| San is a 65-year old male from Indonesia. He sent | | | | family members can learn some lessons from this |
| me an e-mail on 8 August 2007 with the following | | | | episode. |
| message. | | | | 1. When someone is down with cancer, the initial |
| I was first diagnosed with stage 3B lung cancer | | | | reaction is panic. This is further compounded when |
| on August 1, 2005. The cancer was found in my | | | | the doctor said that chemotherapy must be done |
| left lung. At that time my left lung was two-third | | | | immediately otherwise the cancer is going to |
| filled with fluid. The doctor tapped out the fluid | | | | spread further. Gullible patients buy such "veiled |
| from my lung and this was followed by | | | | professional warning" easily. Is this reasoning right? |
| chemotherapy. Doctor said chemo had to be | | | | I always tell patients and their family members to |
| done immediately otherwise the cancer would | | | | keep their cool after their diagnosis. The cancer |
| spread further. | | | | had already spread long before it had been |
| I agreed and underwent chemotherapy | | | | diagnosed. Cancer cells were already in the body |
| immediately. The treatment consisted of six | | | | but remained undetected. Therefore, it is not |
| cycles of Gemzar and carboplatin. After the | | | | entirely true to say that chemotherapy has to be |
| treatment, the cancer almost disappeared and the | | | | done immediately to stop the spread. The cancer |
| CEA dropped to normal value. The fluid in the lung | | | | had already spread! It is wise to take time to |
| dried up. After this round of chemo I was asked | | | | evaluate your options. Why the rush? I believe |
| to continue with a drug called Tarceva. But the | | | | any decision made is haste or under duress is |
| drug was not effective. | | | | never a good decision. |
| The doctor tried another round of chemotherapy | | | | 2. After the chemo was done, the CEA dropped. |
| on me. After the second round of chemo the | | | | The doctor is happy and the patients are happy. |
| doctor suggested surgery. After thinking for | | | | The "magic bullet" had done its job, so to say. But |
| sometime, I and my family agreed to have an | | | | were patients ever told that this so called cure is |
| operation. This was done in April 2006. During the | | | | not going to last? |
| operation, almost one half of my left lung was | | | | 3. As an "insurance" patients are often prescribed |
| removed. After the operation the doctor gave | | | | drugs. In this case, San was asked to take |
| me another round of chemotherapy. This | | | | Tarceva. Not long ago, lung cancer patients were |
| consisted of four cycles. He told me that this | | | | asked to take Iressa, but this drug had already |
| chemo was to clean up all the left over cell. | | | | been withdrawn (in the Western world but not in |
| After the operation, I was cancer-free for eight | | | | Asia!) because it caused severe and sometimes |
| months. By March 2007, while on a routine check | | | | fatal side effects besides being shown to be not |
| up, the doctor found that the cancer had come | | | | effective. Tarceva is just another sibling of the |
| back. There was fluid in the lung again. In addition, | | | | same drug family. It is not surprising at all that |
| I was told that the cancer had spread to my | | | | Tarceva, in spite of its high cost, was not |
| back bone and brain. | | | | effective. Medical literature showed that Tarceva |
| When the doctor found that the cancer had | | | | only prolonged life by merely two months. It was |
| recurred, he immediately suggested that I go for | | | | never shown to cure lung cancer. |
| radiotherapy for my brain. This was followed by | | | | 4. When the treatment is not effective, often the |
| chemotherapy again (my fourth round). The first | | | | next course of action is to give more of the |
| cycle of chemo did not appear to be effective | | | | same thing! San was given more chemotherapy |
| anymore. The CEA was elevated. The doctor | | | | and this time around more toxic drugs were used. |
| changed to another drug. The "new drug" was | | | | Besides chemo, more fire power were called in -- |
| able to hold/control the cancer the way it was (it | | | | radiation and the knife. These methods are what |
| did not shrink the tumor but my CEA was stable). | | | | they call "slashing, burning and poisoning" in the |
| During chemotherapy my body felt pain and | | | | belief and hope that all cancer cells in the body |
| weak. I preferred to stay in bed and had no | | | | can be eliminated. Perhaps the world needs to be |
| mood to do anything. I also experienced skin | | | | reminded of what Einstein said: "doing the same |
| irritation. | | | | thing over and over again and expecting different |
| After the chemo, my conditions had | | | | results" is "insanity." |
| deteriorated.o My both feet can not feel the floor | | | | 5. I have learnt early after establishing CA Care |
