spread. However since patients came with hope and expect the oncologist to do something, he has to administer the prescribed industry treatment protocols whether he believed in them or not, whether he would practice the same treatment on himself or not!

Maybe the chemo drugs today are more powerful in combating cancer and Dr Albert Lim has changed his views after starting private practice. I do not know. After my father passed away I did not keep in touch. I hear of him on and off from some patients and through reading his articles.

Over the years, I had two close friends and my step mother who succumbed to cancer. They had their share of stories when dealing with oncologists.

Dr Albert Lim and most other oncologists are averse to alternative therapies, labeling anything that is not from Western medicine as quackery. I am not denying that there are some cases where cancer patients have benefitted from oncology treatment. My aunt now in her eighties survived breast cancer for forty years. She could only afford minimal cancer treatments from the hospital and nothing else. Another friend now in his fifties has against all odds battled cancer over twenty years with chemotherapy, stem cell replacement, consuming birds nest daily and mainly a strong willed mind.

However in many other cancer cases, the treatments prescribed by the oncologists did more harm than good. Unfortunately many specialists in private practice run their clinics like running a business. They have high overheads and of course, there is always the thrill of making money like any other business. In private practice, everything revolves around money.

I strongly believe in the mind-body model, the intelligence of the body to heal itself and that diet and herbs are Nature’s gifts to mankind. I do not know you but I have been following your work on and off since the publication of your first book.

At that time, my old classmate and dear friend, suffered from Stage 3 NPC. She went to a famous oncologist and was prescribed a course of radiotherapy. At the end of the sessions, he asked her to say AHHH… looked at her tongue and throat and declared her free from cancer. No other tests were done. I asked her to go to your clinic as additional treatment but she refused.

She was jubilant and went round testifying in the churches that God healed her. Six months later, the cancer came back with a vengeance. She sought treatment from a UH oncologist who gave her chemotherapy but it was too late. I saw her two weeks before she died. She held my hand and said the saddest words I ever heard “I was a fool to believe Dr T ” (the first oncologist who declared her cured). Faith is invaluable but we must be realistic.

Last year, my close friend who is a well known corporate figure, died from Stage 4 stomach cancer which spread to bones, pancreas and abdomen. Initially he was given six months to live. He was treated by the best oncologists in Singapore and locally as his company paid the medical bills. After the first six months of chemo treatment and breathing meditation which we encouraged him to learn, the PET scan showed that the cancer had disappeared. The Singapore oncologist said to him, ‘Whatever you are doing, continue with it’!

At that time, I asked him to go to your clinic to get additionally therapy. However he refused saying that he would follow the doctor’s advice. He too was jubilant and immersed himself fully in his hectic work and had no time for his breathing and meditation. Six months later, the cancer came back. He spent the next twelve months with massive chemo treatments, switching from one drug to another when the cocktail did not work. It was sad to see his health and body getting worse with each treatment. He passed away 2 ½ years after he was diagnosed. The company spent nearly RM2 million for the treatments. How many patients can afford to pay such massive sums for cancer treatment?

When friends tell me so-and-so is diagnosed with cancer, I always recommend that they explore your alternative therapy with an open mind. It is up to each to follow his inner guide as to what treatment they should sought. Living and dying are not in our hands. We do what we can to help by telling patients that there are alternatives besides chemotherapy.

I hope this fills up the gap in your blog as to how Dr Albert Lim died.

When I read Dr Albert Lim’s obituary, I wondered how he felt the instant he was diagnosed. It would have been truly useful if Dr Lim had documented his own journey. That would have been ultimate service to humanity.

Did Dr Albert Lim administer the same toxic treatments he recommended to others for himself? Do chemotherapy and other oncology therapies work? Well, it would seem not but we shall never know.  It is very easy to preach but not easy to walk in the patient’s shoes. Anyway, may the good he has done live on.

In closing, since we did not get to hear Dr Albert Lim’s experience, it may be interesting to read how other oncologists wrote about their own cancer journey.

http://www.npr.org/2010/12/14/131760656/a-breast-oncologist-diagnosed-with-the-disease

http://www.nytimes.com/2005/05/24/health/policy/24docs.html?pagewanted=all&_r=2&

http://www.kevinmd.com/blog/2012/02/diagnosis-stomach-cancer-profoundly-oncologist.html

The following article had gone viral but it is a very touching account from Dr Richard Teo (not an oncologist but a plastic surgeon) from Singapore who documented his cancer experience before he passed on. Irrespective of one’s religious beliefs it will be worthwhile to read with an open mind.

http://www.heavenaddress.com/Dr-Richard-Teo-Keng-Siang/424153/379719/content

Wishing you all the best always.

Yim,

Petaling Jaya

My Comment:

Thanks dear writer for giving us your precious time to share your thoughts. You have done your part! Let me conclude with these quotations:

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Comment added: 23 May 2013

“Another question left unanswered. What medical treatments did he receive and he died because of his cancer or his treatment? ”

I have some further information.

Last week, I met a family friend of Dr Albert Lim. She informed me that she only got to know Dr Lim had cancer two months before he passed away.

