Metastatic Lung Cancer: Meaningless Fall and Rise of CEA With Iressa and Tarceva

DS is a 54-year-old lady from Singapore. In 2010, she had persistent coughs for about six months.  In November 2010, she went to the hospital after having severe headaches and vomiting.  She was hospitalised for tests. Subsequent imaging procedures revealed lung cancer that had spread to her bones and brain.

 

Brain scan on 29 November 2010: Multiple small intra-axial solid and ring enhancing lesions in the brain parenchyma. Findings highly suggestive of brain metastasis.

CT Thorax of 30 November 2010: A 4.8 x 4.6 cm mass is seen in the medial basal segment of the left lower lobe.  Few satellite nodules measuring up to 1.2 cm are also seen distally in the left lower lobe. Left hilar lymph nodes are enlarged measuring up to 2.6 x 1.4 cm. Further, mediastinal lymph adenopathy is also seen involving the subcarinal and aorto pulmonary lymph nodes. Small subcentimeter sized pre tracheal lymph nodes are also seen.

Bone scan on 8 December 2010: Abnormal uptake projected over the right scapula /glenoid, suspicious of metastasis. Indeterminate uptake at the L5 vertebra. Mildly increased tracer uptake over the right temporal-mandibular junction. Degenerative changes involving the sternum, knees and feet.

DS was treated with Iressa (150 mg daily from December 2010 to mid-April 2012) and monthly injection of Zometa  (for her bones). Iressa was stopped after the drug was found to be no more effective.

Her doctor then prescribed Tarceva. From mid-April 20-12 to June 2012, DS was on Tarceva (75 mg daily, and one 150 mg pill taken every two days).  DS still continued receiving Zometa infusion once a month.

Within two weeks on Tarceva she suffered side effects such as: pimples and rashes. The doctor reduced the dosage to half. Her tumour marker – CEA – kept on rising. The lung tumour increased in size, her bone and brain metastases worsened.

 

Vitamins and Supplements

  1. Barley Green / chorella powder
  2. Vitamin B12 or B-complex
  3. Vitamin C – 500 mg
  4. Calcium 800 mg
  5. IP6 (inosital hexaphosphate) 800 mg
  6. Milk thistle
  7. Glucosamine + Chondrotin
  8. Omega 3 or Krill oil
  9. Curcumin extract
  10. Probiotics plus enzymes
  11. Chia seeds, protein shakes, blueberry concentrate.

CT Thorax of 27 October 2011: Since CT scan of 30 May 2011, a mixed response is seen where the dominant left lower lobe nodule shows increase in size whereas the subcentimeter nodule nodule in the left lower lobe lateral basal segment has virtually resolved.

Bone Scan of 13 April 2012: Scan shows foci of increased tracer uptake at: inferior glenoid region of the right scapula (more intense and extensive); T12 vertebra (new) and L5 vertebra (more extensive). Since 25 May 2011, there is interval progression of bone metastases.

MRI Brain with Contrast of 16 April 2012: There are multiple new areas of pial /cortical as well as parenchymal enhancing lesions, highly suggestive of metastases.

Now, the doctor is suggesting that DS undergo chemotherapy with Alimta + Cisplatin. She refused.

DS decided to stop Tarceva and came to Penang to seek our help. She presented with the following:

  1. Pains in left shoulder (scale 5 out of 10) if carry things.
  2. Chest congested and “tight.”
  3. “Crawling” sensation on back of head and sometimes face.
  4. Internal “ticks or twitches” on face.
  5. Sometimes, feet swollen.
  6. Urination 7 to 8 times during waking hours, once at night.
  7. Persistent non-productive coughs. Sometimes felt like being strangled and this feeling passes after a while. Very strong coughing fits sometimes causes urinary incontinence.
  8. Pain in chest after coughing.

DS was prescribed Capsule A, Lung 1 and 2 tea, Brain 1 tea, Bone Tea, Pain Tea and Cough 10 and Cough 11.

Her AcuGraph reading on 7 September 2012 appeared fairly good compared to other cancer patients. She had imbalances of her LU (lung), SP (spleen), KI (kidney) and GB (gall bladder) meridians.  Based on this reading, DS was prescribed A-Lung-2 and A-Kid-2 tea.

 

 

 

 

Comments

If you have been reading our articles in this website, I am sure you would have come across stories of lung cancer patients who have taken Iressa and /or Tarceva.  I think I have said and written enough, just read the stories below:

Lung Cancer and the Side Effects of Iressahttps://cancercaremalaysia.com/2012/08/15/lung-cancer-and-the-side-effects-of-iressa/  

Meaningless Shrinking of Tumour by Chemotherapy https://cancercaremalaysia.com/2012/05/26/meaningless-shrinking-of-tumour-by-chemotherapy/ 

Lung Cancer: The Meaningless Decrease and Increase of Tumour Markers After Chemotherapy https://cancercaremalaysia.com/2012/04/30/lung-cancer-the-meaningless-decrease-and-increase-of-tumour-markers-after-chemotherapy/ 