| anymore. The doctor said this was due to the | | | | that removing a part of the lung is never a way |
| effects of the chemo drug.o I lost all of my hair.o | | | | to cure lung cancer. My patient Number Two (of |
| My hands feel numb.o I have no appetite and no | | | | the thousands I have seen) had a lobe of his lungs |
| strength.o I cannot walk straight. I feel out of | | | | resected. He suffered badly and eventually died. |
| balance.o I feel pain in my left chest, my neck, | | | | San had half of his left lung removed but the |
| and back bone. Sometimes I have to stay in bed | | | | cancer moved to his brain and bones. The knife is |
| the whole day because of the pain.o I cannot | | | | not shown to have cured advanced stage cancer. |
| sleep well. Probably I can only sleep 3 to 4 hours | | | | 6. San wrote that he was cancer-free for eight |
| (maximum). Sometimes to force myself I take | | | | months. I would dispute that. When the tumor is |
| sleeping pills but it only works for approximately | | | | removed, no one is able to see the "tumour" |
| 4-5 hours (maximum).o My bowel movements | | | | anymore - therefore, the |
| are uncertain. Sometimes I experienced diarrhea | | | | "period-that-you-do-not-see-the-tumour" is |
| but there were times I was constipated.o My | | | | mistakenly perceived as cure. I also learnt that |
| appetite is not good at all but I forced myself to | | | | surgery is only to "buy" time -- to remove the |
| eat in order to regain strength. I always force | | | | "rotten" tissue. It may not necessary remove all |
| myself to eat even though sometimes I cannot | | | | cancer cells from the body. |
| taste the food because my tongue is numb and | | | | 7. The thing that matters is: do patients recover |
| has no taste.o There are redness and small | | | | and are truly cured? Evidence such as reduced |
| swellings at the side of my nails.o I cough during | | | | CEA, shrunk tumour, etc., do not mean much. |
| the day and night. It is a continuous cough but | | | | These are good "selling points" to provide "false |
| sometime it stops by itself and then comes back | | | | hope" but patients should know that these so |
| again. Most of the time it has yellow | | | | called good signs don't last. |
| colored-phlegm.o Most of the time I feel | | | | 8. In San's case, the cancer recurred and spread |
| breathless. When I walk too far I feel I am | | | | to his brain and bones. The battle is about to be |
| running out of breath. When I walk up the stairs I | | | | lost but the "General" thinks there is still a fighting |
| need to rest several times after every 4 to 5 | | | | chance that the war can be won. Give more fire |
| steps. Lately, there was one time that I felt a | | | | power! This time, the embattled cancer cells fight |
| pinch pressure at my chest and I had difficulty | | | | back. This time around the cancer cells are |
| breathing. This happened at night and I don't know | | | | "numbed" and become resistant to the drugs. And |
| when it will come again. | | | | they strike back with vengeance. |
| Before the medical treatments I was a very | | | | 9. At last, the doctor saw reality. Short of |
| active man and was able to do anything. I feel | | | | declaring the war lost, he prescribed vitamin pills. |
| that the cancer is taking everything from my life. | | | | The patient, in this case, was left "hanging high |
| I heard the testimony of Mrs. Patoppoi (in Jakarta, | | | | and dry" often worse off than he first started -- |
| Indonesia) who had breast cancer many years | | | | physically and financially drained to the core. They |
| ago and who is still doing fine until today. | | | | are lucky if the State Social security or Health |
| Please advise how I can treat my cancer. I am | | | | Insurance pays for the costs. Unfortunately in this |
| taking "the oil from red fruit" but it does not | | | | part of the world, the patients and their family |
| seem to help. So I plan to stop it. My doctor only | | | | members need to resort to their entire life's |
| gave me vitamin B12 to counter the effects of | | | | saving or selling their property, etc., to settle the |
| my chemotherapy. Besides that I didn't take any | | | | hospital bills. |
| other supplement. | | | | 10. Dr. Lai Gi-ming, Taiwan Cooperative Oncology |
| I'm now desperately seeking your help. | | | | Group, National Research Institute was right when |
| Comments | | | | he wrote: "The thing that most frustrates modern |
| This is a sad sorry. It is also an often repeated | | | | doctors is that, after surgery, chemotherapy and |
| story that I encountered most of the time. It | | | | radiotherapy, all they can do is keep chasing and |
| reflects the state-of-the-situation of medical | | | | chasing the cancer!" It is only that this stage that |
| treatment for cancer today. Patients and their | | | | patients come to us for help. |