Neuroendocrine Cancer: Magic? Fluke Shot? Hocus pocus? or God’s Blessing?

Status

Jim (not his real name) is a 29-year-old Indonesia. He is an engineer – a graduate of one of Australia’s prestigious universities. He and his wife, Grace (not her real name) came to seek our help. Let me briefly relate to you his story.

Some time in January 2019, Jim went out with friends for a drinking session. He vomited blood.  Later, he passed out blood in his stools. Jim has a history of gastric ulcer.

Jim went to a private hospital in Melaka and did an endoscopy and CT scan. The result showed:

  • Enlarged liver with multiple solid nodules in both lobes. The largest in the right lobe is about 6 x 6 cm.
  • There is an enlarged perigastric node about 2 cm.

Jim went to Hospital A in Singapore for a second opinion where an endoscopy was again done followed by a PET scan and a biopsy. The results showed:

  • The 1.8 x 1.3 cm lesion in the gastric fundus, represent the known primary neuroendocrine neoplasm.
  • Pericoeliac and paracaval lymph nodes are likely nodal metastases.
  • Numerous lesions in the liver, representing metastases. The largest lesion is approximately 6.8 x 5.9
  • There a several 0.2 to 0.4 cm nodules in both lungs. Lung metastasis remain a consideration.

After being told that he had neuroendocrine cancer, Jim and his family decided to go to Koh Samui, Thailand to undergo a 11-day detox program. This cost him SGD5,000.

On his return from Koh Samui, Jim decided to seek further treatment in Hospital B in Singapore. On 12 February 2019, he did a PET gallium dotatate scan – an imaging procedure specially for neuroendocrine cancer.

Note:  A small amount of a radioactive drug called Dotatate is given by injection before the PET scan. Dotatate attaches to neuroendocrine tumors (NETs) and shows up on the PET image as bright spots.

Below are the results:

On 13 February 2019, Jim was started on chemotherapy. The drugs used were: Cisplatin + Etoposite. In addition, he was also given Denosunab,  an injection for his bone.

(Note: Denosumab (trade names Prolia and Xgeva) is a human monoclonal antibody for the treatment of osteoporosis, treatment-induced bone loss, metastases to bone, and giant cell tumor of bone).

Jim continued to receive another shot of chemo with Cisplatin + Etoposite. But for the third shot, the drugs were changed to Irinotecan + Temodal.

(Note: Temozolomide or Temodal is used to treat brain tumour – glioblastoma multiforme or recurrent  anaplastic astrocytoma. It is sometimes used to treat bone cancer that has come back. This drug is usually used with irinotecan).

So from the third to eighth chemo, Jim received Irinotecan + Temodal.

Together with chemo, Jim also received Neulastim Booster.

(Note: Neulastim Injection is used for boost production of white blood cells, to help with fever due to low WBC in patients undergoing chemotherapy).

After the seventh chemo Jim’s started to have problems. He developed skin rashes, intially under his arm and parts of the body.

On 29 June 2019, Jim received his first shot of hormone injection called Lanreotide Autogel. Thiis cost SGD4,000 each injection and he had this twice.

(Note: Lanreotide lowers many substances in the body such as insulin and glucagon (involved in regulating blood sugar), growth hormone, and chemicals that affect digestion. It is used to treat acromegaly (increased level of growth hormone), carcinoid syndrome and a certain type of pancreatic or digestive tract tumor that may spread to other parts of the body).

(Note: Carinoid syndrome – signs and symptoms of carcinoid tumors in the digestive tract include: Abdominal pain, diarrhea, nausea, vomiting and inability to pass stool due to intestinal blockage (bowel obstruction), rectal bleeding, rectal pain and redness or a feeling of warmth in your face and neck (skin flushing).

After the eighth chemo Jim started to have more rashes. They spread throughout the body from head to toes and hands.

On 12 July 2019, Jim was give another type of hormone injected called Sandostatin.

(Note: Sandostatin is given to control symptoms such as diarrhea or flushing in patients with tumors such as carcinoid, pancreatic islet cell tumors, gastrinoma, or vasoactive intestinal peptide-secreting tumors.It is also used to treat acromegaly, when the body produces too much growth hormone, and the hands, feet, face or head grow too large).

On 12 Septermber 2019, Jim decided to give up medical treatment and he and  wife Grace flew to Penang seeking our help.

Take a quick look at the time line Grace prepared for this article.