Meaningless Shrinking of Tumor While on Tarceva https://cancercaremalaysia.com/2012/04/26/meaningless-shrinking-of-tumor-while-on-tarceva-treatment/ 

Meaningless Decline of CA 15.3 and Tumour Shrinkage Following Treatment With Iressa and Tarceva https://cancercaremalaysia.com/2012/04/26/meaningless-decline-of-ca-15-3-and-tumour-shrinkage-following-treatment-with-iressa-and-tarceva/ 

Lung Cancer: After One-and-half Years of Iressa, He Moved to Tarceva https://cancercaremalaysia.com/2012/09/04/lung-cancer-after-one-and-half-years-of-iressa-he-moved-to-tarceva/

Mom With Lung Cancer: Surprise! Surprise! Four Years on Herbs and Still Doing Well! https://cancercaremalaysia.com/2012/08/30/mom-with-lung-cancer-surprise-surprise-four-years-on-herbs-and-still-doing-well/

Let me conclude with some quotations for you to reflect on:

 

 

Lung Cancer: The Meaningless Decrease and Increase of Tumour Markers After Chemotherapy

HK (S97) is a 57-year-old man from Indonesia. Blood test showed that his CA 19.9 was elevated.  A CT scan on 15 March 2011 in Singapore revealed a small right pleural effusion and small nodules in his right lung.

A PET scan done on 17 March 2011 indicated:

  1. Hypermetabolic primary tumour at the right lung apex.
  2. Smaller subcentimeter nodules (below the resolution of PET) in the right lung, suspicious for intrapulmonary metastases.
  3. Right pleural effusion with multiple FDG-avid pleural nodules.
  4. FDG-avid left supraclavicular, subcarinal and right paratracheal nodes, suspicious for nodal involvement.

HK underwent chemotherapy as below:

Date

Procedure

CEA

CA 19.9

19 March 2011 Biopsy at a hospital in Kuala Lumpur.    
22 March 2011 Lung cancer confirmed.    
24 March 2011 Chemo – first cycle, day 1 – Gemcitabine + Cisplatin    
30 March 2011 Chemo – first cycle, second injection 12Apr 11 = 85.5 12Apr 11 = 435.9
20 April 2011 Chemo – second cycle, day 1 – Gemcitabine + Cisplatin    
26 April 2011 Chemo – second cycle, second injection    
28 April to 1 May 2011 Fevers  < 38 C, admitted to hospital    
11 May  2011 Chemo – third cycle, day 1 – Gemcitabine + Cisplatin 11May11 = 123.5 11May11 = 291.6
18 May 2011 Chemo – third  cycle, second injection    
31 May 2011 PET scan – results showed improvement 30May11 = 90.5 30May11= 220.3
1 June 2011 Chemo – fourth cycle, day 1 – Gemcitabine + Cisplatin    
8 June 2011 Chemo – fourth  cycle, second injection    
22 June 2011 Chemo – fifth  cycle, day 1 – Gemcitabine + Cisplatin    
29 June 2011 Chemo – fifth cycle, second injection    
13 July 2011 Chemo delayed due to lack of blood    
20 July 2011 Chemo – sixth cycle, day 1 – Gemcitabine + Cisplatin    
27 July 2011 Chemo – sixth cycle, second injection    
11 August 2011 PET scan – results showed no changes or further improvements 10Aug11 = 64.2 10Aug11 = 164.8
13 August to 17 Nov. 2011 Three months on Tarceva – Rashes in the face and legs. 14 Sep11 = 130.3

12 Oct 11 = 217.7

14 Sep11 = 85.7

12 Oct 11= 114.1

17 November 2011 PET scan – results showed cancer  was more aggressive 16Nov 11 = 523.0 16Nov11 = 438.2
26 November 2011 Chemo – first cycle of Alimta    
16 December 2011 Chemo – second cycle of Alimta 4 Jan 12  = 666.5 4 Jan 12 = 4,422.0
5 Jan12  to

1 Feb.12

Chinese herbs    
3 February 2012 Started on CA Care herbs  – Caspsule A + B, Lung 1 and Lung 2, Pain, Liver Tea 1 Feb. 2012

=737.5

1 Feb. 2012

= 3,917.0

  While on CA Care’s herbs 10 Mar 2012

 = 629.8

10 Mar 2012

= 3,609.0

 

Comments

Study carefully the rise and fall of his CEA. From 85.5 it increased to 123.5 and then decreased to 64.2 after which it started to climb to 130.3 to 737.5. After CA Care’s herbs it went down to 629.8.

Study carefully the rise and fall of his 19.9. It started with 435.9. With chemotherapy it decreased to 291.6, 164.8 and eventually 85.7. However with more treatment the CA 19.9 started to increase to 114.1, 438.2 and eventually 4,422.0. After CA Care’s herbs it went down to 3,609.0.

When the CEA or CA 19.9 went down after chemotherapy, patient and his family were happy and the doctor surely is similarly happy and “believes” that the treatment has done the trick. But there is no cause for celebration because the decrease of CEA and CA 19.9 are just meaningless. It happens often – only that those concerned never want to see reality. They want to believe that chemotherapy is going to cure their cancer!

