RAM was a 64-year-old lady from Indonesia. She was diagnosed with cervical cancer in December 2000. According to her daughter, the tumour was only the size of a green pea and was visible. RAM was referred to the cancer hospital for treatment. In January 2001, she was started on radiotherapy. Altogether she had 26 radiation treatments and this was followed by HDR brachytherapy (i.e., internal radiotherapy). She also underwent chemotherapy at the same time.
After the medical treatments, RAM was alright for a while. In March 2002, RAM started to have pains in the backbone and the abdomen. A CT scan done on 13 March 2002 showed the presence of at least three hypodense foci in segment 6 of right lobe of her liver suspicious of either cysts or metastatic deposits. Her uterus was distended with fluid within the endometrial cavity. There was mild thickening of the uterine cervix, post radiotherapy. Multiple sclerotic foci scattered in the lumbar vertebral bodies, iliac bones and right head of femur. These were suggestive of sclerotic bony metastasis.
RAM went back to the same cancer hospital. She again underwent 11 times of radiotherapy. After the treatment, RAM’s health started to deteriorate. Disappointed, she went to another private hospital in Penang. The medical report dated 22 June 2002 stated, “She consulted me for the first time on 17 June 2002 with complaints of severe pain in the back and right side of the face. X-rays confirmed secondary sclerotic lesions in the ribs, clavicles, scapulae, skull vault, upper cervical spine and lumbosacral spine suggestive of metastases”. This meant the cancer had spread extensive to her bones. The doctor prescribed RAM a three-month supply of artificial saliva, amitriptylline, morphine sulphate and maxolon.
RAM stopped coming to Penang for treatment. She stayed home. Her entire right side of the body was in pain. She was not able to eat. She breathed with difficulty. Her daughter came to see us on 30 August 2002.
A small pea-sized tumour in the cervix had created havoc within a year. Are we made to believe that this is a natural course of event in cervical cancer – a pea-sized monster suddenly becoming ferocious and invaded the liver, ribs, skull and bones all over the body?
How could that be? Think carefully and calmly. Could it be due the chemo-drugs or the deadly radiation? If RAM was to take it easy – if she were to do NOTHING, would she be in her current situation? Would NO treatment at all make her worse off? What could have been worse than the current situation?
Her daughter told us that RAM was a healthy lady and weighed 65 kg when she started with medical treatments. After the treatment she became a vegetable. In June 2002, the doctor told her family that RAM had only THREE months to live. RAM eventually died, 1 year and 8 months after her diagnosis.