1 4 &5 Sep-17 Endoscopy Melaka Hospital
2 10-Jan-19 Gastric pain, cold sweat, throw out blood & black stool
3 19-Jan-19 CT Scan, Blood test, Endoscopy & Biopsy Melaka Hospital
4 23-Jan-19 Re-do Endoscopy & Biopsy Singapore Hospital
5 23-Jan-19 PET Scan Singapore Hospital
6 29-Jan-19 Positive Biopsy report Singapore Hospital
7 29-Jan-19 Detox program for 11 days Resort, Koh Samui
8 8-Feb-19 Consult to Dr. X for another Singapore Hospital Singapore Hospital B
9 12-Feb-19 PET Gallium Dotatate Scan ( special for Neuroendocrine ) S’pore Hospital B
10 13-Feb-19 1st Chemo (Cisplatin & Etoposite) 3 days/cycle + Neulastim Booster S’pore Hospital B
11 13-Feb-19 1st Bone Injection Denosumab (xgeva)
12 5-Mar-19 2nd Chemo (Cisplatin & Etoposite) 3 days/cycle + Neulastim Booster
13 26-Mar-19 3rd Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster
14 27-Mar-19 Insert Port a cath Surgery Centre, SG
15 1-Apr-19 Hydration 1day S’pore Hospital B
16 12-Apr-19 Hydration 2 days & Albumin IV S’pore Hospital B
17 15-Apr-19 4th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster
18 17-Apr-19 Start taking herb 2x a day Herbalist Singapore
19 6-May-19 5th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster S’pore Hospital B
20 20-May-19 Hydration 1 days 1 L Hospital in  Melbourne
21 27-May-19 6th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster S’pore Hospital B
22 17-Jun-19 7th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster
23 26-Jun-19 Skin rashes started come out at under arm & body side
24 29-Jun-19 1st Hormone Injection Lanreotide Autogel (1 month dose 1 syringe) S’pore Hospital B
25 29-Jun-19 Hydration 1day S’pore Hospital B
26 2-Jul-19 Albumin IV 4 days S’pore Hospital B
27 3-Jul-19 Kidney USG S’pore Hospital B
28 8-Jul-19 8th Chemo (Irinotecan & Temodal) 5days/cycle + Neulastim Booster S’pore Hospital B
29 8-Jul-19 Hydration & Albumin IV 5 days S’pore Hospital B
30 12-Jul-19 Rashes spread to head , toes, palm hands
31 12-Jul-19 3days Hormone Injection Sandostatin ( 3x injections daily ) S’pore Hospital B
32 16-Jul-19 Hydration 2 days S’pore Hospital B
33 29-Jul-19 Hydration & Albumin 3 days S’pore Hospital B
34 30-Jul-19 1st Consult Dermatology Dr. Y S’pore Hospital B
35 31-Jul-19 2nd Bone Injection Denosumab (xgeva) S’pore Hospital B
37 31-Jul-19 2nd Hormone Injection Lanreotide Autogel (1 month dose 1 syringe) S’pore Hospital B
37 12-Aug-19 Very tired, almost black out, skin getting worse, water retention
38 20-Aug 2nd Consult Dermatology Dr Y S’pore Hospital B
39 21-Aug Hydration & Albumin 3 days S’pore Hospital B
40 2-Sep Hydration & Albumin 4 days S’pore Hospital B
41 9-Sep 3rd Consult Dermatology Dr Y, Steroid Injection S’pore Hospital B
42 11-Sep Did IgG Food Sensitivity test Diagnostic, Singapore
43 12-Sep Consult with Dr Chris Teo, taking herb CA Care Penang
44 19-Sep Consult Dr Z for blood test Melaka Hospital
45 3-Oct Shingles Infections Skin Clinic Melaka
46 7-Oct 2nd consult with Dr Chris Teo CA Care Penang
47 16-Oct Low Albumin, IV 100ml a day x 3days Melaka Hospital

 

Was Jim cured by those highly scientific, up-to-date medical treatment in Singapore?

You make your own conclusion after seeing the photos below. By the way, for all the adventure in Singapore Jim spent no less than SGD100,000 (that is 0.3 million ringgit).

Feb 2019 before chemotherapy ——– Feb 2019 to Sept 2019, after chemo and hormone injection. SGD 100,000 gone. Ended up bald, severe skin peeling, severe diarrhoea, swollen feet, etc. Worth it?

