He Died Of Lung Cancer — Treated by the Best Oncologist in One of the Best Hospitals in the World

It was 3 a.m. when I finished reading the last page of this 224-page-New York Time #1 Bestseller.

When breath becomes air

The Author: Dr. Paul Kalanithi was an outstanding neurosurgeon with very impressive academic credentials. He graduated from Stanford University with a BA and MA in English literature and a BA in human biology. He earned an MPhil in history and philosophy of science and medicine from the University of Cambridge. Later, he went to Yale School of Medicine where he graduated with a cum laude. Paul then returned to Stanford to complete his residency training in neurosurgery.

To Paul, being a neurosurgeon is a noble calling. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is.

Unfortunately, fate has it that Paul did not end up being a full-fledged neurosurgeon. Well into his six-year-residency  he was diagnosed with stage 4 metastatic lung cancer. Less than two years (22 months) after the diagnosis he died — just when he was ready to graduate.

I read this book with a heavy heart — sad that such a brilliant and caring doctor like Paul had to leave so soon.  Lucy — Paul’s wife wrote, When I see the hospital where Paul lived and died as a physician and a patient, I understand that had he lived, he would have made great contributions as a neurosurgeon and neuroscientist. He would have helped countless patients and their families.

Such is the sad, cruel reality about life. Lucy wrote, What happened to Paul was tragic, but he was not a tragedy. True indeed. I always believe for anything that happens, there must be a reason if only we look at the bigger picture.

Salute the Neurosurgeon!

Paul did well in life — he studied literature, history and philosophy before doing medicine. With such academic background he was well prepared to become a caring doctor — a cut above others. Here are some quotations of what Paul wrote in his book:

  • As a resident, my highest ideal was not saving lives — everyone dies eventually — but guiding a patient or family to an understanding of death or illness. Where there’s no place for the scalpel, words are the surgeon’s only tool.
  • Our patients’ lives and identities may be in our hands, yet death always wins. Even if you are perfect, the world isn’t. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win for your patients.
  • Like my own patients, I had to face my mortality and try to understand what made my life worth living. With limited time, Paul wrote this book. He did not get to finish it.

Prognosis and Statistics

As a neurosurgery resident Paul had operated on brain cancer. After surgery it is the standard practice to send patients for follow up chemo and/or radiation. Here doctors often talk about prognosis with their patients and family members.

This is something Paul wanted us to know. He wrote, By this point, I had learned a couple of basic rules. First, detailed statistics are for research halls, not hospital rooms … Second, it is important to be accurate, but you must always leave some room for hope — Median survival is eleven months or You have 95 percent chance of being dead in two years — I come to believe that it is irresponsible to be more precise than you can be accurate. Those apocryphal doctors who gave specific numbers (The doctor told me I had six months to live): Who were they, I wondered, and who taught them statistics?

Limitation of Science

  • Although I had been raised in a devout Christian family …I, like most scientific types, came to believe in the possibility of material conception of reality, an ultimately scientific worldview that would grant a complete metaphysics, minus outmoded concepts like souls, God, and bearded white men in robes.
  • Scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units.
  • Science is based on reproducibility and manufactured objectivity.
  • Science … its inablity to grasp the most central aspects of human life: hope, fear, love, hate, beauty, honor, weakness, striving, suffering, virtue.
  • Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. 

Stage 4 Lung Cancer

  • At age thirty-six, I had reached the mountaintop; I could see the Promised Land …. then a few weeks later I began having bouts of severe chest pain … my weight began dropping … from 175 to 145 pounds. I developed persistent cough. Little doubt remained.
  • In May 2013, it was confirmed that Paul had a stage 4 non-small cell EGFR-positive lung cancer. At that time he was in his sixth year of residency — one more year to
  • The irony was that Paul had never smoked.

The World’s Best Oncologist

  • The search was on — to find who was the best lung cancer oncologist (USA). Houston and New York had major cancer cancers …The replies came back quickly and more or less unanimously: Emma (also in Stanford) not only was one of the best — a world-renowned oncologist who served as the lung cancer expert on one of the major national cancer advisory boards — but she was also known to be compassionate, someone who knew when to push and when to hold back.
  • On many occasions when consulting Emma, it was clear that this compassionate oncologist did not “dictate things” to her patient. I could hear Emma’s voice again: You have to figure out what’s most important to you.
  • Emma once told Paul: I’m totally happy for us to make your medical plan together; obviously, you’re a doctor, you know what you’re talking about, and it’s your life.
  • At their initial consultation, Paul wanted to discuss the prognosis — possibly how much time left. Emma evaded the question and said, We’re not discussing that.
  • Two months in, Emma remained vague about any prognostication, and every statistics I cited she rebuffed with a reminder to focus on my values.

Temporary Response

Paul had an EGFR-positive tumour. No intravenous chemotherapy was indicated for the moment. He was put on an oral targeted drug called Tarceva.

His cancer responded to the treatment — My lungs, speckled with innumerable tumours before, were clear except for a one-centimetre nodule in the right upper lobe … there had been a clear, dramatic reduction in tumour burden.

Paul regained strength and he returned to work in late 2013, completing his seventh year of residency.

Relapse — Chemotherapy: Too many cooks spoil the broth?

In spring of 2014, the cancer relapsed. The only option left was chemotherapy.  This was what happened after one of his chemo sessions.

  • I began to deteriorate, my diarrhea rapidly worsening … my kidneys began to fail. My mouth became so dry I would not speak or swallow … my serum sodium had reached a near-fatal level. Part of my soft palate and pharynx died from dehydration and peeled out of my mouth … I was transferred to the ICU. I was in pain …. a pantheon of specialists was brought together to help: medical intensivists, nephrologists, gastroenterologists, endocrinologists, infectious disease specialists, neurosurgeons, general oncologists, thoracic oncologists, otolaryngologist …. 
  • I was acutely aware that with this many voices, cacophony (unpleasant mixture of loud sounds) In medicine, this is known as the WICOS problem: Who Is the Captain Of the Ship? The nephrologists disagreed with the ICU doctors, who disagreed with the endocrinologists, who disagreed with the oncologists, who disagreed with the gastroenterologists. I felt the responsibility of my care… tried to corral all the doctors to keep the facts and interpretations straight.

It is hard to tell laymen, like you and me, to take charge of your own health and treatment when you are in the hospital surrounded by all those experts. But yet, that should be the way it should be!

Chemotherapy took a heavy toll on Paul. He wrote: Withered, I could see my bones against my skin, a living X-ray. At home, simply holding my head up was tiring. Lifting a glass of water required both hands. Reading was out of question.

Chemo Failed – He Died

  • Treatment wasn’t an option — not until I regained some strength.
  • Emma, I said, what’s the next step?
  • Get stronger, That’s it.
  • But when the cancer recurs … I mean, the probabilities …. I paused. First-line therapy (Tarceva) had failed. Second-line therapy (chemo) had nearly killed me. Third-line therapy, if I could even get there, made few promises.
  • You have five good years left, she (Emma) said. She pronounced it, but without authoritative tone of an oracle, without any confidence of a true believer. She said it, instead, like a plea… Doctors, it turns out, need hope, too.

Paul did not live to write the closing chapter of his book. It was left to his wife, Lucy, to document his last hours on earth in the Epilogue. Paul died, two months short of two years (on Monday, 9 March  2015) after his diagnosis. He was 37 years old.

  • In the Epilogue Lucy said, Writing this book was a chance for this courageous … (Paul) to teach us to face death with integrity.

To us who is still living, I also say, Let us learn to embrace death with courage and understanding.

Lessons from Paul’s Experience

As I read this book, I learned many things. And I kept thinking and asking. Let me share my thoughts with you.

Family of Doctors

Paul came from a family of doctors. His father, brother, uncle, wife  are all doctors. Paul was not any ordinary doctor. He was trained in one of the best medical schools in the country. When he had cancer, he had the best oncologist in the world to treat him. Few of us would not have that privilege and opportunity. Perhaps we don’t need the best when it comes to cancer? What difference would that make?

Modern medicine had contributed very much to lighten human sufferings. Let no one doubt about that. But when it comes to cancer and its treatment, perhaps we need to take a step backward, pause and explore more.

43 Wrong-battle-wrong-weapons

48-We-fought-ca-Cancer-won

Yes, many people wrote about the need to rethink the war on cancer, but there are many others who would strongly defend the status quo. Why change? Why look for something else when the present ways serve the Cancer Industry so well?

When my wife and I started CA Care in 1995, to help cancer patients, I knew absolutely nothing about cancer and its treatment. No, I did not go to medical school. I relied on my Ph.D. and my research experience on plants to do what is right for those helpless and hopeless patients. After 20 years of dealing with cancer patients, I can say this to all and sundry. As far as cancer treatment is concerned, there  are other options than just chemo and radiation. Perhaps by taking the non-conventional path, you could live longer, with less suffering and not having to deplete your life’s saving to pay for the medical bills.

I have written numerous studies in these two comic books.

Title-Page-600

Available at http://bookoncancer.com/productDetail.php?P_Id=75

In Lung Cancer – What Now?  I have documented 12 cases of lung cancers – nine of which are about patients who failed to find the cure that they wanted, in spite of spending hundreds of thousands of ringgit on their medical treatments.

Meaningless shrinkage of tumour by Iressa

1 2

Meaningless shrinkage of tumour by Tarceva

3

These two cases happened with patients in Jakarta (above) and in Malaysia (below). And this also happened some years later with Dr. Paul in Stanford. What can we learn from such cases?

Title-page-600

Available:  http://bookoncancer.com/productDetail.php?P_Id=73

In Lung Cancer – Success Stories, I presented 12 cases of patients who opted for “alternative” treatment for their lung cancer.

Statistics of Lung Cancer Survival

4 5 6 7

 

Dr. Paul had Tarceva. This drug helped him for about a year. Then the cancer came back again. He then had chemotherapy and died. He survived 22 months after his initial diagnosis. That happened in Stanford under the care of the best oncologist in the world.

Back in Malaysia, there is also a professor who is the best for lung cancer. According to him, most of his patients who were treated in his clinic died after two years.

The same achievement as in Stanford?

