Kimoterapi

“Kimoterapi adalah satu kaedah yang dikatakan sangat berkesan untuk merawat barah. Ia adalah “magic words” yang sering keluar dari mulut pegawai perubatan dalam menghadapi barah. Adalah amat penting anda mengetahui maklumat yang sebenar mengenai kimoterapi sekiranya doktor mencadangkan anda menjalani kimoterapi.Kerana seringkali pesakit barah diberi penerangan sepintas lalu sahaja memandangkan adakalanya doktor terpaksa menyembunyikan sesuatu fakta kerana pelbagai sebab. KIMOTERAPI ialah satu kaedah untuk membunuh sel barah yang didapati membelah dengan terlalu cepat sehingga menyebabkan berlaku ketidakseimbangan kepada tisu badan.Pihak farmasi merekodkan sehingga kini terdapat lebih daripada 100 jenis dadah yang digunakan untuk rawatan kimoterapi. Penggunaannya bergantung kepada jenis barah,tahap barah dan lokasi barah berada. Adakalanya doktor terpaksa menggunakan kombinasi dadah kimoterapi untuk jenis2 barah berlainan. Terdapat pelbagai cara untuk melakukan kimoterapi bergantung kepada jenis dan tahap barah,kesihatan anda dan sejauhmana potensi barah akan merebak pada organ2 penting anda. 1.Melalui salur darah.Dadah akan disalurkan melalui salur darah yang cara menyeluruh keseluruh badan anda.Ini dilakukan sekiranya barah anda berada pada tahap 4 dan sel barah anda telah merebak ke banyak bahagian badan anda.Kaedah ini dikenali “INTRAVENOUS IV”. 2.Melalui mulut.Kaedah ini anda mengambil dadah kimo melalui pil yang ditelan. 3.Melalui suntikan.Dadah kimo disuntik terus kepada kedudukan barah atau tumor. 4.Sapuan pada kulit.Kaedah ini digunakan untuk barah kulit. Apakah kesan sampingan Kimoterapi.Kimoterapi terkenal dengan banyak kesan sampingan dan adakalanya doktor tidak menyatakan kesemuanya atas pelbagai sebab.Berikut adalah kesan2 sampingan yang agak lengkap yang perlu anda ketahui. 1.Pendarahan samaada melalui mulut atau rongga badan yang lain. 2.Kekeringan,kulit menjadi bersisik,kering dan berkedut 3.Keguguran rambut samaada sebahagian atau keseluruhan. 4.Kebas pada tapak tangan atau kaki. 5.Perubahan kepada sistem pendengaran anda.Contohnya bunyi bergaung. 6.Sering muntah adakalanya disertai darah. 7.Bengkak pada sistem deria atau pada organ badan. 8.Perubahan kepada warna kulit 9.Mudah dujangkiti penyakit samaada demam,batuk dsbnya.Kerana sistem imun telah binasa. 10.Kerosakan pada organ penting seperti jantung,hati,saluran darah dsbnya. 11.Kelesuan atau tidak bermaya. 12.Hilang selera makan. Adakalanya simpton2 diatas adalah berbentuk sementara dan akan hilang apabila anda memberhentikan rawatan kimoterapi.Kebiasaanya doktor akan menggunakan dadah2 tertentu untuk menghadapi setengah2 simpton.Namun jika terjadi kerosakan pada organ2 tertentu badan ia kebiasaanya bersifat kekal.Ini termasuk kerosakan pada saluran darah. Kos Rawatan Kimoterapi. Sebelum anda menerima tawaran kimoterapi sila pastikan anda berkemampuan dari segi kewangan anda.Ini adalah kerana biasanya doktor tidak benar2 dapat memastikan berapa lamakah atau berapa kalikah anda harus menjalani kimoterapi.Dan adalah juga penting anda bertanya kepada doktor anda kebarangkalian anda terpaksa beralih kepada dadah yang lebih kuat setelah memulai dengan dadah yang kurang kuat.Dadah yang lebih kuat amat mahal.Adakalanya ia bolih mencecah sehingga RM5000 ke RM10,000 untuk sekali kimo di hospital swasta dan hospital kerajaan dalam lingkungan RM2000.Kos ini belum mengambil kira beberapa faktor lain umpamanya pembedahan kecil,tempat rawatan ( adakalanya kimo bolih dilakukan dirumah ). Jika anda mempunyai insuran kesihatan pastikan jumlah bayaran yang akan ditanggung olih pihak insuran dan polisi anda menyatakan jenis ubat barah yang didalam skop ditanggung olih pihak insuran.Pihak insuran mempunyai kaedah2 tertentu untuk membataskan pembayaran bergantung kepada premium yang anda bayar. Yang mustahak,tanya doktor anda dahulu jenis2 dadah yang dijangka digunakan dan serahkan pada pihak insuran.Olih itu anda perlu bijak bila membeli polisi insuran.Perubatan barah perlu dituliskan dengan jelas didalam perjanjian bukan hanya sekadar janji mulut agen2 insuran.Kerana pengubatan barah bolih sahaja mencecah ratusan ribu ringgit Sebelum anda membuat keputusan untuk menjalani kimoterapi perkara pertama yang perlu anda ketahui ialah “apakah jenis barah yang sedang anda hadapi dan kepantasannya merebak kepada organ2 penting yang bolih melumpuhkan keseluruhan sistem badan anda.Umpamanya,adakah tumor anda berada berhampiran jantung atau paru2 anda.Adakah anda menghadapi barah pada organ penting seperti barah perut atau barah usus.Mengapa ini penting”