Jim said the severe peeling of the skin  was indeed a very painful experience. His skin peeled and peeled for about 10 to 13 times. It addition, he suffered severe diarrhoea – about 20 times a day to the extent that he said he virtually fell “asleep” in the toilet. Jim will share his experience in the next posting.

Let us look at the results of his PET scan.

Comparison of scan results: 29 July 2019 (top row) vs 12 February 2019 (bottom row)

Comparison of scan results: 29 July 2019 (left row) vs 12 February 2019 (right row)

Something wrong with the bones? Scan on 29 July 2019 (left column) seemed to be more serious than scan done on 12 Feb 2019 (right).

Did the cancer go away after all the treatments?

Again, ask this question: From the above, do you see any improvement? And what had  scientific, modern medicine done to him? Study what the reports carefully and you will know the answers.

My comments

Most patients who come to see us are like Jim and Grace. They have come to the end of the road as far as medical treatments are concerned. Where else can they go to for help? Yet the medical world sees alternative medicine as hocus pocus. They call people like me snake oil peddlers!

When I first saw Jim in such a  pathetic condition, I was really upset. Here is a young man being subjected to such torturous treatments in the name of “science.”  But deep in my heart, there was a feeling that I would be able to help him — no, not to cure him but to help and make his life a lit bit better.

Each morning, as I prepare to come to the centre to see patients, my prayer to God, the Almighty Healer is always  this — God show me your way. Teach me what I have to do to help people in need. This is what I call  asking for God’s blessing for whatever happens after that!

In the next posting I shall present  you videos of our conversation. You will learn about the traumatic experience that Jim went through.

I prescribed Jim some herbs and was very concern if the herbs would help him or not. Below are some of the emails for you to evaluate.

 Sun, Sep 15, 2019:  Hi Dr Chris,

Currently Jim’s face & toes got water retention due to lack of albumin. This has happened 5 to 6 times  already since the past 4 months. This water retention is followed by tiredness, swollen & not feeling well.

Doctor at SG will give Albumin IV usually 2 bottles for 5 days. But it will become low again after 1-2 weeks & he need another albumin again. Which is not helping at all.

Last time you said you have herb for swollen face & toes. Please advice what herb to overcome this? Please advice.

Sat, Sep 21, 2019: Dear dr chris,

The past few days, 10 minutes after drinking the herb, Jim will need to go to the toilet. One day he can pass motion for around 7 times. Do you mind if we send you picture of the poop?

Lately, he is also feeling a bit tired. Is it the side effect of the herb? Should we be worried about it?

Also, we just started on Edema today. Will let you know how it goes in the next few days.

Tue, Oct 1: Hi Dr,

Thank you for your reply. After taking Lower Edema for 10 days until today, his leg still swollen, but not getting worse. And he still pee 6-7x a day (last time when his leg swollen he only pee 2-3x a day. Means all liquid intake become water retention. During that time we have no choice & did Albumin IV 10bottles 5 days in a row, then slowly his albumin level going up & he starting to pee 7- 8x per day & his water retention gone. But It will recurrence every 2 weeks time which make us worried.

Do you think this swelling due to his liver not good or what else?

The first 2 weeks he feels tired, skin still worse, sometimes nausea, & more bowl movements more than 5x. Every time he drink herbs, 10 mins later confirm go toilet.

But now after taking herbs for 3 weeks time, he is much better now. The skin, the energy, mood are better and can go out to do some activity which we are very happy to see his condition now.

Now only his leg swollen & still having lack of leg power (since few months ago).

He took the herbs regularly & diets following your cook book. Totally no meats except fish sometimes.

Please advice on this current condition.

Mon, Oct 21: Dear Dr Chris,

 I compiled Jim’s medical record since his first symptom until now.

– Medical Timeline (excel)

– All scans & Endoscopy

– Each month blood test

– Histopathology report

– Photos of his peeled skin

We are very happy if you can help us look through these file for your further analysis. His current conditions is much better after taking your herb, and we are very happy & thank you and auntie for your kind help.

Tue, Oct 22, 2019 : Dear Dr,

Thank you for your kind reply. He feels good, can do some activities & he continues  using the machine also. Overall the energy is good can go out around 5 hrs a day.

Thank you for your help.

Wed, Oct 23, 2019: Dear Dr,

We are the one should thank you because you help us through this struggling time. We are fine with the pictures, sharing with others.

