2.3 cm Malignant Breast Lump: Surgery, Chemo and Radiation — Disaster

This is a tragic story which I find it real hard to “understand.” WF is 32 years old. In early 2014, WF felt a lump in her left breast. At that time she was pregnant and was about to deliver her baby. So nothing was done until after the birth of her baby.

On 14 March 2014, WF had an ultrasound of her breasts. “There is a 17 mm x 9.6 mm lesion at 2 o’clock position of left breast, 4 cm from the nipple.” A FNAC (Fine needle aspiration cytology) done in a Taiping private hospital showed “benign breast lesion.”

WF did another FNAC in April 2014. This time it was done in a private hospital in Penang. Unfortunately, the result showed “atypical cells … Highly suspicious of an infiltrating duct carcinoma.”

A trucut biopsy was done on 12 April 2014 confirmed an invasive ductal carcinoma.

WF consulted another doctor in another private hospital.

25 April 2014Ultrasound of Both Breasts Irregular hypoechoic lesion between 1-2 o’clock. It measures 23 x 18 x 12 mm. Some microcalcifications seen. In keeping with a neoplasic lesion.

Based on the above, WF had surgery. A wide local excision of the left breast mass was done (lumpectomy). The tumour removed was 23 mm in size. Two of the axillary lymph nodes were involved. All resection margins were free of malignancy. Immunohistochemical study indicated a triple negative tumour: ER negative, PR negative and c-erb-B2 negative. It was a Stage 2B cancer.

9 May 2014Ultrasound of Thyroid Multiple tiny nodules seen on both thyroid lobes, likely benign.

WF subsequently had 6 cycles of chemotherapy. Neither she nor her husband knew what drugs were used. Anyway, each cycle cost RM 6,000. WF lost her hair, felt tired and nauseous during her treatment. Chemotherapy was completed by October 2014. Then WF received 20 sessions of radiation and this was completed in November 2014.

About a month later, in late December 2014, the cancer spread to WF’s brain. There were 3 lesions in her brain. WF received 2 sessions of radiation to her head in January 2015.

Two months later, March 2015, CT scan showed the cancer had spread to her lungs, bone and liver.

WF was again asked to undergo 4 cycles of chemotherapy. WF did one cycle after which she and her husband came to see us and decided not to proceed with the treatment.

Chris: Did you ever ask the doctor if surgery, chemo and radiation were going to cure your cancer?

Husband: The doctors said there is a  80 percent chance of cure?

Chris: Did you ever ask what happen to the remaining 20 percent?

No reply.

Study the numbers of her blood tests.

Date CEA CA 15.3 (normal 0-32)
5 June 2014 Less 0.5 12.3
18 Nov 2014 0.4 9.7
10 Feb 2015 Less 0.5 13.2
10 March 2015 n/a 20.3
24 March 2015 n/a 37.0
7 April 2015 n/a 96.1
22 April 2015 1.4 142.6

In March 2015, WF was started on chemotherapy again because her CA 15.3 started to rise, indicating that the earlier chemotherapy had failed. Therefore, the answer is more and more chemo?

The following are results of her CT scan and MRI.

  1. Before chemotherapy
9 May 2014CT scan of Brain, Neck, Chest, Abdomen and Pelvis Recent wide local excision of left breast carcinoma and left axillary clearance.Brain: There is no shift in the midline structures of the brain. No mass or abnormal enhancement. No extracerebral fluid collection.Lymph nodes: There are no enlarged supraclavicular, axillary, internal mammary, mediastinal or pulmonary hilar nodes.Lung: There is no pulmonary nodule or other significant pulmnary abnormality.

Liver:  Liver parenchymal density is normal. Two small hypodense lesions in segment 8, both measuring 4 mm and another two hypodense lesion in segment 7, both measuring 3 mm. Likely represent small cysts.

Bone: no significant lytic or sclerotic bone lesion seen.

 

  1. After chemotherapy
9 January 2015MRI of brain Bilateral cerebral metastases.Left frontal cortex – 21 x 16 x 15 mm well defined multilobulated massLeft basal ganglia – 9 x 8 x 9 mm.Occipitotemporal cortex – 8 x 8 6 mm.

Lesions also associated with perilesional oedema.