“Kimoterapi atau barah adalah berkaitan dengan pesakit itu sendiri.Kimoterapi dan barah tidak mendatangkan apa2 bahaya kepada keadaan orang disekeliling. Namun satu perkara yang mungkin nampak benar pada pandangan anda ialah orang yang menjalani kimoterapi terdedah dengan pelbagai jenis serangan virus yang tidak dapat dimusnahkan olih sistem imun badan mereka yang telah musnah.Kadangkalanya mereka akan muntah.air liur yang masih mempunyai virus2 yang masih aktif mungkin bolih sahaja menjangkiti orang disekeliling yang menggunakan bekas peralatan mereka. Begitu juga sebaliknya orang yang dalam keadaan tidak bersih atau ada selsema atau serangan kulat bolih sahaja menjangkiti pesakit barah yang sedang menjalani rawatan kimoterapi.Bahkan keadaan mereka lebih berisiko tinggi kerana mereka tiada imun system atau punya imun sistem yang lemah.Olih itu dalam soal ini pesakit barah yang lebih terdedah kepada pelbagai masaalah berbanding mereka yang tidak ada masaalah barah. Manakala barah tidak diturunkan melalui sentuhan dengan pesakit”

“ibu saya menghidap barah hati, doktor mencadangkan rawatan kimoterapi selepas pembedahan yg dilakukan 2 bln lepas tidak memberi kesan malah bertambah besar…umur ibu saya sekarang 68 tahun….adakah rawatan kimoterapi sesuai dgnnya”

“protocel diambil samada bersama taheebo atau biji aprikot pahit adalah amat berkesan untuk menghalang aktiviti tumor dari membesar. terima kasih”

“Pakar2 barah menyatakan manusia mendapat barah badan kekurangan satu nutrient yang amat penting iaitu nutriet antioksidan yang bolih didapati dari bijiran dan tumbu2han. Badan kita memang mempunyai kadar trypsin dan kimotrypsin yang mencukupi namun apabila kita makan terlalu banyak protin khususnya dari binatang pengkerias perlu menjana lebih banyal trypsin/chemotrypsin untuk mencerna protin. Untuk pengkerias melakuka perkar2 tersebut mereka memerlukan bahan2 mentah tambahan yag bolih didpati dari tumbuhan dan bijirin. Olih itu anda perlu menyemimbangkan permakanan anda dengan mengambil banyak sayuran/buah2an dan bijirin tertentu. Nenas umpamanya mempunyai agen2 yang membantu proses pencernaan.Betik contoh terbaik yang supply enzim2 tertentu untuk fungsi pengkerias.Sayuran2 hijau adalah anti oksidan yang terbaik.Antaranya yg terbaik adalah ulaman”

“Untuk kolon peringkat 3 kaedah yang biasa ialah membuat pembedahan mengeluarkan tumor atau lympnode dan olih kerana pada peringkat ini barah biasanya telah keluar dari koloninya kimoterapi akan digunakan selepas itu. Dalam perkara ini doktor biasanya akan mempunyai pelbagai pandangan mengapa mereka membuat kimoterapi terlebih dahulu.Atau mungkin sahaja mereka mencuba kaedah kimoterapi kerana berpendapat tumor bolih dikecutkan dengan kaedah tersebut tanpa pembedahan. Jika tumor tidak juga mengecil mungkin baru mereka akan melaksanakan pembedahan.Menghadapi barah adalah umpama anda pergi berperang dengan pelbagai strategi.Adakalanya doktor merasakan strategi kimo sebelum pembedahan adalah cara terbaik untuk menang menentang jenis2 barah tertentu.Mungkin juga mereka berpandangan pesakit mempunyai masaalah kesuhatan yang lain yang tidak memungkinkan pembedahan dilakukan pada saat ini,dan untuk merawat masaalah sampingan memerlukan masa sedangkan tumor dalam kolon perlu dirawat dengan segera. Anda perlu tanya rasionalnya kaedah ini kepada doktor anda.”

“ibu saya menghidap barah payudara stage 4 dan telah menjalani pembedahan pd 6/5/2011 yg lalu, kemudian doktor mendapati barahnya telah merebak ke tulang. doktor mencadangkan rawatan kimoterapi selepas sebulan pembedahan. …umur ibu saya sekarang 67 tahun….adakah rawatan kimoterapi sesuai dgnnya?”