If you do the same thing over and over again. You can expect the same results. Is that not what science teaches us? Remember what Henry Ford and Einstein said.

Insanity both

In this story above, mom opted for CA Care Therapy. She declined chemotherapy even though she was told that without chemo she would die within six months. Professor X was surprised how mom had survived for four years without chemo. Is that an achievement or quackery (like many in the medical industry want us to believe)?

Why haven’t you die yet?

89 10 11

CA Care has been around for about 20 years now.  Like Dr. Paul, my wife and I went into this because it was a “calling” — an answer to my prayer. Looking back, we have no regrets. Instead, we feel blessed to be able to help patients who need our help. They come from far and near.

 

 

 

 

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Lung Cancer: Meaningless Temporary Drop of CEA After Iressa

In September 2013, Liz – a 54-year-old Indonesian – has pains around her right rib-cage. An USG indicated fluid in her lungs. Liz was referred to a lung specialist who thought she had tuberculosis (TB). Liz was prescribed TB medication for three months.

After three months, there was again fluid in her lungs. About 1.3 litres of fluid was tapped out. Liz was told to continue taking her TB medication.

Liz went to Jakarta and  consulted another doctor. Pleural tapping was again done and 0.6 litre of fluid was removed from her lung. Liz was again asked to continue with her TB medication.

Not satisfied Liz went to Singapore. Blood test, CT and PET scan were performed (note: no CT or PET scan were ordered by doctors in Indonesia).

Blood test results, 14 April 2014

Alkaline phosphatase 188 (H)
AST/SGOT 84  (H)
ALT/ SGPT 83  (H)
GGT 100  (H)
CEA 44.3  (H)
CA 125 26.6  (H)
CA 19.9 4.6
AFP 6.4

 

CT Scan of the Thorax, 14 April 2014

  • A large right -side pleural effusion is seen involving the upper lobe of the right lung and extending to involve the middle lobe.
  • Suspicious of a nodular mass more than 2 cm in size present in the upper lobe of the right lung.
  • Presence of a small nodule in the left lung in the lower lobe, 6 mm in size. This is suspicious of a possible metastatic lesion.

Cytopatholoogy report of right pleural fluid, 14 April 2014

  • pleural fluid negative for maligancy.
  • pleural fluid is haemorrhagic with few inflammatory cells and an occasional mesothelial cell.

PET/CT Study on 15 April 2014

  • Hypermetabolic mass in the upper lobe of the right lung is consistent with pulmonary malignancy.
  • Mildly hypermetabolic paratracheal and precarinal nodes are suspicious of nodal metastasis. Multiple nodules scattered in both lungs are suspicious of pulmonary metastasis.
  • Hypermetabolic lytic lesions in the thoracic vertebra and left ischium are compatible with metastases.

Cytopathology report – FN lung biopsy, 17 April 2014

Malignant cells present consistent with infiltrative moderately differentiated pulmonary adenocarcinoma.

MRI Brain

No MRI imaging evidence of intracranial metastatic disease is detected.

Liz was not able to walk by herself and had to use the wheel chair. She received 10 sessions of radiation treatment. After radiotherapy, she was able to walk. But she still had cramps and numbness in her legs. Liz told us that this leg numbness and cramp developed after 2 months on the TB medication.

For her lung cancer, the oncologist prescribed Iressa, costing SGD 3,500 per month. 

Meaningless temporary decrease of CEA after taking Iressa

April 2014 Started on Iressa, CEA = 44.3
11 June 2014 X-ray chest: Slight interval improvement. CEA = 18.7 (decrease from 44.3)
13 August 2014 X-ray chest: Stable lobulated opacity seen. CEA = 31.2 (started to increase)
14 October 2014 X-ray chest: No significant change. CEA = 36.0 (slight increase)
20 January 2015 X-ray chest: Right pleural effusion is stable. CEA = 47.6 (increase from initial value)

 

Meaningless improvements of PET scan images after taking Iressa (Study of April 2014 versus October 2014).

April-2014-bad

(Top: April 2014 after Iressa bottom: October 2014)Oct-2014-improve

(Left: April 2014 after Iressa right: October 2014)Meaningless-bone

Iressa did not help Liz. The oncologist offered two options:

  1. Stop taking Iressa and go for chemothrapy.
  2. Or continue taking Iressa for another 2 months and see what happen.

Liz decided to stop further medical treatment and came to seek our help.

 

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

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

Lung Cancer: Given Honest Answers Patient May Run Away from Chemotherapy

SS (E345) is a 55-yer-old lady. Her problem started around October 2013 when she started to have coughs with a bit of phlegm. There was no blood. She consulted a GP who gave medication but the problem persisted on and off. At last she requested her GP to do an X-ray of her chest. There was “something” in her lung. SS was referred to a hospital in her hometown for a CT scan.

CT scan done on 18 October 2013 showed a lobulated mass at the right hilar region. It measures 2.9 x 3.2 cm. SS was asked to consult a lung expert in a private hospital in Penang.

Bronchoscopy and Surgery Failed

SS did a bronchoscopy. In this procedure the doctor inserts a bronchoscope into the nose or mouth. This allows him to view the inside of the airways and lungs. Unfortunately for SS, the bronchoscope could not penetrate the passageway deep enough and the doctor saw nothing!  Fluid taken from the lung during the procedure did not show presence of malignant cells.

The doctor suggested a better option would be to do an open surgery. SS agreed but she was asked to do a PET scan first. The PET scan results on 30 October 2013 showed:

  • No intracranial lesion is seen.
  • Few small 5- 7 mildly active hypodense lymph nodes are seen in the right and left side of the neck.
  • A 42 mm metabolic active mass is seen in the middle of the right lung. Multiple smaller 2-7 mm nodules are seen in the rest of the right lung.
  • Few metabolic active lymph nodes measuring 14-26 mm are seen in the right para-trachea, subcarinal and right hilar region of the mediastinum are noted.

Composite

 

Based on the PET scan results the doctor was optimistic that surgery would provide good “success.” SS proceed with the surgery as recommended by the doctor. Unfortunately it was an open-close job – failed. The doctor took some tissue samples for biopsy.

The result of the biopsy indicated:

  • right pleural node biopsy: no malignancy seen.
  • right lower lobe biopsy: well differentiated adenocarcinoma.
  • right medial lobe: metastatic adenocarcinoma.
  • right paratracheal node: metastatic adenocarcinoma.

The tissue is positive for EGFR (meaning oral drugs such Iressa or Tarceva is indicated).

 

 

Consultation with Oncologist

SS was referred to the in-house oncologist for further management. The following are excerpts of our conversation.

Daughter: The oncologist said it is better to take oral medication than undergoing chemotherapy (infusion). Chemo has more bad side effects. My mother can take either Iressa or Tarceva.

Chris: Did you take the drug?

D: No. I asked the oncologist the following questions:

a) Are there side effects of the oral drug. His answer: Yes, patients may become itchy and have pimples or sores.

b) Can the oral drug cure my mother? His answer: Cannot cure. It is just to control.

c) Control for how long? His answer: It all depends on the patients.

d) From your experience, how long does the control last? His answer: For some patients the control lasted for one year. After one year, the drug was not effective anymore. But for some other patients the control lasted for 2 years before becoming ineffective.

e) After Iressa becomes ineffective, what do we do next? His answer:  Go for chemotherapy (injection).

D: The cost of Iressa is more than RM 200 per tablet. It comes to about RM 8,000 per month. Why take it when it is not going to be effective?

C: After 1 or 2 years on the drug, you will then have to go for chemo. Did you ask if chemo is going to cure your mother?

D: No, chemo cannot cure her. Each chemo costs about RM 2,000 per cycle. Later cycles would cost more – RM4,000 to RM5,000. She needs to do 4 to 6 cycles first and then we will see what happen after that.

Reluctant Q & A Session at RM 100

C: When you ask such questions, did you see if the oncologist was happy to answer you?

D: He seemed very reluctant and uneasy. Appeared like he had the answer and he did not have the answer. Also appeared like wanting to answer and not wanting to answer.

C: How long was your consultation?

D: About an hour and his consultation cost RM 100.

C: Wow, that’s great! One hour! I am indeed very surprised that he gave you so much time. You as patient, need to ask and ask the doctor such questions before undergoing any treatment. Be empowered and don’t be dumb. Now, go home and read this comic book::

Title-Page-600

(See https://cancercaremalaysia.com/2014/04/14/info-about-lung-cancer-ignorance-kills/)

I have written many books but many people find reading difficult. Some people don’t want to read. Now, I make comic books instead so that you don’t have to read too much. You can finish reading this book within an hour. So go home and read this. Learn from the stories of these people. Be empowered – be smart. Example, if you take Iressa and this cost you RM 8,000 per month. So, for a year, that would come to about RM 90,000. But can it cure you? No! In addition you have to suffer from itchiness, etc.

Opted for Chemo at Government Hospital

C: Your head – bald? Why?

D: She had chemo at the government hospital in January 2014. She completed 4 cycles – each cycle at 3 weeks interval.

C: Did you suffer?

Patient: Not very bad. I was constipated. My head and some parts of my body became itchy.

C: Did you have to pay for the chemo?

D: Yes, RM 50 per cycle. They used Gemcitabine (Gemzar) + Cisplatin. After the fourth cycle, the CT scan showed stable result.

C: Okay, at least you did it at the GH and did not have to pay so much. If you were to do it at a private hospital, it could cost you anywhere from RM 4,000 to RM5,000 per cycle. (Note: For comparison, a patient from Indonesia has 12 cycles of chemo (same drugs – Gemcitabine + Cisplatin) in a private hospital in Singapore. The total bill came to RM 0.5 million. And the treatment also failed. See: https://cancercaremalaysia.com/2014/04/24/two-billion-rupiah-chemo-and-surgery-failed-oncologist-said-more-chemo-you-just-have-to-trust-me/ ).

Do more chemo, and more chemo – until you die?

Patient: The tumour did not grow bigger. It did not get small either.

D: The doctor said my mother had to take Iressa or Tarceva as a follow up. I again asked how long must my mother need to be on this oral drug. The answer: It all depends on the patient. When Iressa becomes ineffective, she will go for chemo again. So we decided not to take the drug.

C: It seems that you are going round and round the same road.