10 January 2015CT scan Neck, Thorax and Pelvis There is no evidence of local recurrence.Interval development of a few small lung nodules within the right lower and left upper and lower lobes. They are too small to characterise but may represent secondary deposits.Apical region of left upper lobe – 3 mm noduleRight lower lobe – 3 mm nodule

Basal segment of left lower lobe – 4 mm nodule.

10 February 2015MRI of brain Partial regression of bilateral cerebral metastases.Left frontal cortical lesion – 11 x 8 x 10 mmLeft basal ganglia – 7 x 6 x 5 mmRight occipitotemporal cortex – 6 x 5 x 4 mm

There is no associated perilesional oedema.

No new nodule seen.

24 February 2015MRI of brain Cerebral metastases increased in size.Left frontal cortical lesion – 17 x 11 x 15 mmLeft basal ganglia – 8 mmRight occipitotemporal cortex – 9 mm

Perilesional oedema has also increased.

24 March 2015MRI of brain Cerebral metastases minimally increased in size. Reduced perilesional oedema. There are likely post radiation changes.Left frontal cortical lesion – 16 x 13 x 16 mmLeft basal ganglia – 8.3 x 8.0 mmRight occipitotemporal cortex – 9 x 9 mm
7 April 2015CT scan Neck, Thorax and Pelvis Increased size of pulmonary metastases. Interval development of hepatic and skeletal metastases. And mild retroperitoneal lymphadenopathy.Lung: Apical region of left upper lobe – 4 mm nodule with central cavitation.Right lower lobe – 4 – 5 mm noduleBasal segment of left lower lobe – 4 – 5 mm nodule.

Liver:  Numerous small hypodense lesions inn both lobes of liver. Larger lesions measuring up to 15 mm.

Lymph nodes: Multiple mildly enlarge para-aortic lymph nodes – measuring up to 12 mm. Smaller lymph nodes are present along the aortocaval space.

Bone: There is an irregular poorly defined lesion in the manubrium sterni eroding the bony cortex. There is also suggestion of similar lesions in the lower cervical spine.

We need to acknowledge that the oncologist did a “good” job of taking the base line of WF’s health before chemo and radiation were started. Yes, before the treatments, WF’s brain, lymph nodes, lung, liver and bone were all clear! Meaning at that point in time, her cancer did not spread anywhere! So the doctor confidently told WF and her husband that there was a 80 chance of cure!

Then chemotherapy and radiotherapy were started.

Barely a month after treatments were completed, problems started to show up.

First, the brain. There were 3 metastatic spots in the brain. There was no such tumour before right?

Radiation was given to the brain.  The tumours shrunk a bit —  by just a bit — and then started to grow again.

By end of March 2015,  WF’s CEA started to increase telling us that chemotherapy / radiation had failed.

Then, more chemo was suggested. WF had one cycle of this second-round chemo.

In April 2015, CT showed the cancer had spread to her lung, liver, lymph nodes and bone, besides the brain.

1-Mouth-sores

Sores causing difficulties to eat

2 Compo-Brain-Lng

Brain and lung

3 Compo-Liver

Liver

Ask these questions.

  1. April 2014 she was diagnosed with a 2 cm malignant breast lump. A year later, April 2015, the cancer had spread to her brain, lung, liver, lymph nodes and bone. She did surgery, chemo and radiotherapy as dictated by the doctors. How could this be? Why do the treatments when the cancer cannot be contained or cured?
  2. Dare you ask, what if WF were to do nothing? Just leave the lump as it is. Would she end up the way she is now – with more cancer all over in the body?
  3. Is WF’s case unique or exceptional? There are many more tragic stories like this. Here is another example, click this link: Does chemotherapy make sense?
  4. When asked if the treatment would cure her cancer, WF was told, There is a 80 chance of cure. Do you believe this prognosis? Listen to another story: Breast Cancer: Do this chemo – 100 percent cure! You believe that?
  5. In WF’s case, what made the cancer so aggressive? Do you dare ask this question? Read this: Chemotherapy SPREADS and MAKES cancer more AGGRESSIVE,

Is The Present Day Cancer Treatment Based on Faulty and Inadequate Science?

  1. Some people may wish to say this is a triple negative cancer. So it is an aggressive type! Some people may say it is just your luck! My response: Many patients live a healthy life by making a CORRECT choice! It is your life.