Thu, Oct 24, 2019: Hi Dr Chris, 

After reading the story you wrote, I felt happy because now we are on the right track. After chemo  so many side effect & no improvement. We were really down at that time and luckily we came  to see you. Hopefully this story will help others patients too. We really appreciate your kindness & help.

Thank you Dr Chris!

He is doing quite well now, but I understand he can’t over do. So we trying to manage it.

  1. Now no more diarrhea problem. Only during 3rd to 8th chemo (Irinotecan side effect), diarrhea 15-20x a day (even after atrophine injection 1-2x a day). After stop chemo no more. Currently 4-5x a day. Not painful.
  2. His last Albumin IV on 16 Oct for 3 days. After that blood test shown still border line 33 L (range 35-50). But last 4 days we soaked his toes on warm water + Epsom salt. It’s help reduce the swelling. Now looks normal already. Hopefully will stay normal because it happened so many times already & no solution until now.
  3. Now, skin no more peeling off, only dry in some area (near lips, thigh). After taking herb about 2 weeks his skin does not peel off anymore.
  4. He can sleep well now, no more melatonin / sleeping pill this past one month until now.
  5. His shingles is gone, leaving scars only.

AFTER TAKING THE HERBS

 

Let me conclude by asking you to reflect seriously these words of advice:

   

Acknowledgment: Thank you Grace (not her real name) for your help in providing us with all the pictures and medical reports to enable us to write this story.

 

 

 

 

 

 

 

Carcinoid Tumour of the Intestine: Surgery not indicated, chemo would not cure! Three weeks to live. But still alive after 9 months!

CH is 50-year-old male. He had chronic constipation with pain for about 6 months but did nothing about it.

Eventually he landed in a hospital and was told he had two tumours. One at the anorectal junction, 4.4 cm in length and 1.7 cm thick. There was also a mass at the mid sigmoid colon, measuring 1.5 x 2.7 cm.

CT scan also showed:

  • Multiple non-enhancing lesions in both lobes of the liver which measure up to 4.5 x 3.9 x 5.0 cm.
  • Numerous tiny well-defined nodules seen in both lung fields.
  • No lymphadenopathy.
  • No bony lesion.

A biopsy was done and the histopathology report indicated a neuroendorine tumour, most likely a high grade carcinoid.

(Note: Neuroendocrine tumors (NETs) are RARE neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. Many are benign, while some are malignant. They most commonly occur in the intestine, where they are often called carcinoid tumors, but they are also found in the pancreas, lung and the rest of the body).

CH consulted 4 doctors and all of them said he needed chemotherapy. A doctor in a private hospital said CH had only 3 weeks to live. So CH immediately underwent chemotherapy, initially for 3 cycles (to do 6 cycles).

While undergoing chemotherapy, a friend of CH came to seek our help. CH was unable to travel then. We prescribed some basic herbs and did not expect CH to live long enough to be able to come and see us.

To our surprise, a week later CH and his friend drove from Kuala Lumpur to our centre. 

Video 1: Surgery not indicated, chemo would not cure. After one week on herbs, he felt better!

 

During his first visit, CH said he had better appetite and there was less pain after taking the herbs. He had  more energy. Also there was less blood in his stools.

The tumour is still inside and could not be removed. CH had to do chemo but this would not cure him!

CH was told to continue with 3 more cycles of chemo. But this time it would be at a government cancer hospital. The government oncologist told CH that he had 2 months to live!

I told CH not to worry too much. All of us will have to die one day. What is important is, take the herbs and you feel better. Don’t get worse — stomach bloated, pain here and pain there — then that would be miserable. Remember everyone of us has to die. What is important is to die well.

Video 2: After 3 cycles of chemo and a month on herbs, his health improved. But I want a cure!

 

A month later, CH came to see us again. This time another friend drove him here. CH said he felt better and had very much less pain (scale of 9/10 reduced to 2/10). He only took the Pain Tea and did not have to resort to all kinds of pain medications by the doctor.

There was less blood in his tools and he passed out jelly-like substance together with some blood.

Chris: Now that you are getting better, do you think you are going to die now?

CH: Not so soon.

Chris: I would wondering why doctors are not curious enough to know why you don’t die yet?

Chris: Now that you are better, what else do you want?

CH: I am hoping you can cure me.

Chris: No la … how can that be?

Video 3: After 6 cycles of chemo and 5 months on herbs, he looked like a normal healthy person!