D: You do the chemo.  Then you take oral medication. Then go for chemo again. Then take oral drug again.

C: Did you ask when can you stop the treatment?

D: No, no idea.

C: Oh, see how long can you stand the treatment? Then until you die?

D: Exactly.

C: So they are being honest with you. You need to know that there is no cure for lung cancer – even with chemo!

Take Home Lessons From This Case

1. There is no cure of lung cancer. The oncologist acknowledged that.

2. But of course, there is treatment (provided you have the money to pay for it, or are willing to endure the side effects).

3. According to the oncologist, take oral drug – Iressa or Tarceva. You will suffer less side effects.

4. Iressa or Tarceva does not cure. It may cost you RM 8,000 per month. And it may be effective for one or 2 years only.

5. When you have reached the dead end with oral drug, go for i/v (injection) chemo which also cannot cure.

6. Then, if you are still alive and still have the money to spend, go for oral drug again.

Have plenty of money to splurge?

You have an option to go to Singapore  — go to the best and the famous. There they may also give the same stuff, chemo with Gemcitabine (Gamzar)  + Cisplatin. That seems to be the gold standard.

A patient from Indonesia paid about RM 500,000 (half a million ringgit!) for 12 cycles of that stuff. Result: miserable failure. https://cancercaremalaysia.com/2014/04/24/two-billion-rupiah-chemo-and-surgery-failed-patient-said-ill-die-not-because-of-my-cancer-its-because-of-the-chemo/

Another Indonesian, was treated with one oral drug after another interspersed with chemo, over a period of about 3 years. He spent about half a million ringgit as well. Result: just the same failure and the cancer got worse. https://cancercaremalaysia.com/2013/11/29/lung-cancer-chemo-experiments-that-failed-and-failed/

Yet another Indonesia had chemo after chemo and spent about one million Singapore dollars and he died after about 2 years of treatment.

I have learned something interesting from this case study. If you wish to try your luck with chemotherapy but do not have the money to splurge, you still have a chance! Go to the (Malaysian) government hospital. This patient (SS) paid only RM 50 for a cycle of chemo with Gemcitabine + Cisplatin. For 4 cycles she only paid RM 200 — compared to half a million ringgit in Singapore! After all they use the same toxic drugs anyway! And the result is just the same,  FAILURE – wherever you go!

If you want to opt for less hefty medical bills, then go local.  Only that  you don’t get to become the patient of the best and the famous.  The husband of one lung cancer told me he spent about RM 300,000 over 2 years on his wife’s treatment. HIs wife took Iressa and had chemo after chemo. She died just after her husband came to see us.

Lung Cancer: Meaningless Shrinkage of Tumour and Decline of Tumour Markers’ Reading

TP (S-522) is a 62-year-old lady. In March 2013, she told us that she had been coughing for some 3 to 4 months. This developed into severe pain in the arm and back. A GP in her hometown took an X-ray and did a CT scan. It was probably lung cancer. TP went to Singapore for further management.

TP did PET scan and MRI followed by a biopsy.  The cancer had spread to her bones.  For her bones TP had radiation and was given Zometa injection. Biopsy indicated that the tumour was EGFR positive. TP was prescribed Iressa instead of intravenous chemotherapy.

Two months on Iressa, blood test showed improvments. Her LDH, CA 125 and CA 15.3 started to decline (table below).  TP continued with her Iressa. She barely had coughs.

Date

LDH

CA 125

CA 15.3

22 March 2013

301

191.2

86.3

15 April 2013

274

235.6

118.9

21 May 2013

144

11.1

39.1

9 September 2013

167

12.2

21.0

13 January 2014

513

330.2

186.1

PET/CT scan on 10 September 2013 showed:

1. The previously noted lung lesions are less avid compared to the study done on 23 March 2013.

2. The previously noted FDG avid nodes are less avid or resolved.

3. The previously noted FDG avid bone and serosal lesions are less avid or resolved.

Overall findings are in keeping with interval partial metabolic response.

PET scan on 22 March 2013 (before taking Iressa)  vs 10  September 2013 (after taking Iressa)

Comparision-after-taking-Ir

 Blistering and peeling of the toe – one of the side effects of Iressa

Side-effect-of-Iressa-toe-n

Indeed after taking Iressa for about 6 months, the results were very impressive. Unfortunately this “good luck” did not last. On the 7th month, late October 2013, TP’s conditions started to deteriorate. She started to cough again, had pain in her chest and her voice became hoarse.

Blood test results on 13 January 2014 showed LDH, CA 125 and CA 15.3 had increase to the level much higher than on 23 March 2013 when she was first diagnosed with lung cancer.

Comments

When you or your loved ones get cancer, you go to the oncologist expecting him/her to cure you! Without doubt the oncologist would prescribe chemo – either as an injection or oral drug. Some patients ask if the treatment could cure them or not. Others take it for granted that the treatment is going to cure them! Perhaps TP is one person who believed or expected that the Iressa which the oncologist prescribed was going to cure her. Why not? The constant chronic coughs that she had almost vanished after taking Iressa. Then the blood test showed “positive” results. PET scan showed the tumours had shrunk and had almost disappeared.  Bravo! Time to celebrate!

However, there is be NO celebration if you know what can happen next. Barely a month or two after this “celebrated success” the cancer struck back with vengeance.   It became worse than she started off when there was no treatment.

Is such result or development something out of the norm?  No, it is nothing unusual. It happens very often!

Dr.  Heise wrote in his website (http://www.drheise.com/chemotherapy.htm):

What does “effective” mean? Whether a cancer treatment is “effective” or not is a matter of definition. The FDA defines an “effective” chemotherapeutic drug as one which achieves a 50% or more reduction in tumor size for 28 days. Only 28 days! In the vast majority of cases, there is absolutely no correlation between shrinking tumors for 28 days and the cure of the cancer or extension of life.

When a cancer patient hears the doctor say that chemotherapy is “effective,” he/she thinks that what the doctor really means is that it will cure the cancer. But what really happens is that the chemotherapy merely temporarily shrinks the tumor (usually for only a short period of time), but at the same time, it poisons the cells of the immune system – so that later on (after only a few months to a year), the tumor will start to grow back more viciously and become larger than ever, leading to very poor survival rates.

Does it seem cruel to tell a cancer patient that chemotherapy is “effective”, when according to research, it is a known fact that the tumor shrinkage will only be temporary and statistically speaking, the patient has been virtually guaranteed of a much earlier death than if the cancer ran its course without intervention? Is telling a cancer patient that chemotherapy is “effective” really just “good marketing” of the expensive but ineffective chemotherapy drugs?

Lung-Liver Cancer: When Everything Went Wrong for Her

KF (S-364) is a 40-year old Indonesian lady. In 2011, she had coughs for more than a year. There was no blood in her phlegm. She took cough syrup but was not effective. In January 2013, she became breathless and found it difficult to climb the stairs. Her problem became more serious and she went to a private hospital in Tangerang. There was fluid in her lungs. Pleural tapping was performed once. But this procedure did not help her much. She was still breathless. Another tapping was done but there was no fluid.

A CT scan was performed and the doctor said there was a tumour. She was referred to a lung surgeon who told her that surgery was not indicated because her lungs could be filled with fluid and there was “not enough preparation” for him to proceed with the surgery.

Not satisfied, KF went to another lung specialist in a Jakarta hospital. Another CT scan was done, specimens were collected, etc., but the specialist could not determine the cause of her problem. The lung specialist suggested that KF’s problem could be due to “jamur” or parasites! KF was prescribed antibiotics. KF was also asked to do a biopsy, which she declined.

KF came to a private hospital in Penang in April 2013. She consulted a lung specialist. A CT done on 5 April 2013 showed:

  • Extensive circumferential heterogeneously enhanced lobulated masse in the left hemithorax.
  • There is a central fluid / necrotic area seen
  • Compression of the left hilar vessels and bronchi
  • There is infiltration into mediastinum
  • Trachea, oesophagus and heart are displaced to the right side
  • Suspicious left pericardial invasion seen
  • A faint hypodense nodule seen in segment 8 of the liver measuring 15 mm in diameter.
  • Impression:  Large circumferential left hemithorax mass with liver metastasis and suspicious left pericardial invasion. Differential diagnosis: 1. Mesothelioma  2. Bronchogenic carcinoma. 

s364-a

s364-b

A biopsy of the left chest tumour indicated poorly differentiated adenocarcinoma infiltrating the chest wall.

Immunohistology report of 20 April 2013 indicated the cells are positive for CK7 only and negative for CK20 and TTF-1.

The lung specialist referred her to a surgeon who told her surgery was not indicated for her case. KF was then referred to an oncologist. KF was prescribed 5 type of medication and one of which was Iressa. KF was asked to go home and try the Iressa and see what happen. If Iressa was not effective, KF would have to undergo chemotherapy.

A week in the private hospital cost RM 21,000. In addition she paid RM 7,000 for the medication inclusive of a month’s supply of Iressa.

KF was told Iressa would cause side effects. And she was not willing to take it. Someone living in the same apartment as she, told her about CA Care. She came to seek our help on 25 April 2013. She presented with the following:

  • Difficulty sleeping
  • No appetite
  • Tiredness and lack of energy
  • Difficulty breathing
  • Cough throughout the night with white phlegm.

We prescribed KF Capsule A, B, C, D and E. In addition she has to take many teas: Lung 1 and 2, Lung Phlegm, Liver 1 and 2. She was given Cough 5 for her coughs (white phlegm).

What had gone wrong?

  1. She went to the hospital in Tangerang. Fluid was tapped out but she did not improve much. The doctor could not say if it was cancer or not. Not satisfied she went to another hospital in Jakarta. Here again there was not much help. One doctor even suggested that the problem could be due to “jamur” or parasites. I wonder how the lung expert could ever give such a suggestion! Anyway the anti-jamur medication did not work for her. 
  2. The patient came to a hospital in Penang. After a week stay she was discharged and was still not satisfied. She came to CA Care for help.
  3. A week’s stay in the hospital cost her RM 21,000. Did she get any better? The lung specialist could not help. She was referred to a surgeon who could not solve her problem either. The next obvious stop was the oncologist. The oncologist offered five medications one of which was Iressa. The total cost of the medication was RM 7,000. She was told to try out Iressa for a month and see if this could help her!  But she was not keen on Iressa because of the possible side effects. We felt sorry for KF – having made to pay for such an expensive medication which she was not willing to take.
  4. Was Iressa prescribed based on “scientific” fact or on a trial and error basis? Immunohistology showed that cells were only positive for CK7 and negative for CK20 and TTF-1. Is this the kind of cancer that would respond to Iressa?  I also do get patients who told me that she/he was asked to take Iressa in spite of the fact that test showed that the cells were negative for Iressa. But the justification given was that even for such “negative” cases Iressa seemed to work on some patients. Looks like we have to throw science out of the window!