Paula Black was given 3 to 6 months to live after being diagnosed with breast cancer. She declined chemotherapy!  Read more https://cancercaremalaysia.com/2015/01/15/advanced-breast-cancer-part-1-you-need-not-have-to-die/ and https://cancercaremalaysia.com/2015/01/19/advanced-breast-cancer-part-2-to-die-or-to-heal-is-your-choice/

Jane had a 1.2 cm lump in her right breast. Like WF above, she did a lumpectomy. Her tumour was a double negative type — negative for ER, negative PR but strongly positive for c-erbB-2. P53 was strongly over-expressed.

Jane was told to undergo chemotherapy. The package of chemotherapy + Herceptin would cost RM 120,000 while radiotherapy cost an additional RM 35,000. Jane was told that the benefit of chemotherapy and radiotherapy would be 16 percent – i.e. 16 out of 100 women are alive and without cancer because of the combined therapy.

To Jane the benefits of chemo and radiation did not make sense. She promptly refused further medical treatments and came to seek our help on 10 January 2010.

Jane told us that she refused chemotherapy because she did not want to lose her hair. In addition, her mother-in-law had lymphoma and died after two cycles of chemotherapy.

It is now 2015 (five years plus),  Jane is still doing fine. Yes, your life is in your hands – to stay healthy or to die is your choice! More about Jane: https://cancercaremalaysia.com/2013/06/10/breast-cancer-does-chemotherapy-and-radiotherapy-make-sense/

 

 

 

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Breast Cancer Went Wild After Surgery, Chemo-Radiotherapy. E-Therapy Helped Relieve Her Pains

Eva (not real name) was 33 years old when she was diagnosed with breast cancer. She underwent surgery at a hospital in Hong Kong in June 2009.

The histopathology reports indicated the following:

1.  Left breast mass at 1 o’clock – excision

Diagnosis: Fibroadenosis, Fibroadenoma.

Right breast mass at 1 o’clock, lumpectomy.

Diagnosis: Infiltrative ductal carcinoma, grade 2. No sentinel lymph node metastasis (0/14).

Tumour size: 1.1 + 0.6 cm.

Resection margins clear.

Positive for estrogen and progesterone receptors, highly proliferative activity. Negative for c-erbB-2 oncoprotein.

2.   Right breast lump at 3 o’clock, lumpectomy

 Diagnosis: Fibroadenoma.

After surgery, Eva received 6 cycles of chemotherapy – 3 cycles using FEC (5FU + epirubicin + cyclophosphamide) and 3 cycles of Taxol. This was done in Hong Kong. She received 30 radiation treatments in Macau. There was no further medication after this.

A follow-up mammogram in 2011 showed everything was clear.

In 2012 (i.e. some 3 years later) Eva started to have back pain. MRI in December 2012 showed some spots in her lumbar.

In January 2013, a PET / CT scan showed extensive bony metastasis. She was prescribed Tamoxifen and Xeloda and pain killers.

Medication

After taking Xeloda she was not able to sit down or walk. She had to be hospitalized for a week and given painkiller injection. She was discharged and had to use the wheelchair.

At the end of February 2013, Eva decided to return to her home in Indonesia.

In late March 2013, she consulted an oncologist in Penang. She was told to undergo chemotherapy again using Carboplatin. She has to take an oral drug, Navelbine.  She has to undergo six cycles of this treatment and each cycle would cost RM 7,000. In addition she needs a monthly injection of bisphosphonate for her bone. This would cost an addition RM 1,700 per month.

Can the treatment cure her? The oncologist said: Not sure!

Eva refused further medical treatment. Eva and her mother (who also has cancer) came to seek our help on 21 March 2013. She presented severe pain and was unable to sleep at night. Her movements were very restricted.

Her CA 15.3 results over the years showed an increase from 12.7 to 246.1

Date

CA 15.3

21 October 2011

12.7

29 August 2012

36.8

5 November 2012

80.1

23 January 2013

246.1

The following are the results of her PET/CT dated 16 January 2013.

  1. There is no hypermetabolic lesion noted in the residual right breast.
  2. There are multiple hypermetabolic lymph nodes seen over the right internal mammary region, right superior mediastinum, right supraclavicular fossa and lever V of right neck.
  3. No hypermetabolic node found in bilateral axillary regions, left supraclavicular fossa or left neck.
  4. The left breast shows normal FDG uptake.
  5. Hypermetabolic nodule noted in the right pectoralis major at the level of 1st anterior rib.
  6. There is physiologic uptake of brown fat in bilateral lower necks.
  7. Physiological FDG uptake seen in the brain parenchyma.