“Ibu anda mempunyai selama 30 hari sblm menjalani rawatan kimoterapi. Ia adalah sautu jangkamasa yang panjang untuk puan mencuba cara alternatif Saya tidak fikir dr akan menasihatkan kaedah kimoterapi untuk usia ibu puan seandainya ada kaedah2 lain yang lebih selamat.Dr mungkin sahaja tiada pilihan lain. Saya cadangkan puan untuk mencuba kaedah alterntif dahulu moga2 beliau tidak perlu menjalani kimo seandainya dr mendapati tompokkan tumor pada tulangnya berangsur berkurangan. Puan saya cadangkan memberinya Taheebo Life Tea diambil bersama enzim megzyme forte. Amalkan meminumnya 8 cawan sehari. Yang terbaik adalah menggunakn protocel bersama Taheebo Life Tea dan enzim. Namun buat masa ini Protocel telah tiada stok.( 2 minggu lagi baru sampai ) Menggunakan ketiga-tiga suplimen diatas adalah seperti merawat barah dengan menggunakan 3 terapi barah sekali gus untuk kesan maksima.Namun 2 terapi adalah juga baik untuk menghalang penularan berterusan bakteria barah. Cuba ini dahulu sebelum puan mempertimbngkn kaedah kimoterapi”

“Apa kebaikan & keburukan rawatan kimoterapi? Kerana baru-baru ini ada seseorang datang kepada ibu saya, mengatakan rawatan kimoterapi banyak buruknya dari baiknya..benarkah itu? 9 tahun dulu ibu saya pengidap kenser payu dara. Alhamdulillah sembuh tapi sekarang ia menyerang pula ke tulang belakang. Sekarang ibu saya sedang dalam rawatan kimoterapi. Umurnya sudah memcecah 60 tahun dan hatinya berbelah bagi, untuk meneruskan atau tidak rawatan tersebut. Boleh beri pandangan… jika ada ubat atau rawatan yang lain saya ingin sekali berkongsi dan mencuba”

“Penggunaan kaedah kimoterapi untuk barah mempunyai side effect jangkamasa panjang dan pendik.Dan ianya bergantung kepada tahap atau jenis dadah kimo yang digunakan.Lebih kuat dadah atau dos yang digunakan lebih teruk side effectnya dan satu perkara yang perlu diberi perhatian serius ialah side effect kepada organ2 dalaman yang penting seperti hati,pengkerias dan paru. Umur memainkan peranan yang penting dalam keupayaan kita menanggung side effect ini.Doktor sepatutnya lebih maklum tentang perkara ini,namun mereka mungkin sahaja tiada alternatif lain.Orang yang buat rawatan kimo mesti makan dengan cukup makanan2 yang berzat,jika ia tidak mampu makan makanan yang berzat beri ia suppliment atau nutrient2 dalam bentuk kus umpamanya jus monavie dan susu kambing. Jika puan ingin mengelakkan kimoterapi saya syorkan puan untuk gunakan Taheebo Life Tea samada dalam bentuk kapsul atau barks yang direbus dan diminum,dan Tablet megazyme forte,ia enzim untuk pengkerias yang amat penting untuk menghadam protin sel barah. Sms atau call 019-2594593 untuk check stok dan pembelian”

“Namun satu perkara yang mungkin nampak benar ialah orang yang menjalani kimoterapi terdedah dengan pelbagai jenis serangan virus yang tidak dapat dimusnahkan olih sistem imun badan mereka yang telah musnah.Kadangkalanya mereka akan muntah.air liur yang masih mempunyai virus2 yang masih aktif mungkin bolih sahaja menjangkiti orang disekeliling yang menggunakan bekas peralatan mereka. Seperkara lagi ialah mengenai pesakit barah hati yang berpunca dari hepatitis,mereka sentiasa menyimpan kuman hepititis dalam darah mereka,jika anda dalam keadaan terluka dan tercedera akibat bekas jarum suntikkan dan sebagainya,yang digunakan terhadap pesakit barah hati,anda mungkin sahaja terdedah kepada pemindahan virus tersebut ke dalam diri anda. Dan gejalanya akan timbul 10 atau 15 akan datang kecuali anda telah ada pelalian dari serangan virus hepatitis. Begitu juga sebaliknya orang yang dalam keadaan tidak bersih atau ada selsema atau serangan kulat bolih sahaja menjangkiti pesakit barah yang sedang menjalani rawatan kimoterapi. Bahkan keadaan mereka lebih berisiko tinggi kerana mereka tiada imun system atau punya imun sistem yang lemah. Olih itu dalam soal ini , pesakit barah yang lebih terdedah kepada pelbagai masaalah berbanding mereka yang tidak ada masaalah barah.”

CANCER STORY

Research on effectiveness of herbs and alternative therapies for cancer

http://cancercaremalaysia.com/tag/chemotherapy/

 

Get It Right: Can Chemotherapy Really Cure Cancer?

Posted on 03/11/2012 by CA Care

If you are a scientist, and if you have done many scientific experiments / research in your life, and if you have a bit of common sense (never mind about having a Ph.D. — these days you can buy one easily), you will know that something is not right with the current medical way of treating cancer using poisonous drugs.

Well, I am not a medical doctor – in a way, that is a blessing because I can critically “see” that something does not add up. Why?

But, let me also say this. You don’t need to be a scientist to “see” what I see and to know what I know. Hear what a broadway playwright and a movie star has got to say:

In this article, I am not trying to tell you how bad or how good chemo is. I think you have had enough of that. I am going to bring you yet another different but related message. I hope you can learn many things from what is written below.

The recent website of the Dana-Faber Cancer Institute, Boston, USA, had this headline: Advanced cancer patients overoptimistic about chemotherapy’s ability to cure, study finds

http://www.dana-farber.org/Newsroom/News-Releases/Advanced-cancer-patients-overoptimistic-about-chemotherapys-ability-to-cure-study-finds.aspx

A study was conducted and led by medical researcher, Jane Weeks, who is also a professor of medicine at Harvard Medical School and Professor of Health Policy and Management at Harvard School of Public Health.