Notes on The Epidermal Growth Factor Receptor (EGFR)

According to Kakiuchi et all, Gefitinib (Iressa), has shown potent anti-tumor effects and improved symptoms and quality-of-life of a subset of patients with advanced non-small cell lung cancer (NSCLC). However, a large portion of the patients showed no effect to this agent.  http://www.ncbi.nlm.nih.gov/pubmed/15496427

Lung adenocarcinomas with mutated epidermal growth factor receptor have significant responses to tyrosine kinase inhibitors, although for unselected patients it does not appear to have a survival benefit. Both EGFR mutation and gene amplification status may be important in determining which tumors will respond to tyrosine kinase inhibitors. http://www.jthoracdis.com/article/view/87/152

The tumors that responded to the EGFR TK inhibitors (TKIs) gefitinib and erlotinib contain somatic mutations in the EGFR TK domain. The two most common EGFR mutations are short in-frame deletions of exon 19 and a point mutation (CTG to CGG) in exon 21 at nucleotide 2573. Together, these two types of mutations account for ~90% of all EGFR mutations in NSCLC. Other recurrent but far less common EGFR mutations known to be associated with sensitivity to EGFR TKIs include mutations in exon 18 and in exon 21. Screening for common EGFR mutations in patients with lung adenocarcinomas can now be performed in clinical molecular diagnostic laboratories to predict which patients will respond to EGFR TKIs. It can be performed on archival material as well as on fine-needle biopsies. http://www.nature.com/modpathol/journal/v21/n2s/full/3801018a.html

Predicting Sensitivity to Iressa and Tarceva

Iressa (gefitinib) and Tarceva (erlotinib) were being tested in large numbers of patients with advanced non-small cell lung cancer.  Iressa did not improve overall survival compared to placebo treatment in previously treated NSCLC  patients.

However, about 10% of Western patients treated with either of these drugs had dramatic and sometimes long-lasting responses. Investigators at the Dana Farber Cancer Institute, Massachusetts General Hospital in  Boston, and also at Memorial Sloan Kettering Cancer Center in NYC published results showing that most of these “dramatic responders” had recurring mutations in the tyrosine kinase (TK) domain of the EGFR gene.

In the NSCLC patients who have mutations in the TK domain of the EGFR. This makes the cancer cell exquisitely sensitive to dying when the switch is turned off by a drug like Iressa or Tarceva, and explains why some patients can do so well on these drugs. Although there can be mutations anywhere in the TK domain, only some of them confer sensitivity to the TKIs.

About 45% of sensitizing mutations are what are called in frame deletions in exon 19, making them the most common EGFR mutations. About 40-45% of the sensitizing mutations are point mutations in exon 21. Most of the remaining mutations don’t cause the EGFR to be sensitive to EGFR TKIs.

A point mutation in exon 20 resulting seems to allow the EGFR TK to work much better than normal. Mutations in exon 20 have also been associated with resistance.

Mutations can be detected using sequencing to identify every mutation in the tyrosine kinase domain, whether predictive of responsiveness to TKIs or not. Another method is something called allele-specific polymerase chain reaction (PCR) which can then be detected by a machine. This method only detects 28 of the most common EGFR mutations, but generally requires smaller amounts of tissue than sequencing and has a slightly faster turnaround time. There is also evidence that this method may be more sensitive than direct sequencing.

Quoted from: http://cancergrace.org/lung/2010/10/10/overview-of-molecular-markers-in-lung-cancer/

Read more:  Practical Management of Patients With Non–Small-Cell Lung Cancer Treated With Gefitinib  http://jco.ascopubs.org/content/23/1/165.full

 

 

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: After One-and-half Years of Iressa, He Moved to Tarceva

SS is a 73-year-old male from Johor. He was a casual smoker of about 20 plus years. Sometime in early 2010, he experienced weight loss and lack of energy. There was no cough. He went to the general hospital and fainted while there. A CT scan on 13 May 2010 indicated lung cancer, as below.

SS was subsequently referred to the university hospital in Kuala Lumpur. He was started on the oral drug, Iressa, on 21 February 2011.

On 22 June 2011 another CT scan was done and the results showed:

  1. The mass in the left lower lobe has increased in size from 2.3 x 2.7 x 1.0 cm to 4.0 x 2.2 x 3.1 cm.
  2. The adjacent pleural base mass has increased in size from 6.8 x 2.1 x 8.0 cm to 6.9 x 2.1 x 6.7 cm.
  3. New lung nodule in the right upper lobe.

Impression: Comparison with the previous CT scan there is progression of the disease.

SS continued taking Iressa and was monitored regularly by CT scan.

CT scan done on 19 September 2011 showed the following:

CT scan on 12 December 2011 showed:

  1. A slight reduction of the pleural base mass.
  2. No significant changes in the size of the left lower lobe mass.
  3. Multiple liver lesions and solitary right lung nodule, no significant changes compared to previous study.

A comparison study with CT was done on 26 March 2012. The results showed:

  1. The lung mass in the left lower lobe is still seen and appears slightly increase in size – measures 3.9 x 2.9 cm (previously 2.6 x 2.5 cm).
  2. The adjacent bronchiectatic change remains.
  3. Three lung nodules seen in left upper lobe each measures 2- 5 mm; previously only one seen in the right apex.
  4. Multiple persistent hypodense lesions in the liver in segments 8, 5, 2, 3, and 4 remains similar in sizes and appearance.
  5. Underlying generalised osteopenia and degenerative spine changes.
  6. Left thyroid lobe hypodense lesions remain similar.
  7. No suspicious lytic bone lesions.

Scans on 13 May 2010 & 19 September 2011 (top) and 26 March 2012 (below)

SS came to seek our help on 19 August 2012. He was told by his doctor that Iressa was not effective and about a week ago he was asked to stop Iressa and this was replaced with Tarceva.

SS had been taking Iressa for almost one and half years at a cost of about RM 7000 per month. Tarceva costs him RM 8,900 per month.

SS said he wanted to try out herbs and would not wish to continue with his doctor’s medication.

SS’s  meridian bioenergy was read using the AcuGraph (below):

There is a marked energy imbalance between the upper   (left) and lower part of his body (right). We prescribed herbs to correct the imbalance of his LU and BL energy.  SS also told us that he has problems with his prostate. Unfortunately, no one has addressed this problem. For this, we prescribed Prostate A tea. In addition we prescribed SS Capsule A, C-tea, Lung 1 and Lung 2 teas, for his cancer.

Comments

As I was writing this article, a lady from Singapore wrote:

Dear Chris,

I am thinking of going up to Penang to consult you … I was diagnosed in December 2010, with lung cancer (adenocarcinoma), with metastasis to the brain, adrenal glands, lymph nodes and bone. I took Iressa for 1 year, then switched to Tarceva when the CEA started climbing up again. CEA went down from 400+ to 28 within the first few months of taking Iressa, then plateaued for a few months and then started climbing again from December 2011. I am currently on Tarceva.

The case of SS happened in Kuala Lumpur. Now you see a similar story repeated in Singapore! I am reminded by what was supposed to be said by Einstein below:

If you are following and reading this website you will know that cases like the above are not rare or exceptional! May be the results are and can be expected to happen to you! Read: https://cancercaremalaysia.com/category/lung-cancer/

Please don’t get me wrong. I am not suggesting anyone is insane here. What I am suggesting here is: Why don’t you be a bit WISER?

I remember my friend SK. He did not go to any university but he was wise. You don’t have to be a university graduate to be a wise person! SK had lung cancer that had spread to his liver. He said: I saw the oncologist. He told me to do the chemo. When I saw everybody do chemo, everybody do radiotherapy, I told myself this must be the only way. I went back to the doctor and asked him to do the chemo on me. So SK underwent both chemo and radiotherapy. He did not get well but instead ended up with three more tumours in his liver. And they were growing in size. SK told me: I knew then that I had taken the wrong path. I started to find other ways. You can listen to his story here.

Why do people keep repeating the same, old “mistake”? Perhaps ignorance! Perhaps they are just being stubborn or even arrogant – believing that they know better! But often it is just plain powerlessness, being placed in a situation that a person does not know what else to do. SK knew he had a choice – to find other options and not repeating the same “mistake” which Einstein said is insanity

Like SK, you should know that you too have a choice. But for some people it is better to choose the devil that you know than the angel that you don’t know!

I have no problem with what you choose. My responsibility ends after telling you the truth the way I know it. So, be wise and make your choice.

What Your Need to Know About Iressa (or gefinitib)

  • The US-FDA approved Iressa for lung cancer based on the results of a study of 216 patients with non-small cell lung cancer (NSCLC), including 142 patients with refractory disease, i.e., tumors resistant or unresponsive to two prior treatments.
  • The response rate (defined as at least 50% tumor shrinkage lasting at least one month) was about 10%.
  • On September 24, 2002, the Oncologic Drugs Advisory Committee (ODAC) recommended that where there are no viable treatment options, a 10% response rate was reasonably likely to predict clinical benefit and recommended that Iressa be approved. Source: http://www.medicinenet.com/script/main/art.asp?articlekey=23250 

If you understand this statement correct, it just means this: Iressa does not cure lung cancer. Iressa  caused shrinkage of tumours for at least a month in only 10 percent of patients.  Many alternative practitioners (including me) will tell you that shrinkage of tumour is just plain meaningless. Ask yourself: Why do I take Iressa? Is it to cure my lung cancer? Is it to only shrink by lung tumour for a few months and then it grows back again? 