Extensive bony metastasis

  1. Multiple hypermetabolic deposits are present in:
    1.  bilateral pariental bones and left occipital bone,
    2. Right sphenoid body
    3. Clivus,
    4. Left submandibular ramus,
    5. Sternum,
    6. Left scapula,
    7. Right upper humerus,
    8. Right 4th and 5th ribs,
    9. Left 3rd and 10 ribs,
    10. Bilateral iliac bone,
    11. Left ischium,
    12. Bilateral pubis,
    13. Lesser trochanter of right femur,
    14. Left femoral neck,
    15. Extensive involvement of spinal column from cervical spines to sacrum.

The CT images show:

  1. Lytic destruction at the corresponding area,
  2. And soft tissue mass in some of the lisions.
  3. Focal hypermetabolic mass protruding into the spinal canal and compressing the dura sac, including right lateral aspects of C3 level, anterior aspect of T9 and T10 levels, anterior and right lateral aspect of T11 level as well as left anterior aspects of T12 level.

PET / CT scan showed the cancer had spread to some 29 locations in her body as below

Slide1

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E-Therapy at CA Care

We really felt sorry for Eva seeing her in such severe pain. We decided that Eva should try the e-therapy right away and requested her to postpone her return home. She needed to stay in Penang for an additional 5 days. And here is her story.

In summary after 2 days on the e-therapy, Eva had less pain and was able to sit up and watch the television for 2 hours. This is something she could not do before. She had to lie down in bed most of the time. With the e-therapy she could sit, walk and move around without much difficulty.  We told Eva to come back to Penang for the e-therapy again if her problems recurred.

This Is What We Often Encounter – Failed Medical Treatment, Healing Crisis after Herbs, Bad Diet and Family Problems

Part 1: Failed Medical Treatment

CE is a 56-year-old lady. She lives in Penang, down the road where our centre is.  Sometime in March 2010 she was diagnosed with Stage 4 breast cancer. No operation was indication. A doctor in a private hospital tried RFA (radiofrequency ablation) for her tumours.  She received two treatments with RFA – one to her breast lump and another to her bone.

Unfortunately, by August 2010 the tumour recurred in the same left breast.  She underwent 6 cycles of chemotherapy at a government hospital.  The treatments were completed in May 2011, by which time all the lumps in her breast were gone.

Six months later, in December 2011, CE developed breathing difficulties. Her lungs were filled with fluid. A month later, in January 2012, she had severe headaches for 2 weeks. The cancer had spread to her brain. She underwent 5 sessions of radiotherapy to her head. She was given painkiller medication.

In February 2012, she had breathing difficulty again. She had pains in her left leg. The cancer had spread to her bones. The doctor at the government hospital gave up on her. She was referred to the Hospice. She was prescribed morphine.  There was no hope.

Part 2: Healing Crisis After Taking Herbs but She Was Better

CE and her daughter came to seek our help on 17 February 2012. She was prescribed Capsule A, teas for her Bone, Lung, Brain and Pain.

24 February 2012: One week on the herbs, her condition improved. Her intake of painkiller was reduced by fifty-percent. Previously she needed to take 4 tablets a day, and after the herbs this was cut down to 2 tablets per day. She felt more energetic. Her facial expression was better.

CE (patient):  First day, I moved my bowels. Second day, I had diarrhea. Third day I had more diarrhea.

Chris: The first few days of taking herbs, patients generally go through a “healing crisis” – a cleansing process. There could be more pain, you become more tired or you have diarrhea, etc. These are good. Do not take any medication, the problems will resolve by themselves. I have a patient who moved  her bowels ten times a day after taking the herbs. Take it easy.

Daughter: She had five bowel movements!

C:  Oh, ten times would be better!  Take it easy and be patient. Now, do you still have diarrhea?

CE:  I have no more diarrhea.

C:  This is what I am telling patients. You may have pain after taking the herbs, then the next day more pain and perhaps more pain for some more days. Then the pain becomes less and less and eventually it will be gone. Everyone has to go through this difficulty or “healing crisis.”

D: She does not need to take so much pain medication now. Before she took four times of medication a day.

CE: After take the herbs, I only took painkiller twice a day. Today I only take one time.