 

On this glorious morning of late December 2016, CH and his wife came to see us. I could not recognise CH because he was not bald anymore. He presented as a healthy person. CH said this time he drove from KL to Penang by himself. In fact, these days he felt so good and he had been driving around without any problem.

A good achievement indeed for a man who was supposed to die within 3 weeks!

CH said he had completed 6 cycles of chemotherapy at the end of September 2016. There was no medication from his oncologist and the next follow up will be in February 2017.

In late October 2016 CT scan showed that:

  • Previous multiple small lung nodules — some show stable size, regression and disappearance of lesion.
  • There are multiple subcentimeter mediastinal lymph nodes. All appear unchanged.
  • Increasing in size and numbers of multiple liver lesions. The largest in segment 8, measures 7.6 x 7.4 cm. This indicates worsening of liver metastasis.
  • Slightly increased size of the lower rectal mass causing narrowing of the rectal canal, measures 4.5 cm in length (previously 4.4 cm).
  • Sclerotic lesions at the neck of left femur, right transverse process of L3 and T6 vertebral body.

Comments

There are many lessons we can learn from this case.

  1. I received many emails from people who wrote on behalf of their friends. My answer has always been — No use. No need to try to be a “hero” trying to “save” someone else if that person or his/her family members can’t even come and see us. What can I do on line? In this case, CH’s sent a friend all the way from KL. It was not possible to me to send him home empty handed. So, I did prescribed CH some basic herbs.

I am glad that when CH got well after a week, he took it upon himself to come to Penang and talked to us. That is the spirit we want! Show that you are interested to help yourself first before others can help you. Sitting in front of a computer and expecting good things to happen is asking too much.

  1. CH had a rare type of cancer. According to the oncologist, even chemo would not cure him. On top of that CH was told by the oncologist of a private hospital that he had only 3 weeks to live. Do you ever wonder why the oncologist needs to say such thing? Is he playing god? Or is this a way to “frighten patients to death” so that they would not want to think for themselves anymore but to submit to his recommended chemo treatment immediately? No time for second opinion anymore. Don’t waste time, you are dying! Right?

Read what Dr. Groopman said:

17-play-god-six-month-to-live

I fully agree with this learned professor. No mortal can decide how long you life. That’s God’s prerogative. So it is indeed foolish for anyone to believe what they are being told i.e., when they would die.

  1. I am fully aware that talking to patients about his/her death is not a nice topic to bring up, especially when they sit in front of you looking or feeling “half dead.” Some even consider it a taboo.

But, if you really want to help yourself and find healing, I believe it is important that you are made aware of the reality of the situation. Face the problem squarely! There is no point being in denial. I hope by talking openly about death, you realize that everyone has to die, not only you! No matter how much you want to deny it or fear it, there is no escape. So why can’t we accept it as a natural process of life without any fear. If we have to “go” let us go in peace. That’s my message to our patients. Perhaps with acceptance like this, healing comes more easily.

  1. There is one important aspect of healing which some patients forget, that is, to cultivate a sense of gratitude. Accept things the way it comes to you and always be grateful for what you are and what you have. If you can eat, can sleep, can move around without pain — what else do you want?

Yes, everyone who comes to us want a cure! CH was hoping for us to cure him too, in spite of being told that chemo would not cure him and he had only few weeks or months to live.

While we don’t want you to lose hope — you should aspire to get the best by doing your best — we also want to remind you that you may end up being “cheated” or taken for a ride if someone promises you that he can cure your cancer! So beware.

  1. We are indeed glad to see CH doing fine up to this point — at least he can now live a normal, healthy life in spite of having many “bombs” embedded inside him. This is what we mean when we tell patients, Learn to live with your cancer. You don’t have to wage a war against the cancer inside you!

Up to this point, we see CH’s healing as a grace and a blessing. Accept it that way and you can be more at peace with life.

  1. Often patients are told that when they are undergoing chemotherapy, they should NOT take any herbs or supplements. Then they can eat whatever they like! There is no truth in such dogma!

5-oncologsit-harm-patients

 

In this case, CH did well indeed. He did chemo and took herbs at the same time, while taking care of his diet. Is that not wonderful? Is that not safe enough — no harm comes out of this combination?

Is the Power-that-Be not curious or interested enough to know why CH is still alive and doing well? Oh, no we don’t want to know! It does not interest us a bit. Is that what it is?