In the case of HK above, again I say, the increase and decrease of his tumour markers is meaningless. At the end of the day, this is what his lung looked like. No use and no cure.

 

Increase or decrease of CEA and CA 19.9 after chemotherapy is meaningless when the end results of the treatment are like these!

Lung Cancer: Surgery, No Chemo But On Herbs – CEA Elevated After Bad Diet

 

Jan (M471) is a 55-year-old male from Indonesia.  He is an ex-smoker of 40 plus years. Sometime in mid-2008 he had coughs. There was no blood in his sputum. He went to Melaka for a checkup. A CT scan indicated cancer of the lung. Not satisfied he came to Penang for a second opinion.

A colonoscopy, done on 20 September 2008, indicated haemorrhoids and presence of polyps in the colon and rectum. Biopsy of the colonic polyp indicated tubular adenoma associated with moderate dysplasia, while the polyp from rectum was hyperplastic.

CT scan of the thorax indicated a small irregular 1.7 x 1.7 x 1.6 cm nodule. The paratracheal, carinal and right hilar lymph nodes were enlarged ranging from 1 to 3 cm.  Impression: Features are suspicious of underlying early carcinoma of lung.

Jan underwent an operation to remove the tumour in his lung. He was told he had a 85 to 90 percent of cure if he had surgery. Histopathology report confirmed a moderately differentiated squamous cell carcinoma, pT1N1Mx, Stage 2A. Surgical margins were free of malignancy. The total cost of his medical treatment came to about RM 35,000.

Jan was asked to undergo chemotherapy. He refused and came to seek our help on 8 October 2008. He was prescribed Capsule A, C-tea, Lung 1 and Lung 2 tea and GI 1 tea.

About a month later, 14 November 2008, Jan came back to see us again. He said he felt healthier and his sleep was better. He was asked to undergo chemotherapy. The doctor said chemotherapy can cure him. He declined.

Jan is from a small town in Sumatera. It is a long travel to come to Penang from his home. From home he has to take a 3-hour-bus-ride to a town where he would have to take another 24-hour-bus-ride to Medan. From Medan he has to fly to Penang. In spite of this long journey, Jan come to see us regularly.  On most visits to us, Jan said he was well and healthy with no complaints. His CEA decreased from the initial 133.66 (before surgery) to 27.6 (after two years on herbs). However, on 21 October 2010, Jan was jolted by the sudden rise of his CEA from 27.6 to 83.12 (See table). We were disappointed too. What had gone wrong? From experience we could roughly guess the answer. We asked him, “What did you eat wrong these past month?”

Date

CEA

Remark
19 Sept 2008

133.66

 
15 July 2009

51.2

 
22 Oct 2009

43.0

 
14 May 2010

27.6

 
21 Oct 2010

83.12

Bad diet – ate meat, fried food and tau sar paw
4 Dec 2010

75.58

 
31 Mar 2011

93.97

 
25 Aug 2011

57.9

 

Jan admitted that since he was doing fine, he did not keep to his diet very well. He ate the food that we asked him to avoid such as meat, fried food and “tau sar pow” (bun made form sweet beans boiled in pork lard). He used corn oil for his cooking instead of coconut oil. We explained to Jan we did not know the cause of the rise in his CEA – it could be due to the problem of his colon since he had polyps or it could be due to his lungs. Anyway, the only option is to go back to his good diet again. Jan promised to do just that. About a month later, the CEA dropped to 75.58 only to increase again to 93.97 in March 2011. However, in August 2011 his CEA was down to 57.9. With this decrease Jan seemed to believe that diet is important for his wellbeing.

Overall, Jan’s health was alright. It has been three years since his lung surgery. And he declined chemotherapy and opted for herbs instead. Up to this day, he is able to eat, sleep and do his routine activities without any problem. It did not matter if the CEA was at 93.97 or 57.9 – these numbers did not make any difference in terms of his wellbeing. In short, his quality of life has been maintained through his cancer journey, minus the chemo of course.

Acugraph Study

The AcuGraph taken on 26 August 2011 showed improvements – a more balanced meridian reading compared to the one take on 22 October 2010 (below).

 

Some questions for you to reflect on:

  1. After surgery Jan refused to undergo chemotherapy in spite of being asked to do so by his doctor. What happened to him now? What could have happened if he was to undergo chemotherapy? Will he be as well as he is today?
  2. After the surgery, his CEA dropped from 133 to 51 and then to 27 – and he was only on herbs and “good” diet. Do you believe that herbs and diet are effective in keeping his cancer at bay? Or do you prefer toxic drugs to do the job?
  3. Jan started to take “bad” food after two years of being in good health. His CEA shot up to 83. He realized his mistake and started to go on his “good” diet again. After six months his CEA went down to 58. Do you still insist that cancer patients can eat anything they like and that food has nothing to do with cancer progression and/or recurrence?
  4. From October 2010 to March 2011, Jan’s CEA hovered around 76 to 94. In spite of that he felt well. His wellbeing was not affected by either a high or low CEA.  What does this tell you? Learn to live with your cancer! Don’t let the lab test numbers make you sick!