Possible side effects:  Each person’s reaction to any drug is different. Some people have very few side effects, while others may experience more:  Diarrhoea, acne-like rash, loss of appetite, feeling sick (nausea) and being sick (vomiting), tiredness, eye problems, change in blood pressure, breathing problems and it is potentially very serious, and a small number of people have died because of the lung problems they have developed while taking Iressa.  Source:  http://www.andygaya.com/chemotherapy/chemotherapy-gefitinib.html 

Cost:  About RM 7000 per month

What Your Need to Know About Tarceva (or erlotinib)

Between August 2001 and January 2003, researchers enrolled 731 patients with advanced non-small cell lung cancer (NSCLC) whose disease had progressed after one or two courses of chemotherapy. The patients were divided randomly into two groups. One group (488 patients) received Tarceva and the other group (243 patients) received a placebo.

Results 

  • Those who took Tarceva has a median survival of 6.7 months compared to 4.7 months for those on placebo.
  • At one year, 31 percent of the patients taking Tarceva were still alive compared to 22 percent of those taking the placebo.
  • The time it took before the cancer progressed was also longer in the Tarceva group – 2.2 months compared to 1.8 months in the placebo group.
  • Researchers found certain subsets of patients were most likely to respond to Tarceva: Asians; women; patients with adenocarcinoma; and those who had never smoked.
  •  Patients receiving Tarceva experienced more toxic side effects. For example, 9 percent of the Tarceva group suffered from moderate-to-serious rash while none of the placebo group did. Overall, 5 percent of patients stopped taking Tarceva because of toxic effects as compared to 2 percent of those taking placebo. Source: http://www.cancer.gov/clinicaltrials/results/summary/2004/lung-and-erlotinib0604

If you understand the results of the above research, you will know that Tarceva does not cure any lung cancer. Those who took Tarceva lived longer by 2 months (median survival 6.7 months vs 4.7 months). After one year, 31 percent of patients were still alive – meaning 69 percent of patients died even if they took Tarceva. If you take Tarceva, your lung cancer progression is delayed by 0.4 months — 0.4 months? What does that mean – the disease slowed down by just about 2 weeks only?

Study the numbers carefully. Ask yourself again: Why am I taking Tarceva? Is it going to cure me? And it is proven that Tarceva produced toxic effects on patients – 9 percent of patients in the study gave up taking Tarceva because of the side effects.

Possible side effects: Skin changes, tiredness (fatigue) and a general feeling of weakness, feeling sick and being sick, eye problems, changes in hair growth, sore mouth and ulcers, loss of appetite, and breathing problems. Source:  http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Biologicaltherapies/Cancergrowthinhibitors/Erlotinib.aspx

 Cost:  RM 8,900 per month.

As a conclusion, you may ask: But what choice do I have?  There is no choice if you choose to remain deaf, dumb and blind to what is going on around you!  At least to start with read what I have written in here:  https://cancercaremalaysia.com/category/lung-cancer/

Lung Cancer and the Side Effects of Iressa

PL is a healthy 66-year-old female.  She developed coughs sometimes in late 2011. The medications given by her doctor did not help with her coughs. A CT scan done on 2 November 2011 indicated a 3.2 x 3.8 x 4 cm nodular lesion at the right lower lobe of her lung. Another elongated poorly enhancing lesion is seen at the left apex, measuring approximately 2.2 x 2.3 x 4.8 cm in size. In addition there was mild right pleural effusion (fluid in her lung). This made PL breathless, listless and devoid of energy.

PL underwent pleural tapping. Her condition improved after fluid was tapped out of her lungs. Unfortunately, a week later, the fluid came back again. Another tapping was done. The doctor suggested that PL do a biopsy. PL refused.  A week later, the fluid recurred in the lung and PL has to undergo another tapping. And after the procedure PL agreed to do a biopsy. “Gluing procedure” or pleurodesis was carried out after the pleural tapping but this was not effective.

A tru cut biopsy of the mass at the lower right lung was performed and it confirmed a well differentiated adenocarcinoma of the lung.  A report dated 21 November 2011 showed that the tumour was positive for EGFR (epidermal growth factor receptor).  This means, the use of the oral drug, Iressa was indicated.

PL was given two options: to take Iressa for her cancer or to undergo chemotherapy using a combination of Alimta and Cisplatin. PL opted for the oral drug, Iressa.

On 1 December 2011, PL was started with Iressa. Her condition improved but after three months she started to suffer  severe side effects. She developed pimples and sores with pus on her head and later had rashes in the face, neck and pubic area. She was referred to a skin specialist for help. She shaved her head bald. She was told to stop taking Iressa and her problem resolved after two weeks. She resumed Iressa, her rashes and sores and pus recurred. This recurrence went on for three times.

The doctor reduced her Iressa dosage – taking the drug on alternate day instead of everyday. But even with the reduced dosage, the side effects still persisted. PL decided to stop taking Iressa and came to seek our help on20 July 2012. She told her oncologist that she is going for “Chris Teo’s herbs.”

On 8 August 2012 – after being on herbs for about three weeks, I sat down to talk with PL in greater detail.

Did Iressa help her?

The answer is yes. The initial problem of fluid kept recurring after each pleural tapping. But after taking Iressa the fluid stop recurring. PL’s health normalised.  A comparison of the CT scan done on 2 November 2011 and those done on 20 February 2012, showed the tumours in her lung had shrunk significantly. That is what patients and oncologist hope for!

CT scan on 2 November 2011

CT scan on 20 February 2012

Iressa had delivered the desired effects – the tumour shrunk.  But how meaningful is tumour shrinkage? Does this translate into a cure? Unfortunately not! The tumour can grow again after a while. Read these stories:

Meaningless Shrinking of Tumour by Chemotherapy   

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

Meaningless Decline of CA 15.3 and Tumour Shrinkage Following Treatment With Iressa and Tarceva

Meaningless Shrinking of Tumor While on Tarceva 

Iressa Does Not Cure Lung Cancer Expensive drug with side effects 

The medical doctors of the Evinta Medical Center, Arizona, USA (http://www.envita.com/) said:  By and large cancer growth response, or “shrinkage,” remains the primary focus of cancer treatment. Unfortunately, research demonstrates that such responses do not often correlate to elevated survival in patients. When traditional cancer treatment reports a 20 or 30 percent effect, it simply means that the patient’s tumor shrunk by 20 to 30 percent. This is deceptive because the cancer typically grows back, oftentimes larger, and resistant to the chemotherapy. The real measure is how long life is sustained and its quality therewith. Envita is results oriented and we measure our success in terms of tumor change, as well as the long-term outcomes and quality of life experienced by our patients. This continues to be our driving force for developing and perfecting unique, quality treatments for our patients. 

Read what Dr. Ralph Moss said:

Can Iressa cure her?

The answer is NO. The oncologist told PL that it all depends on the person. In other words, different people respond differently. Some patients survive for one year, others two years and some even survive five years. But all of them still die even after taking Iressa. PL was told that she has to be on Iressa for as long as she can afford it. But there is no knowing how long she can survive. This goes to say that actually it is n=1. Whatever research that is done – and whatever percentages that are bashed around to impress patients – it does not apply to PL at all. PL has to take the Iressa and only she would know what can happen to her. So, this is what they call, scientific medicine!

Unexpected Severe Side Effects

Before taking Iressa, PL was told about some possible side effects. But what actually happened to PL was beyond expectation. According to the oncologist it was the worst side effects he had ever seen! Whatever it is, scientifically proven drug can cause such problem.

I posed this question to PL:  Since Iressa helped you and make you well – why do you want to stop taking it? At least this can take care of your lungs.

PL:  I would rather die than suffer. I want to live and enjoy my life. I don’t want to suffer.

I posed another question: Do you mean to say that the side effects of Iressa are so bad that you would rather die than live? You cannot live with the side effects?

PL replied that it was indeed hard to live with such side effects. Pus oozed out of the sores. Sometime it became itchy. Sometime it was painful. So the cost of survival in terms of side effects is not worth it. This does not take in consideration the cost of the treatment yet. A full dosage of Iressa costs about RM 6,700 per month.  It is good that PL’s health insurance paid for the drug every month. What if there was no insurance coverage?

Since PL decided to stop taking Iressa, the oncologist offered her chemotherapy, telling her that these days chemo-drugs are mild and more “friendly” and do not have all those dreadful side effects. I asked PL what drugs the oncologist was to give her. PL did not know except to say that it would be a mild one.

Let me tell you a story about Alimta. KP was a Malaysian who lived in Perth, Australia. He had lung cancer that had spread to his liver. He underwent chemotherapy and at the same time took herbs. He did well and this amazed his Australian oncologist. Unfortunately, a scan showed that there were still traces of tumours in him. The oncologist suggested more chemo – this time with a combination of Avastin + Alimta.

KP called me from Perth one morning  and asked if he should go ahead with this treatment. I said: NO. After all you are doing fine. Why take the risk? Learn to live with your tumour!  I did not get to hear from KP again after that. The gist of the story is, KP did not follow my advice. He went ahead with this so called new, state-of-the-art concoction!

While undergoing the treatment KP bled from the nose for no apparent reason. While sleeping, blood oozed out from his nose, stained his pillow and T-shirt. The treatment failed. KP came back to Malaysia and related what had happened to us. Listen to his story:

By then it was too late. KP was in severe pain and his stomach was bloated. There was nothing much I could do to help. On 18 September 2011 KP died.

There is a another story regarding lung cancer and Alimta, RM 300,000 of Medical Adventures Did Not Cure Him 

Comments:  I advised PL to learn to live with the tumours in her lungs. For as long as she can lead a normal life, be grateful for each day when she awakes! Don’t expect the herbs to cure her lung cancer! I don’t even expect the tumour to shrink after taking the herbs. Almost all patients die because of metastasis and not just because of the tumour!  Of course, patients want magic – they want their cancers to go away completely. But there is no magic. We have to learn to accept that reality.

PL’s oncologist said herbs are not scientifically proven! Well, patients have to make their own choice. Do what you think is right. Follow your heart! Remember, sometimes the head can lead you astray!