Others in the research team are Deborah Schrag, MD, MPH and Paul Catalano, ScD, Angel Cronin, and Jennifer Mack, MD, MPH, of Dana-Farber; Matthew Finkelman, PhD, of Tufts University; and Nancy Keating, MD, MPH, of Brigham and Women’s Hospital.

What Did They Study?

§  The study was conducted by surveying 1,274 patients at hospitals, clinics and treatment centers across the USA. Participants were recruited from geographically diverse populations and health care systems in order to systematically evaluate cancer care delivery in the U.S.

§  Study participants had been diagnosed with metastatic lung or colorectal cancer at least four months earlier and had received chemotherapy for their disease.

§  They studied their records in great detail.

The Results of the Study

They found that 69 percent of patients with advanced lung cancer and 81 percent of patients with advanced colorectal cancer did not understand that the chemotherapy they were receiving was not at all likely to cure their disease. Their expectations run counter to the fact that although chemotherapy can alleviate pain and extend life in such patients by weeks or months, it is not a cure for these types of advanced cancer except in the rarest of circumstances.

§  Patients with advanced lung or colorectal cancer are frequently mistaken in their beliefs that chemotherapy can cure their disease.

§  Inaccurate expectations about the role of chemotherapy were found among patients from varied backgrounds treated in many different health care settings across the U.S.

§  Surprisingly, patients who rated their communication with their physician highly were the most likely to hold overoptimistic views about chemotherapy’s curative potential.

§  Strikingly, those patients who rated their physicians as worse communicators were more likely to have a realistic view of the potential benefit of their chemotherapy.

§  While there is no doubt that communication about prognosis in advanced cancer is challenging, a sizeable minority of study participants did grasp the incurable nature of their cancers.

§  Dr. Weeks noted: “If patients do not know whether a treatment offers a realistic possibility of cure, their ability to make informed treatment decisions that are consistent with their preferences may be compromised. This misunderstanding may pose obstacles to optimal end-of-life planning.”

§  Dr. Deborah Schrag said: “skilled clinicians can set realistic expectations without their patients’ losing either hope or trust.”

This study was published in the Oct. 25, 2012 issue of the New England Journal of Medicine. The study was funded by grants from the National Cancer Institute and by a grant from the Department of Veterans Affairs

Mass Media Response To The Results Of This Study

1.     Are cancer patients’ hopes for chemo too high? http://www.reuters.com/article/2012/10/24/us-cancer-patients-idUSBRE89N1M220121024

§  At least two thirds of people with advanced cancer believed the chemotherapy they were receiving might cure them, even though the treatment was only being given to buy some time or make them comfortable.

§  Their expectations are way out of line with reality,

§  Perhaps ironically, the patients who had the nicest things to say about their doctors’ ability to communicate with them were less likely to understand the purpose of their chemotherapy than patients who had a less-favourable opinion of their communication with their physicians.

§  This is not about bad doctors and it’s not about unintelligent patients.This is a complex communication dynamic. It’s hard to talk to people and tell them “we can’t cure your cancer.”

§  Doctors find it uncomfortable to hammer home grim news and patients don’t want to believe it.

§  It was a reminder to doctors to slow down and take some time to realize how hard the issue is.

§  If patients actually have unrealistic expectations of a cure from a therapy that is administered with palliative intent, we have a serious problem of miscommunication we need to address.

Hossein Borghaei, an oncologist at the Fox Chase Cancer Center in Philadelphia said:

§  What are you supposed to do, stand in front of someone with advance disease and argue with them? It’s not productive.

Thomas Smith and Dan Longo of Johns Hopkins University School of Medicine wrote:

§  The results are probably due, in varying degrees, to patients not being told their disease is incurable.

§  Patients not being told in a way that lets them understand.

§  Patients choosing not to believe the message, or patients being too optimistic.

§  Many patients think they are going to beat the odds.

2. Many cancer patients mistakenly believe chemotherapies will cure them, new study says

http://www.boston.com/dailydose/2012/10/24/many-cancer-patients-mistakenly-believe-chemotherapies-will-cure-them-new-study-says/P4Sv84A5u4syPuWeD9ANUI/story.html

§  A majority of patients with advanced lung and colorectal cancer harbor the fundamental misperception that treatments that can extend life and alleviate pain might also cure them.

§  But the study couldn’t pinpoint where it occurs: whether patients receive unclear information from a physician or fail to fully comprehend what they are told, or whether there is a kind of clinical “collusion” in which the discussion moves rapidly from a dire prognosis to a focus on what can be tried, leaving patients with an inflated sense of hope.

§  The issue here … thinking that a treatment offers a chance of cure when in fact it doesn’t. This deprives these patients of the opportunity to weigh the risks of chemotherapy, including the chance of some rough side effects, against the true benefits, perhaps some symptom relief and a few months longer life but no chance of cure.

Dr. Eduardo Bruera, chair of the Department of Palliative Care and Rehabilitation Medicine at the University of Texas MD Anderson Cancer Center, said:

§  A bearer of good news might be seen in a more welcoming way; that might explain why sugar-coating might make people more liked by their patients.