C: No need to take four times a day anymore? You need to take the pain medication if there is pain. It is no use to suffer. Take the pain killer if the herbs do not help you. You need to relieve the pain. Only thing is we don’t want to take too much of pain medication and be dependent on it.

Okay, you took the herbs for a week now. Are you getting any better?

P: I am more “cheng sin” (more alert).

D: I don’t know if she has improved or not from the inside, but looking at her facial expression, certainly she is much better now.

C: Patient should be able to know if she is “improving” or not. She should be able to “feel” the improvements. I too would be able to “see” if patients are getting better or not by looking and talking to them. And I tell every patient who come here – if you take our herbs for two or three weeks and you don’t feel any better, then stop coming to see me. The herbs are not good for you. Better that you go and see someone else for help.

Part 3: Bad Diet and Family Problems

2 March 2012: Unfortunately her health deteriorated. She did not look healthy. Both her legs were swollen. After some questioning, she admitted to eating “outside food” the whole week.

Daughter: Both of her legs are swollen!

Chris:  Last week when you came, were the legs swollen?

D: No.

C: Do you still have pain?

CE (patient):  Yes.

D:  Her pain medication intake had increased to twice a day. This week she is less energetic. Last week she looked much better.

C: Did she take care of her diet? Or did she start to eat anything she liked?

D: This week I was not able to cook for her. My son was sick and so I was not able to take care of her (mother).

C: So, the whole of this week she had been taking “outside (hawker) food”?

D: Yes. The first week, I cooked her food.

C: This is the problem.

D: It was difficult for me.

C:  Are you the only daughter at home?

D: I live with my family (husband, son and in laws) in Batu Ferringgi (about an hour’s drive away) but my mother lives in Batu Lancang (near our cancer centre). She lives with my sister and brother.  But all of them are working so they have no time to take care of her.

C: What about you? Are you working?

D: Yes. But in the afternoon, I come to my mother’s house to cook for her. But this week my son was sick and I had to take care of him. So I did not have the time to cook for my mother.

C: I understand. But in cancer, diet is very important. As you notice, the first week she was doing much better with no swollen legs. But this week her legs swelled due to bad diet. It is all about “bad” food.

Indeed, there is nothing we can do really. Like they say, “A mother can take care of ten children, but ten children cannot take care of one mother.”  I understand your situation.

Comments

1.  Most patients come “shopping” for magic potion. They expect us to cure them even after medical treatments have failed them. This is unrealistic. We are only human and we can only do that much and no more. This case is not an exceptional case. Read my blog, www.ADayWithChrisTeo.wordpress.com and you understand what I mean.

2. Our path to healing is not a “honeymoon” trip. After taking the herbs or change of diet, there will be a ‘healing crisis”. You will probably have more pains, more coughs, more bowel movements, etc.  (Read more: Healing Crisis). Do not do anything to stop this cleansing process. The problem will solve by itself after a little while. No medication please. Remember that “healing crisis” is a law of cure. Without this happening there shall be no healing.

3.  Diet is the most sore point among patients. When patients start to get well, they want to eat what they like. And after they have eaten all the “bad food” they write us asking why their tumour markers, like CEA, CA 125, CA 19.9, etc., had increased? What can we do? You reap what you sow! It is okay, if patients admit to their mistakes like in the case above. At least we can teach them to do it right the next time. But the worst cases are those who would not want to admit their mistakes and keep on denying that they followed our dietary advice to the letter. Well, there is nothing to be upset or dispute. Winning over this matter does not benefit anyone. For these patients, our advice is – Stop our herbs and find someone else to help you.

4.  As said in the beginning of this article, cancer is not about a tumour in your body, it is about you as a human being. Many patients come and go, unfortunately never recognizing this important aspect – to them cancer is only a misery or disaster in life! Such people die or suffer in vain. They believe that their problems are due to outside factors. They don’t look into themselves to know what have gone wrong. Most cancer patients carry with them a load of unresolved personal baggage – bitterness, hatred, lack of love, family problems, etc. Unfortunately, no chemo, radiation or herbs can help in such matters.  This is what I mean when I said in the beginning of this article, After talking to you for about five minutes I would probably know if I can help you or not. Your personality and problems show up during our conversation. And it is hard to change a patient’s attitudes and lifestyle – it has to be the person himself/herself who wants to change. Without change, no healing can ever take place.