I wonder too about Alimta. Is it ever proven to cure cancer? No? What would happen if PL were to undergo chemotherapy with Alimta + Cisplatin? Would PL end up like KP – dead? Maybe yes, maybe not! No one can tell for sure what is going to happen. So what is the use of scientific proof then when you can even predict the outcome? In the same way – learn this bitter lesson – no one could predict or tell that PL had to suffer such severe side effects after taking Iressa.  Others, the oncologist claimed, did not have such problems. Perhaps Alimta is also very safe for PL? Try your luck if you wish.

Perhaps you need to read these stories about patients who take our herbs:

Lung Cancer Stage 4, Open-Close Surgery. Six Months to Live. She Refused Chemo and Took Herbs for Three and Half Years Now 

Lung Cancer: More than two years on herbs and no chemo! 

Written Off Case Survived Three And A Half Years With Herbs 

Let me briefly relate the story of Suri, an Indonesian lady with lung cancer. Being rather well off, Suri’s husband decided that she must have the best. So they went to Singapore for treatment – gunning for the so-called proven, scientific treatment. Before they went for treatment in Singapore, their relatives in Penang had suggested that they try the CA Care Therapy. The husband vetoed the idea. He said: I refused to entertain that idea. In my mind, that is all hocus pocus. How can herbs be better than the doctors in Singapore? Herbs are just traditional stuff and if they are that good then all doctors will have to close shop. So I dismissed the idea of taking herbs as being absolutely nonsensical.

In Singapore Suri underwent 22 times of radiation treatment, followed by oral drug Iressa. She took Iressa for about a year. Her tongue became numb and so she gave it up. The doctor then gave her Tarceva – another scientifically proved drug! She was on this drug for about two years. A year later, in 2009, the cancer spread to her brain. She underwent chemotherapy. In total she received 40 chemo injections – also using the so-called FDA-approved, scientifically proven drugs! Nothing seemed to work for Suri. As a last resort, her oncologist asked her to take Sutent – another scientifically proven drug laden with all kinds of side effects. I asked her husband: Before she took Sutent, did you not ask if the drug can cure her? He replied: No one dares to answer such a question. The oncologist told me, “I cannot say. The only one who knows the answer is the One Up There!” An interesting answer indeed! The god of science has failed to save.
We are now told to trust the ordinary God that you and me believe in! After Suri took Sutent her consumption of Panadol gradually increased from one tablet per day to six tablets per day. She stopped taking Sutent!  Now, all possible, scientifically proven drugs have failed.

Hopeless and helpless, Suri’s husband decided to come and see us in Penang – to try our so-called unproven, unscientific therapy that has PROVEN to help a lot of other people. On 8 May 2011 Suri was wheeled into our CA Care centre, being unable to walk on her own. She was unable to talk, showed no facial expression and did not seem to know what was going. According to her husband, she behaved like a child. During this visit, I must honestly say I did not expect her to survive much longer. But with God’s grace, a miracle happened. Suri recovered.  You can listen to this amazing story by clicking the links below.

Lung-Brain Cancer: An Impossible Healing 1. Hope After a Disaster – when Iressa, Tarceva, Forty Cycles of Chemo and Sutent Did Not Cure Her 

Lung-Brain Cancer: An Impossible Healing Part 2: A Week of Amazing Healing 

On 6 August 2012, I got an e-mail from Pak Teddy in Jakarta.

Hello Prof. Chris: This morning Suryana Tukiman called me and we had a talk. Now his wife has already started to take our herbs again. According to him the Neurosurgeon was surprised to see the MRI result of the brain – full with white patches but she is still alive and healthy after 1.5 years taking our herbs. The paralysis is due to the tumor pressing onto the motor nerve. Now they use the NGT to pass food, juice and herbs into her stomach. But as you can see on the photo she looks healthy, only a little bit skinny. These photos were taken this morning after Tukiman finished talking with me. I asked him to take these photos so I can send it to you. Teddy.

Photos by Suri’s husband

In my interview with Suri’s husband, I regretted – Money Does Not Buy Cure, he said:For all the treatments – radiotherapy, Iressa, Tarceva, chemotherapy and Sutent – the total cost came to more or less 2 milyar rupiah which is about S$300,000 (almost hitting 0.7 million ringgit?). The cost of one tablet of Tarceva is S$195 and she took this for about 2 years. One tablet of Sutent cost S$210 and she took this for a month plus. One chemo cost about S$7,000. I was curious about one expenditure item of S$120.00. After an enquiry I was told that it was the cost of the chair (plus services provided) which my wife sat on while receiving chemotherapy. The doctor’s consultation cost S$150.00, if I am not mistaken. I was also told to only buy the drugs from the doctor. I was told that cheaper drugs bought outside the oncologist’s clinic could be a fake. I believed everything what the doctor told me. It is okay to spend that kind of money if there was a cure. But there was no cure. I regretted for going to Singapore for the treatment. Let me confess. I was full of remorse. I regretted.

Let me conclude: It is true. Herbs are not scientifically proven. But perhaps, this question is only good or relevant, if you want to do a thesis for a higher degree or pass your university examinations. In real life, does it matter if something you do is scientific or not, provided it does the work – effective and not harmful!  Let us not be naive. The treatment of cancer is not only about the hard science or proof of effectiveness. It is about maintaining the status quo and fueling the greed of the Vested Interests. Understand that the politics of cancer is indeed tragic – all played out at the expense of the sick.

Meaningless Decline of CA 15.3 and Tumour Shrinkage Following Treatment With Iressa and Tarceva

I received an e-mail from Dr. Mark (not real name), a Ph.D. in cancer biology working in a hospital. This is what he wrote:

After visiting the CA CARE website … I realized that this is what I have been looking for in order to help my mum. I would like my mum to try your herbal therapy.

My mum is 70 years old.

At the end of April 2007, she kept complaining of stomach discomforts, bloatedness and loss of appetite. She saw a Gastro-specialist and the diagnosis was H. pyroli infection and she was given antibiotic treatment. Unexpectedly, an X-ray test was also done and her lung was found abnormal. She did a CT scan and blood test including tumor markers on that same day. The results showed a possibility of lung cancer. One week later she did a lung biopsy. The result showed that the lung tumor mass was a moderately differentiated adenocarcinoma. However, she didn’t have breathing problems or coughs at that time.

She was then referred to an oncologist at the same hospital. My mum is an Asian woman with non-smoking history and the tumor type is adenocarcinoma. Hence she falls into the category that may respond well to a new targeted drug called Iressa. The doctor said we can monitor her progress using CA15.3, the tumor marker with highest titer when first found (5,147 on 24 April 2007).

After one month of taking Iressa, her CA15.3 went down to 367 (on 28 May 2007).

On 30 July 2007, it declined further to 68. 

We were so happy that the drug worked so well. A CT scan showed that tumor had shrunk (August 2007).

At the forth month, the CA15.3 raised to 154 (on 27 August). The doctor was a bit worried but mum continued taking Iressa.

A month later the marker rose to 713 (on 28 September 2007). A CT scan showed more shadow in the lung compared to scan done in August 2007. She did a brain CT scan for the first time and some metastases were found in the brain and bones but the lesions were small.

My mother started taking another targeted drug called Tarceva (works on similar mechanism but seemed to be more effective). She had side effects like rashes, dry skin and loss of appetite.

We were very positive of this new drug because according to the literatures more side effects means higher chances of response. However one month after taking the Tarceva, her CA 15.3 went up to 1,496 (on 26 October 2007). The doctor suggested that she go ahead and take for one more month and then do a CT scan after that. I have asked the doctor if results showed that Tarceva doesn’t work, will he put my mum into chemotherapy. He said yes, but due to my mum’s weak conditions, it will be a mild one.

Besides having Tarceva, she is on Bonefos for her bone metastasis. We also give her supplements.

On 18 December 2007, I received an e-mail from Dr. Mark again. He wrote:

My mum has passed away on 30 November 2007. I think she died from pneumonia. Her left lung was totally white. She had yellow sticky phlegm but she had no strength to cough them out. Her white blood count was very high and neutrophil count was over 94%.

My mum only managed to take the herbs and capsule A+B for a few days before she could became unable to swallow anything, including drinks. She deteriorated very, very fast. I didn’t notice that she had any lung problems before visiting you, hence I didn’t get the Lung Phlegm tea for her.

On the evening of 26 November 2007, we managed to get a doctor to make a home visit. He said that my mum’s left lung was hardly functioning and she was dehydrated. He suggested giving her oxygen and dripped her with dextran saline. My mum shook her head when I asked her whether she wanted to go to the hospital. The next day, we rented an oxygen tank and set up drips for her by a nurse at home. The nurse pointed out that my mum was having lots of phlegm and since she couldn’t cough it out, she might be at a risk of getting pneumonia.

On 28 November 2007, she was not improving at all and I asked her again trying to convince her to go to the hospital to solve the phlegm and constipation problems. She finally nodded her head. So we immediately arranged for an ambulance to send her to the hospital which is about 5 to 10 minutes away from our house.

An X-ray film showed that her left lung was totally white. Her heart was shifted to the right, probably due to the fluid in the lung. She had high blood pressure and her heart rate was over 130/min. On the evening of the second day, she became unconscious. The doctors told us that they wouldn’t do resuscitation because it would only prolong her suffering. On the night of the third day we lost her, while all the family members gathered around her. Although we were really sad, we were also glad that she didn’t suffer much from pain.

I really want to say thanks to you and your wife again, for your kindness and hospitality and of course your herbs. It’s too late for my mum to take your herbs. However, it is never too late to know you and CA Care Therapy.

Comments

Dr. Mark had written a detailed account of about his mother’s case – thanks to his training as a observant scientist. I have the privilege of meeting Dr. Mark when he came to see us with his mother’s medical report on 20 November 2007. What struck me most about this case was that CA 15.3 was used to monitor the progress of lung cancer. I asked him if this is a typing error in his e-mail. Shockingly the answer was no.

Initially on 24 April 2007, the doctors used a few markers such as CEA = 462.9; CA 125 = 324; CA 15.3 = 5147; and CA 19.9 = 14. Among them CA 15.3 turned out to give the highest reading. That being so the doctor decided that CA 15.3 could best reflect the treatment progress. Conventionally CA 15-3 is used mainly to monitor patients with breast cancer.