Dr. Deborah Schrag, a colorectal cancer specialist at Dana-Farber and co-author of the study, said:

§  We had this hypothesis when it comes to giving bad news: Doctors who work at an integrated health care network, they’re not an independent practice, they’re more free to disclose the unvarnished truth, without worrying about the ramifications of, ‘If I’m not super cheerful and positive and optimistic, my patients would not like me.

Dr. David Ryan, chief of hematology/oncology at Massachusetts General Hospital said:

§  You have to provide the information about whether a situation is curable or not curable, and what the odds of doing well are for a long period of time.

§  But you also have to provide hope, and it can be difficult sometimes to convey that difficult information and also provide hope.

Oncologists said it was crucial to find where and why the misunderstanding takes root so that doctors can be sure their patients are making informed decisions.

3. Many Terminal Cancer Patients Mistakenly Believe A Cure Is Possible http://www.capradio.org/news/npr/story?storyid=163572138

§  A survey finds that the majority of advanced stage lung and colon cancer patients believe chemotherapy might cure them, when it can actually only buy them a few months. Oncologists are worried about how this impacts end-of-life decision making.

§  Doctors are often called upon to deliver bad news to patients, and there isn’t much that’s worse than a diagnosis of an advanced-stage cancer for which there is no cure.

§  A large majority of patients who receive this news don’t fully comprehend it, or perhaps willfully choose to ignore it.

§  When people have unrealistic expectations they’re much less open to discussing end-of-life planning.

§  But patients always want positive news. In the short term, people will be happier if you give them happier news.”

Sandra Swan an oncologist at the Washington Hospital Center said:

§  Ultimately the doctor’s responsibility is to ensure that their patients fully understands what’s happening to them.

§  There needs to be continued communication about the prognosis and it needs to be done early on. I don’t think physicians do it particularly well. … Many physicians just have a very hard time communicating that they’re not going to be able to cure the patient.

§  Doctors need do a better job of helping terminally ill cancer patients let go of false hopes without squashing all hope.

§  You don’t want to take away hope from patients. They’re not going to be cured but it’s not like they’re going to die instantly. So it is a really hard balance to achieve.

4. Most patients with incurable cancer still think they’ll survive, study finds

http://www.cbsnews.com/8301-204_162-57540242/most-patients-with-incurable-cancer-still-think-theyll-survive-study-finds/

§  Many patients who receive chemotherapy for incurable cancers still believe they can beat the disease, a new study suggests. The researchers behind the study question if patients are simply in denial or doctors are skirting the truth with their patients’ prognoses.

§  The research also highlights the problem of overtreatment at the end of life — futile care that simply prolongs dying.

§  For cancers that have spread beyond the lung or colon, chemo can add weeks or months and may ease a patient’s symptoms, but usually is not a cure. This doesn’t mean that patients shouldn’t have it, only that they should understand what it can and cannot do, cancer experts say. But often, they do not.

Dr. Thomas J. Smith of Johns Hopkins University School of Medicine and Dr. Dan L. Longo, question:

§  Whether patients are being told clearly when their disease is incurable. Patients also may have a different understanding of “cure” than completely ridding them of a disease – they may think it’s an end to pain or less disability.

§  If patients actually have unrealistic expectations of a cure from a therapy that is administered with palliative intent, we have a serious problem of miscommunication.

How should doctors have this difficult conversation with patients?

Smith told CBS This Morning that doctors should operate on an “ask, tell, ask” basis when patients are faced with a life-threatening illness. That means doctors should ask patients up front how many details they want to know about their illness. Then, they should tell patients in understandable terms their prognosis, such as by saying “based on people like you, you may have weeks or months.”

While some patients may have positive attitudes and think they’ll still beat the disease, Smith says he’ll tell patients that doctors won’t stand in the way of miracles, “but we can hope for the best but still need to plan for the worst.”

The study raises concerns about unnecessary but costly medical treatments for dying patients. Smith said having the difficult conversation with a patient about their end-of-life care may lower these costs because many patients may want to be comfortable at home, and not in a hospital. This really isn’t about saving money, so much as honoring people’s choices.”

Read more on CBS: Doctors unveil “Choosing Wisely” campaign to cut unnecessary medical tests http://www.cbsnews.com/8301-504763_162-57409204-10391704/doctors-unveil-choosing-wisely-campaign-to-cut-unnecessary-medical-tests/?tag=contentMain;contentBody

Should parents’ belief in miracles trump medical expertise in end-of-life decisions? http://www.cbsnews.com/8301-504763_162-57493154-10391704/should-parents-belief-in-miracles-trump-medical-expertise-in-end-of-life-decisions/?tag=contentMain;contentBody

Truth Is a Bitter Pill – Hard For You to Accept Reality

Chemotherapy Game Changer for Stage 4 Cancer http://www.envita.com/cancer/finally-chemotherapy-game-changer-for-stage-cancer/?UA-29060687-1

§  The current model and approach being used by numerous cancer centers and hospitals is the “germ theory.” This model aims to focus on destroying cancer cells using a “one size fits all” protocol.

§  The doctors at Envita explain that each person’s cancer is unique and cannot be put into one category or group even if patients have the same type and stage of cancer.

§  So why are cancer centers not using this approach to treatment? It is very difficult for large structured institutions and pharmaceutical companies to move quickly with the world’s modern technologies because they have so much invested in the old system.