I asked if Dr Lim administered any treatment on himself. She said that when he was diagnosed with Stage 4 prostate cancer, he started chemotherapy. However after a few treatments, the cancer got worse and he opted to end the chemo treatment. He preferred to let the cancer advance faster. He knew there was nothing more he could do.

I asked why Dr Lim could not diagnose his own cancer earlier. Apparently, he did not have any symptoms and the cancer markers did not pick up the prostrate cancer. His oncologist friend from Europe who visited him while he was ill, commented that he too, has come across a few cases in Europe where the prostate cancer did not show up in cancer markers.

I heard from one of Dr Lim’s patients that Dr Lim was administering chemotherapy to the patient up to a week before he died. She noticed that he looked very tired and old, but he was very very nice to the patient. Of course it came as a shock to the patient to read that her oncologist died of cancer as no one knew that he was suffering from the disease.

The purpose of my writing is not to run down the Doctor or the treatments. What I learnt from this whole episode is.

1) Cancer is not always detectable at an early stage.

2) When diagnosed with cancer, a patient should educate himself on all options of treatment available and make an informed decision himself.

It is not prudent to rely on medical opinion alone.

All doctors are trained and sponsored in some way by Big Pharma. At the end of the day, they will push drugs which may not yield the desired results but because it is standard protocol, they have to recommend the regime to the patient.

The patient end up spending  and suffering unnecessarily.

Over the last four years when I accompanied my step mum for her cancer treatments at UH, I came across patients who spent all their money at private hospitals. With no money left, they came to UH to seek subsidised  treatments. It was so pitiful to talk to them, some mortgaged or sold their homes, some borrowed money and others took loans to find the elusive care.

I hope the day will come when there will be oncologists with conscience, oncologists who will honestly tell patients when all hope is gone, to stop wasting their money and find some other means of natural treatment and palliative care.

Kind regards.

Yim, Petaling Jaya

 

Breast Cancer: Surgery and Hormonal Therapy Did Not Cure Her

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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.

Breast Cancer: From Despair to Hope in Five Days

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1: Healing In Five Days

2: Her Tragic Story

Acknowledgment:  Permission to use these video clips without having to close the patient’s face is granted by the family.

The gist of our conversation:

1.  Breast lump, ten years ago and she did nothing about it.

She discovered a lump in her breast more than   ten years ago but did nothing about it. The lump grew bigger. In 2008, she went to Kuching, Malaysia for a full-body check up. At that time she did not experience any serious discomfort. However, the check up revealed a stage 4 breast cancer since it had probably spread to her bones.

Did she suffer any pains before the check up? Yes, she had pains around the shoulder blade. After a massage the pains disappeared.

2.  Trips to China to find the cure.

The doctor in Kuching suggested chemotherapy. She refused. The family decided to bring her to China for medical treatment. She received treatments such as chemotherapy, cryoablation and radioactive seeding  in the Chinese hospital.

She stayed about one to two weeks in China during each trip there.  She returned home feeling “alright” only to go back to China again for more treatment each year.

Did they teach you to take care of her diet? No, she was told to eat anything she likes. They did not teach her anything about the diet.

3. A Minor Fall

In January 2011, she had a minor fall. This cause one of her legs to become swollen. But even before the fall, she always had pains in her legs. She consulted a doctor in Kuching about this problem and was told that nothing was wrong with her leg but she probably had cancer in her colon.

4.  Leg Operation

Since February 2011, she was not unable to walk and remained immobilized at home. One of her leg was in pain and the other was swollen. She was unable to place her feet on the ground and stand up because of pains.

She went to Jakarta for further consultation.  Subsequently she underwent a surgery intervention for both of her legs.

Two months after the surgery she was able to walk. There were no more pains in the foot when she stepped on the ground. But the pains in the lower parts of her legs persisted.

 5.  Did no return to China anymore

 Did she go back to China again after this? No. We made a total of six trips to China.  In 2008, she went to China thrice, in 2009, twice and in 2010 once. No use – at every visit they asked us to do PET scan, chemo, etc. She became tired, vomited, etc.

6.  Hospitalization – September 2011

In late September 2011, she had pains in her abdomen and was unable to walk again. She had to be hospitalized. The oncologist suggested a PET scan to find out what was wrong with her. The family declined.  By this time she was taking a variety of medications prescribed by the oncologist, bone specialist and neurologist.

3.  CA Care Penang – 9 October 2011

She was wheel chair bound. She had to be carried up into the airplane. She was unable to stand up by herself.

She was unable to sleep and had pains in her legs throughout the day and night.  After listening to her story that 9 October night, we could only say this to her family, I really don’t know what I can do to help you. But I shall try my best. It was indeed a hopeless and helpless case.

After five days on the e-Therapy and herbs, her conditions improved.  The pains in her legs were almost gone. She was able to sleep and above all she was able to stand up by herself with minimal help.

Update: On 26 October 2011, her daughter-in-law called to say that patient (now at home in Jakarta) is able to walk by herself with the help of a walking stick. On the day when she returned home, she was able to slowly walk into the airplane – no need to be carried into the plane like the week before.