One notorious side effect of Iressa is pulmonary (lung) toxicity. Patients taking Iressa have been reported to suffer from a complex disease known as interstitial lung disease (ILD). This disease causes difficulty in breathing with or without coughs or low-grade fever. The symptoms become severe rapidly and patients have to be hospitalized. The New Straits Times of 6 December 2002 had this heading: 81 deaths linked to lung cancer drug. The Japan’s Health Ministry confirmed 291 cases of debilitating side effects and 81 patients died due to Iressa. On 19 September 2005, Japan Today,had this heading: Miracle cancer drug turns into deadly remedy: The drug produced serious side effects such as severe pneumonia, resulting in death.  

Recall what Dr. Mark said: She deteriorated very, very fast. I didn’t notice that she had any lung problems before visiting you. Was Dr. Mark’s mother another victim of the fatal side effect of Iressa? No one asked. No one dared to ask? Or no one wanted to know?

We felt sorry that the herbs were unable to help in this case. This is what we often tell our patients. It is not how long we live – it is the quality of life that we live while still alive that matters. Be happy and grateful if we can eat, can sleep, and can move around. To fight cancer and destroy it totally is an impossible task no matter what others may want us to believe. 

The initial drop in the tumour maker and the shrinkage of tumour are meaningless as this case had demonstrated. Don’t be misled by such an illusion. In fact, this is not an isolated case. We have encountered and documented many other cases like this, which delivers the same message of misguided and misplaced hope.

You may wish to read our other articles (The Meaningless Shrinkage of Tumor While on Tarceva Treatment, Even High-tech Treatments Do Not Guarantee That Cancer Can Be Cured or Will Not Spread) about Iressa, Tarceva and Bonefos and what they can do for cancer patients.

Don’t be misled – Surviving Five Years Does Not Mean Cure

Patients are often told that if they can survive five years after their treatment, it means they are cured of their cancer! What an untruth! My Aunty had cervical cancer and she received all the necessary medical treatments. She survived thirteen years, then the cancer struck back and went to her lungs and she died.  Where then is the cure? One lady had breast cancer. She survived for some nine years and when she was about to attend the hospital “Survivors Celebration for Life” gathering she had a swollen arm. The cancer had spread to her brain. She received radiation but could not complete the course. She became a “vegetable” and died. Again – where is the cure?

Over the years, we have encountered many cases like the above. Let me present another case for you to contemplate on.

1 February 2012

Dear Dr. Chris,

A friend gave us your Website. I am a lung cancer patient, diagnosed with Advance Non Small Cell Lung Carcinoma, have been and still going through chemotherapy for more than a year. Last week I had fluid drained from my right lung.

My husband and I decided to consult you for treatment. We are from Singapore and do not know how far is your clinic from the airport. How much do you charge for your fee and medication? Do I need to stay at your clinic during the treatment?

Reply: Since you are still on chemo and also have been on chemo for that long … I am not sure if you really need my help. If there is still fluid in the lungs, it just means the chemo is useless. But I am not going to ask you to stop what you are doing. It is your choice. My only problem is, the chemo can kill. But when patients take my herbs and die they will blame my herbs not the chemo. Because of that I would rather you finish with all your medical treatments first. And when you have nowhere else to go after that, then come and see me.   

5 February 2012

Dear Dr. Chris Teo,

Thanks for your prompt reply. My last chemo (the 8th Chemo) was on 26th January 2012. After this, 8th February I shall go for PET scan, then on the 9th Feb consult Dr. This 2nd doctor we consulted said he is going to surrender if the tumor continues to grow. After the 4th chemo, the PET scan showed the tumor was growing. The doctor increased the chemo dosage and included Iressa. And I was hospitalised one month later due to very fast heart beat, 251/min, Electrolytes were replaced. The chemo drugs I was given wereTaxotere, Cisplatin and Iressa.

As what you said, it is my choice, I find no meaning, here protein and booster jab, there chemo. I will not hold anyone responsible for my life and commit everything to God’s hand.

I will make photocopies of my medical results when I get it from the doctor this Thursday. My husband and myself had booked a flight to Penang … we would plead with you whether you could help to see another patient that evening. I am having aching, coughing, body, fingers, toes cramps, head ache and extreme tiredness. This is like an everyday affair after chemo.

9 February 2012

Dear Doctor,

Thanks for your reply. Appreciate your advice and concern. I was hospitalised on Monday due to fast heart beat. Doctor said electrolytes not balanced. Last night, my heart beat went up again to 240/min. I am not discharged yet so I wouldn’t be going to Penang tomorrow.

On 12 February 2012, patient’s husband came to CA Care with details of her medical history.

  1. In 1993, patient underwent a hysterectomy for menorrhagia (abnormally heavy and prolonged menstrual period).
  2. In 2001, she was diagnosed with breast cancer. A mastectomy was done. Subsequently she underwent 12 cycles of chemotherapy and 25 times of radiation treatment. She also took Tamoxifen for 5 years.
  3. In October 2010, patient had a swelling (lymph node) in her neck during a routine medical examination. She was investigated and was confirmed to have a metastatic lung cancer – an adenocarcinoma.
  4. From 23 October 2010 to 11 May 2011, patient underwent chemotherapy consisting of Gemcitabine + Carboplatin for 12 treatments.
  5. From 3 June 2011 to 10 August 2011, she received 4 cycles of Taxotere.
  6. From 12 September 2011 to 12 October 2011, she received 2 cycles of Alimta.
  7. From 10 November 2011 to 8 December 2011, she received 4 cyles of Taxotere plus Cisplatin.
  8. From 22 December 2011 to 26 January 2012, the dosage of Taxotere plus Cisplatin was increased by 20 percent. She had two cycles of this increased dosage. Since CT showed that the tumour was still growing, patient was given Taxotere + Cisplatin + Iressa for the next 2 cycles.
  9. She ended up in the hospital because of:
  • Rapid heartbeat.
  • Shortness of breath.
  • Fevers.
  • Severe coughs with white phlegm.
  • Pain in the shoulder and neck.
  • Swelling of the jaw.
  • Slow to talk.
  • Pale and very tired.
  • When she coughed too hard, her urine flowed out (stress incontinence).

This was when the patient wrote to us, “This 2nd doctor we consulted said he is going to surrender if the tumor continues to grow. After the 4th chemo, the PET scan showed the tumor was growing.” According to her husband, she is going to stop chemotherapy.  Below is what her latest PET scan showed.

 

Comments

In 2001, the patient had breast cancer. She underwent a mastectomy, chemotherapy and radiotherapy.  She then took   Tamoxifen for 5 years. That basically is all what modern medicine can offer any breast cancer patient.  But is she cured? Yes, by the “common medical definition” because she had survived 5 years.  But about 9 years later, October 2010, the cancer recurred in a form of a swelling in her neck and this was later confirmed as lung metastasis.

Is such story a unique and rare occurrence? No. This happens very often. What has gone wrong? Reflect on the quotations below.

 

The conclusion from this case is – medical treatment did not cure her breast cancer! She got lung cancer after 9 years. So, to say that surviving for 5 years is considered a cure is simply not true. It is another big lie! Or, half truth. And this half truth is dangerous. Misleading statement or advice like this could lead you to your grave. Patients often are overjoyed after hitting the 5-year mark and they are often thrown off guard and become complacent. Most go back to their old lifestyle. Then cancer strikes back! As in the case of this lady and my Aunty.

I was curious as to who came out with this idea of “living for five years and you are considered cured”. I searched the internet for a possible answer. This is what I got.

  • The number five used is an arbitrary figure. There is no scientific basis of choosing this number.
  • Dr. David Johnson, deputy director of Vanderbilt-Ingram Cancer Center thinks that: The five-year benchmark becomes a balm for doctors and patients who find the unpredictability of their situations intolerable. Physicians are reluctant to say you might recur, so they would rather use these terms like: “OK, in five years, you’ll be cured.”
  • According to Dr. Karrison, patients need to survive for 20 to 25 years before we can say they are cured. To ask patients to wait this long may be bad for business!

From much reading, I have come to understand that numbers and statistics are often sweet and deceptive – they cannot be trusted and must be viewed with skepticism. Scientific data can be and are often massaged and manipulated to make things look good. Patients like to hear “good news.” They are ready to swallow everything when they hear what they want to hear – what more when it comes from “scientists”! 

What now after the metastasis? 

In this case, patient was given chemos after chemos –  and the combination of cytotoxic drugs changed and changed.  In total this patient had 26 cycles of chemotherapy for her lung cancer. Alimta is the “newest” bullet used. But the “heroic” effort failed. The doctor told the patient that he was about to surrender. Patient landed in the hospital.

When everything else failed, CA Care comes into the picture! So, that’s the reason why I wrote, My only problem is the chemo can kill. But when patients take my herbs and die they will blame my herbs not the chemo. 

That’s the way it is.

Reflect on  the following quotations.

 

 

Lung-Brain Cancer: An Impossible Healing Part 3: Reflection and Confession of a Husband

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

Acknowledgment:  We thank the patient and her family for sharing this bitter-sweet story with us. Permission to use these video clips without having to cover their faces is granted by the patient’s husband.

While Suri was undergoing the e-Therapy at our centre in Penang, we took the opportunity to interview her husband. This is an opportunity to get to know in greater detail about what had really happened.  Below are excerpts of our conversation over a period of three days – 30th and 31st August and 1 September 2011.