§  The doctors at Envita noted that when patients were tested, over 75% of them were on the wrong treatments prior to coming to the center. No wonder so many patients are struggling with cancer!

The war on cancer

Back home in Malaysia, this is what Dr. Amir Farid Ishak wrote in his Star column. http://thestar.com.my/health/story.asp?file=/2012/10/28/health/12226744&sec=health

§  Chemotherapy is not necessarily the best strategy to fight cancer.

§  In several previous articles, I quoted several major reviews on chemotherapy, reported in the top peer-reviewed journals that concluded that chemotherapy only helped 2-7% of the cancer patients, at the cost of so much additional suffering, and enormous financial burden.

§  Oncologists and the medical community in general continue to believe that chemotherapy protocols should be continued despite the overwhelming scientific evidence to the contrary.

§  They then convince cancer patients that chemotherapy is essential if they hope to prolong their lives or recover from the disease. Yet, the scientific studies show that what is believed by the oncologists is not always the same as what is proven by the studies.

§  The most recent comprehensive review of the effectiveness of chemotherapy was published by three oncologists in 2004 in the top cancer journal Clinical Oncology (16:549-560), and the conclusion was that overall, chemotherapy contributes just over 2% to improved survival in all the cancer patients in Australia and the US.

§  In 2004, most of the other oncologists neither refuted nor changed their reliance on chemotherapy despite the conclusive evidence. Now eight years later, although no similar comprehensive review has shown any significant improvement, that review is said to be outdated by some oncologists.

§  What I lament is the painfully slow progress in cancer therapy, such that many are not saved. The US is arguably the most advanced nation medically, yet for 2012, the American Cancer Society expects almost 600,000 deaths from all types of cancer (including 160,000 from lung cancer, 50,000 from colorectal cancer, and 40,000 from breast cancer). One in four deaths in the US is due to cancer. There will be about 1.6 million new cancer cases this year. Those figures certainly show that we are far, far away from winning the war on cancer.

§  Have we won the war? Or have we the lost war?

§  I strongly encourage readers to read War on Cancer – A Progress Report for Skeptics (Feb 2010) by Dr Reynold Spector, clinical professor of medicine at the Robert Wood Johnson Medical School, US (www.csicop.org/si/show/war_on_cancer_a_progress_report_for_skeptics/). His conclusion: “… unlike the successes against heart disease and stroke, the war on cancer, after almost 40 years, must be deemed a failure with a few notable exceptions.”

§  While the oncologists continue to look for the latest chemo and smart drugs, it is my duty to highlight the fact that while the next promising drug will be amply funded to prove its effectiveness, the next promising nutritional therapy is likely to be abandoned because nobody wants to spend money on something that cannot be patented in order to recoup the costs, as well as make a handsome profit.

Comments

For the past 16 years, we at CA Care have been spreading the above message. Now, I am glad to say that cancer experts in the US are saying the same thing. I don’t think I have to add any more messages! But let me just share with you our frustrations over these years.

1.     Almost all cancer patients who came to us have undergone all medical treatments. Most of them are “medically written off.”

2.     And 70 percent of them come expecting us to cure them – they are seeking the elusive magic bullet. There is nothing wrong with wanting to find hope or not giving up hope, except that they are also the kiasu (only want to win) type . For this group of people, we would rather they go and find help elsewhere.

3.     The kiasus want healing on their own terms. They only want to hear what they want to hear. They want things easy and cheap. Boiling the herbs to help themselves is a big chore to handle. They don’t want to take responsibility for their own well being. They want a cure but they want to eat anything they like.

4.     Only 30 percent of those who come benefit from our therapy. They know what they are up against after being told the truth. They are determined to heal themselves and are willing to try. I have great respect and admiration for such patients.

5.     We are fully aware that patients come here to find hope. And telling them that they don’t have any more hope is a disaster. So we know we need to strike a balance. Correct, we cannot cure your cancer, because I believe that no one on earth can cure cancer either! That is the reality. My auntie had cancer. She had surgery and radiation. She thought she was cured. Thirteen years later, the cancer recurred in her lungs and she died. Where is the cure? And do I need to hide that reality to cancer patients?

6.     Make no mistake, I don’t want to mislead them or cheat them. But by telling patients this, do I deprive them of hope? Yes or No, depending whether you are a kiasu or not! If you are the one who only want to win and would not want to lose, you would not like what I say. You don’t want to face reality.

7.     By telling you the truth – that I cannot cure you, does not mean that you are going to die now! If you have been reading the stories in our CA Care’s website, you will note that those patients were told to go home and die, but they do not die. They continue to live! That is hope! At CA Care we have seen miraculous healing week after week and month after month. But, make no mistake, this healing is NOT cure – the cancer can come back again if you become complacent and irresponsible. But the unfortunate part is that many patients are just irresponsible. Period.

8.     So, by being honest and asking you to face reality we are not depriving you of that hope – on the contrary we provide you with new path and take you through another journey of hope. The only problem is this – the journey is not easy to travel and is not meant for the kiasu. I have enough documented stories to show you that you need not have to die yet if you are prepared to take the responsibility of your own healing into your own hands – you do your best and we do our best. And together we take this journey. Many remain healthy for years. Click on the success stories of our cancer patients and hear them tell you their stories. Just one example – I like to tell you the story of this sweet lady from Makassar. http://cancercaremalaysia.com/2012/05/05/cervical-cancer-stage-3b-health-restored-after-taking-herbs-and-giving-up-chemo-radiation-treatments/

9.     The kiasus like to hear only things that they want to hear. For example:

A.     Cancer can be treated! Many patients don’t realize that to be treated is one thing. To get cured is another. While writing this article, I have a lady who came for help. She brought her sister for treatment in a private hospital here and had already spent RM 100,000. A few hours ago, the doctor told the sister to bring the patient home quickly. She was not getting any better – in fact her health had deteriorated. Cancer can be treated for a long as you have the money to pay the bills (and preferable if you have a fat health insurance coverage!) Read my articles: Part 1: The High Cost of Staying Alive in a Private Hospital. Part 2: One or Two Dozens of Drugs A Day Could Not Help Her?

B.     With chemo, you have a 80% chance of curing your lymphoma! Patients love to hear that message of hope. And they believe such statistics! Here is one example. A lady with cervical cancer was told that she had a 98 percent chance of cure with chemotherapy and radiotherapy. She believed her doctor. Four months later the cancer spread to her lungs. And that is cure? I hear this kind of stories very often. http://cancercaremalaysia.com/2012/05/02/cervical-cancer-eighty-nine-percent-chance-of-cure-vanished-with-the-collapse-of-her-right-lung-four-months-after-radiotherapy-and-chemotherapy/

Here is another example. A breast cancer lady underwent chemotherapy, radiotherapy and took Tamoxifen for five years. Then cancer spread to her bones. She asked the doctor why she was not cured. The answer was: It is your fate. But the recurrence has nothing to do with what you eat. It is just your fate. Believe that? Where is the so-called science in cancer treatment? http://cancercaremalaysia.com/2012/05/12/breast-cancer-when-a-so-called-cure-was-not-a-cure/

 

 

Breast Cancer: A War Lost After Mastectomy, Reconstructive Surgery, Chemo and Radiation

Posted on 25/09/2012 by CA Care

Cellulitis After Breast Reconstruction Surgery and Chemo

The file of EC laid buried on my table for almost four years. At first I thought I wanted to write her story but then perhaps it was not necessary – let her secret go away with her, buried in her grave! But on 13 August 2012, a lady came to our centre for help. She too had breast cancer. And her story resembled EC’s case. This make me think again – I should write this story!

EC – an Indonesia female, was 40 years old when a mammogram on 29 August 2003, showed the following results:

Following further evaluation, EC was diagnosed with breast cancer. She subsequently underwent a biopsy leading to a right mastectomy with axillary clearance. At the same time she had a right breast reconstruction with latissimus dorsi flap and saline implant. The histology reported a Grade 3 ductal carcinoma measuring 2.5 x 2 x 1 cm. Three of 17 dissected lymph nodes showed metastatic disease. None of the 2 lymph nodes in level 2 showed metastatic disease.

The immunohistochemistry showed the tumour had hormonal receptors as below:

Taking into account of the 3 involved lymph nodes, EC was started on adjuvant chemotherapy with Cyclophosphamide and Andriamycin (A + C) for 4 cycles. Another 4 cycles of taxol was schedule after the AC. However, the use of taxol had to be aborted due to severe reaction and complications as explained by her oncologist’s report dated 6 January 2004:

She tolerated chemotherapy fairly well with growth support using Granocyte. Although she is not diabetic on repeated measures, she unfortunately developed repeated episodes of skin infection following the last dose of Cyclophosphamide and Andriamycin.

There was substantial celulitis over the implanted right breast. For that reason, EC is finding it difficult to proceed with further chemotherapy with the fear of recurrent flare of cellulitis.

Since there is a fear of further exacerbation of her cellulitis with ongoing chemotherapy, Tamoxifen for 5 years was proceeded instead. As she has already achieved post menopausal status, there is no further recommendation for ovarian ablation at this stage.

EC took Tamoxifen from 2003 to 2005. She received Zometa injection (for bone) ever six-monthly.

Her progress was monitored regularly.

1.     3 April 2004: Mammogram and ultrasound of her left breast and CT of thorax and abdomen showed everything in order. A bone scan on 5 April 2004 showed no specific evidence of bone metastasis.

2.     21 March 2005: Mammographic findings are unchanged. On the four-quadrant ultrasound examination, there are two hypoechoic nodules demonstrated within the left breast. These are benign looking lesions. These ultrasound finds are already present in a previous examination dated 3 April 2004 and allowing for technical differences, are essentially unchanged. CT scan of the thorax does not reveal any mediastinal lymphadenopathy or pulmonary nodules. Two hypodense lesions demonstrated in the liver were also seen previously with no significant interval change in size or in character. These may represent small hepatic cysts. Bone scan showed no specific evidence of bone metastasis.

3.     (Note: Tamoxifen was stopped and changed to Arimidex in 2005 until 2008).

4.     27 March 2006: No suspicious lesion is seen in the left breast. A small cyst is seen at 9 0’oclock position. The other cyst demonstrated previously is not seen today. Ultrasound of abdomen showed liver is normal in size and there are two small cysts present. These are likely to correspond to the hypodense lesions seen in previous CT scan done in March 2005. No solid mass seen. No pulmonary nodules demonstated. No hilar masses seen. No specific evidence of bone metastases.