 

 

1.       The Surrender and Started on Sutent 

  • Actually her problem was detected in 2007. Examination showed a small dot in her lung. She refused to do anything about it. In 2008, while on a holiday trip to China with some friends, she became breathless and vomited. On her return from China she went to Singapore for consultation. Scan showed a large tumour in her lung – probably Stage 3A.
  • She underwent medical treatment for her lung cancer. Unfortunately her health deteriorated. Sometime in February 2011 she complained of poor vision. The eye specialist told her this could be due to cataract. But suddenly she developed severe headaches.
  •  When was she not able to walk? You came to see us in May 2011. About three months before our first visit here. Suddenly her condition just “drop” severely accompanied with severe headache. So when she came here she was not able to walk, her vision was poor – unable to recognize people around her, her left hand and right leg had no strength. Before that she was okay.
  • We brought her to Singapore to do chemotherapy. After the chemo, her condition “dropped” further. We brought her back to Jakarta and did another cycle of chemo.
  •  After that we brought her back to Singapore again to do more chemo. But “someone” up there seems to intervene. She did not have enough white blood cells. So the oncologist could not give her anymore chemo.
  • If her WBC was okay, would you have done the chemo?  We would. I fully believe in the doctor. Daughter: But I never agree to chemotherapy since the very beginning.
  • Daughter: The oncologist surrendered … she gave up. She suggested taking Sutent saying that many of her patients were cured after taking this drug. The doctor told me, “Bring this medication (Sutent) home and try it.”
  • A table of Sutent cost S$210. She took a tablet a day. She had more pains after taking the Sutent. The side effects for her were:  increased blood pressure, headaches and diabetes.  I asked the doctor why she prescribed this drug to her. The oncologist replied, “Many of my patients took it and get well. Go home and try it. If it works it works. If not she just … (gesture with his bent finger).
  • Before she took Sutent, did you not ask if the drug can cure her? No one dares to answer such a question. The oncologist told me, “I cannot say. The only one who knows the answer is the one up there!”
  • After she took Sutent her consumption of Panadol gradually increased from one tablet per day to six tablets per day.

 

 

2.       I regretted – Money Does Not Buy Cure 

  • For all the treatments – radiotherapy, Iressa, Tarceva, chemotherapy and Sutent – the total cost came to more or less 2 milyar rupiah (1 milyar is 1,000,000,000 – nine zeros) which is about S$300,000. The cost of one tablet of Tarceva is S$195 and she took this for about 2 years. One tablet of Sutent cost S$210 and she took this for a month plus. One chemo cost about S$7,000. I was curious about one expenditure item of S$120.00. After an enquiry I was told that it was the cost of the chair (plus services provided) which my wife sat on while receiving chemotherapy. The doctor’s consultation cost S$150.00, if I am not mistaken. I was also told to only buy the drugs from the doctor. I was told that cheaper drugs bought outside the oncologist’s clinic could be a fake. I believed everything what the doctor told me.
  • It is okay to spend that kind of money if there was a cure. But there was no cure. I regretted for going to Singapore for the treatment.
  • Let me confess. I was full of remorse. I regretted because even before she went for chemo, my relative in Penang had suggested that we try the herbs. I refused to entertain that idea. In my mind, that is all hocus pocus. How can herbs be better than the doctors in Singapore? Herbs are just traditional stuff and if they are that good then all doctors will have to close shop. So I dismissed the idea of taking herbs as being absolutely nonsensical.  I say again, I regretted this very much.
  • The doctors told her to eat anything – to make her stronger. And when she regained her strength, she got “hammered” with the chemo again. The cycle went on and one. Where do we go from there? On reflection, I begun to see how illogical it is.
  • While we were in the hospital in Singapore, I saw a patient from Medan. This patient had been going in and out for the past eight years – coming for chemo and chemo. There was no end to it. I was afraid to ask the details of what had really happened. Anyway the patient eventually died after eight years of struggle. It struck me – this is a prolongation of a meaningless survival.

 

 

3. CA Care, the Last Hope

  • In low voice, Suri’s husband said, “Actually my wife requested that I leave her to die. She did not want to suffer any more.” At that point, a distant relative in Penang called us and suggested that we try CA Care. I had a discussion with my children. We shall abandon further medical treatment and go for herbs. At that time we were hoping for pain relief. We would accept if she dies but not to be in pain.
  • When you first came to CA Care, did you ever believe in what we do? I made it very clear to you from the very beginning that I cannot cure you. What you told me that night was most sensible. Stop taking all the bad food that encourage cancer and then use the herbs to help the body against cancer. This makes a lot of sense to me. 
  • We gave her the herbs for a week. She spat it all out onto our face. My relative talked and joked with her. When she was more relaxed we held her down, squeezed her nose and forced the herbs into her throat. After three days of doing that, there were less headaches. We had more confidence in your herbs.
  • She has been on the herbs for 4 months now, have you got anything to say about that? I would like to say thank you so much for helping us. I don’t know what to say. We have been doing this therapy everyday and you didn’t even charge us (broke down and cried). If you want me to worship you, I would do that.

To this Chris replied, Don’t worship me.  Worship God and give thanks to Him. It is not me who do all these. I was just doing my best to help. My two children are doing well with their Ph.D.s. What we are doing here is not about money. In life money is not all important.

  • It is hard to do “good” for others. If you have not experienced what it is like to get cancer, you cannot understand what we are doing and why we are doing this work. 

I understand. I have gone through this suffering for two and half years now. I know what you mean. That is why I am spreading words around about my wife. Many people saw my wife’s improvement.

  • My job is now done. I have nothing else to offer. Now it is your turn to take care and heal her. Never, never ever make any mistake again. Second, take care of her diet well.

Comments

It is not necessary for me to add any more comment. The story and the videos should convey enough messages.

We recognize that the work at CA Care is at odd with current medical thinking. Modern medicine wants to kill or shrink the tumour. And in the process kill the patients too. In The War on Cancer – an anatomy of failure; Dr.  Guy Faguet , a cancer researcher and medical doctor, wrote, “An objective analysis of cancer chemotherapy outcomes over the last three decades reveals that … the cell-killing paradigm has failed to achieve its objective … a model based on flawed premises with unattainable goal, cytotoxic chemotherapy in its present form will neither eradicate cancer nor alleviate suffering” (pg.89).

Dr. Ralph Moss, Ph.D., a highly respected advocate of non-conventional cancer treatment, said, “  If you shrink the tumour by 50% or more for 28 days you got the FDA’s definition of an active drug …. (but) when you see if there is any life prolongation from taking this treatment what you find is all kinds of hocus pocus … this is the great lie about chemotherapy.”

At CA Care we teach patients to live with their cancers. Concentrate on what matters. We don’t know how to cure your cancer and we don’t pretend we can cure your cancer either. But like in this case, we know how to make your life better – if you can eat, sleep,  walk, have no pains and can have a bit longer of meaningful life– what else do you want? Now, we say – Patients, you have a choice! Whatever you choose, is your prerogative. But it is you, and I emphasize –  you and you alone, who are responsible for that choice.

 

Read the full story …

Part 1: Hope after a disaster

Part 2: A week of amazing healing

Part 3: Reflection and confession of a husband

Part 4: What it takes to be a winner


Lung-Brain Cancer: An Impossible Healing 1. Hope After a Disaster – when Iressa, Tarceva, Forty Cycles of Chemo and Sutent Did Not Cure Her

Suri (M971) is a 61 year old female from Indonesia. Her family came to seek our help on 8 May 2011. She was wheeled into out centre being unable to walk on her own. She was unable to talk, showed no facial expression and did not seem to know what was going. According to her husband, she behaved like a child. Listen to her husband telling us his wife’s story of tragedy.

 

 

Suri was diagnosed with non-small cell lung cancer in 2008.

 

She had 22 times of radiation treatments in Singapore. No chemo was done. She was given the oral drug, Iressa. She took it for about a year. Her tongue became numb and so she gave it up. The doctor then gave her Tarceva. She was on this drug for about two years.

About a year later, in 2009, the cancer spread to her brain. She underwent chemotherapy. This was also done in Singapore. Her chemotherapy consisted of the following:

  1. 1 cycle of chemo divided into 3 injections, done once a week for 6 months. That means a total of 18 injections.
  2. 1 cycle of chemo every 2 weeks for 6 months. That means a total of 12 injections.
  3. 1 cycle of chemo every month for 6 months. That means 6 injections.
  4. 1 cycle of chemo every 2 months for a total of 3 injections.
  5. 1 cycle of chemo every 3 months. She received only 1 injection.

In total she received 40 chemo injections.

Three months after all these treatments, MRI showed one additional tumour appeared in her brain.

 

MRI done on 2 May 2011 indicated: “Two small enhancing nodules less than 10 mm noted in the right temporal lobe compatible with brain metastasis.”

Came to CA Care on 5 May 2011

Her husband said, “We knew that chemo did not work for her.  We decided to seek the help of CA Care. Please try and help us. Now the oncologist prescribed this drug, Sutent.  She has been taking in for about a month now. “(Note: after seeing us, the family decided to stop taking Sutent).

She presented with the following serious problems:

  • Severe headaches
  • Vomiting
  • When her two hands are put together, they “fight” trying to tear each other apart.

My comments to the family then were:

  • Based on her medical history, I really don’t know what I can do to help her. We can only try.
  • I don’t want to mislead or cheat you – making your believe that you can find a cure here.
  • If she cannot drink the herbal teas I prescribed, there is no need to bring her here again. There is nothing I can do. But if she can drink the teas, she may benefit from them.
  • As for the prognosis – Don’t think too much or too far! You have spent thousands of dollars and yet they can’t cure you. Don’t expect me to cure you. And I am no magician. But I shall do my best to help. That much I can do.

After Two Months of CA Care’s Herbs

On 17 July 2011, the family brought Suri to come and see us again. Watch the following video and see for yourself the healing that had taken place after two months on our herbs!

 

 

 

Suri’s health had improved tremendously after taking herbs for two month.

  1. Before the herbs, her vision was blurred and she was not able to recognize people around her. But this has since improved. She is now able to recognize people around her again.
  2. Previously she was not able to watch the TV at all. Now, she is able to understand what is going on and can laugh when watching certain programs.
  3. Previously she was not able to comprehend our conversation and was oblivious to her surroundings. Now, she is able to understand and talk to us. She knows what is going on around her. Her sister said, “She can now scold people around her”!
  4. Now she can remember past events and can tell stories based on our old photos. Her husband said, “When she saw our old photos she would talk and talk about it.” But she is not able to remember current events.
  5. In the morning, we bring her for a walk. She can walk 8 rounds of the basket ball court every morning without help. Of course she still lacks strength to walk by herself. Before she couldn’t walk at all.
  6. When sleeping, she can now turn to the left or right. Previously she had to sleep flat and straight unable to turn sideways.

Read the full story …

Part 1: Hope after a disaster

Part 2: A week of amazing healing

Part 3: Reflection and confession of a husband

Part 4: What it takes to be a winner