5.     5 July 2007: No mammographic evidence of malignancy. Tiny left breast cyst. No focal solid mass lesion is visualised. Ultrasound of abdomen showed a 1.9 x 1.7 x 1.5 cm anechoic cyst in segment 7 of the liver. This appears to have shown slight interval increase in size. The previously noted subcentimetre cyst in segment 6 is no longer seen. No other abnormality is seen.

6.     17 December 2007: Bone scan showed no specific evidence of any new bone metastases. Ultrasound of liver showed no sonographic evidence of hepatic metastases apart from a 1.9 x 1.8 x 1.6 cm anechoic cyst in segment 7 of the liver.

7.     15 January 2008: Due to rising tumour markers, PET was ordered to assess for recurrent disease. The cancer had spread to her brain.

EC underwent a craniotomy or brain surgery to remove the tumour. Her tumour was consistent with metastatic carcinoma, possibly breast.

Oral drug Arimidex was abandoned and EC was given Aromasin instead. Zometa injection was continued as usual – every six-monthly.

11 February 2008: EC received 5 times of stereotactic radiotherapy to her brain.

17 July 2008: The cyst in her liver seemed to grow bigger.

EC received another 5 times of stereotactic radiotherapy to her brain.

20 October 2008: Her brain surgery and 10 radiation treatment did not cure her brain cancer. The tumour recurred.

24 October 2008: EC and her husband came to Penang to seek our help. EC was prescribed Capsule A, Brain 1 and Brain Brain 2 teas and Breast M, C-tea plus Brain Leaf Tea.

Comments

Unfortunately EC was not able to follow our therapy properly. We always tell patients – our herbal teas are smelly and taste awful. They have to be brewed and this could be a great chore indeed. And if you have undergone chemo and radiation, the chances are that you will suffer when you first start taking the herbs. Well, but that could not be as bad as the chemo or radiation side effects. Nevertheless, some people are less tolerant when they come to us. The reality is – they expect magic even if medical science has failed them.

We did not get to meet EC and her husband again after their initial visit to us. They had decided to continue with more medical treatments. When nothing worked, EC decided to give up and turned to God for a miracle. She then died.

EC and her husband told us that after the reconstruction surgery and chemotherapy, her breast became red, swollen and painful. I wondered what could have caused this. If you read the oncologist report above, an innocent-sounding terminology was used –cellulitis. What doesthis actually mean? The word cellulitis means inflammation of the cells. Specifically, cellulitis refers to an infection of the tissue just below the skin surface.

The following are information from the internet when I searched for breast reconstruction and cellulitis,and breast implant infection.

Someone posted this question – Is cellulitis of a reconstructed breast (after breast cancer) common?and she wrote: I have gotten cellulitis of my reconstructed breast three times in the last six months. The first time I was hospitalized for a week. I was very sick and it was very painful. Is this a common occurrence? http://www.medpedia.com/questions/1823-is-cellulitis-of-a-reconstructed-breast-after-breast-cancer-common

The Answers:

§  Cellulitis is an inflammatory reaction involving the skin and underlying subcutaneous tissue. Patients who undergo surgery for breast cancer, whether in the setting of breast conservation or mastectomy, are at risk of developing infection at the surgical site and in soft tissue. Surgical trauma predisposes patients to skin infection. Postoperative skin infections develop after 2%–7% of all surgical procedures. The incidence of surgical site infections is 12.4% following mastectomy with immediate implant reconstruction.

§  Infection following breast implants is an uncommon event. This is somewhat surprising, since the human breast is not a sterile anatomical structure. Treatment of the periprosthetic infection usually involves implant removal, but salvage by systemic antibiotics is sometimes possible. ( http://www.ncbi.nlm.nih.gov/pubmed/2663982)

§  Infection can occur with any surgery. Most infections resulting from surgery appear within a few days to weeks after the operation. However, infection is possible at any time after surgery. Infections with a breast implant present are harder to treat than infections in normal body tissues. Toxic Shock Syndrome has been noted in women after breast implant surgery, and it is a life-threatening condition. Symptoms include sudden fever, vomiting, diarrhea, fainting, dizziness, and/or sunburn-like rash. A surgeon should be seen immediately for diagnosis and treatment for this condition. http://www.lookingyourbest.com/info/breastimplant-complications.php

§  Infection is the leading cause of morbidity that occurs after breast implantation and complicates 2·0—2·5% of interventions in most case series. Two-thirds of infections develop within the acute post-operative period, whereas some infections may develop years or even decades after surgery. http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(05)01281-8/abstract

Complications of Breast Implants

§  After having breast implant surgery, about 30% of women will require further surgery within 10 years of their initial operation.

§  Additional surgery may be needed as a result of complications such as capsular contracture (hardening of the scar capsule around the implant, see below), age-related changes to the breast or the shell of the implant rupturing (splitting).

§  If you are having an implant fitted for breast reconstruction following a mastectomy (breast removal) you may have a greater risk of infection and bleeding.

§  Most infections can be treated using antibiotics. But if your breast becomes severely infected, you may need to have the implant removed to prevent further complications developing. You should be able to have the implant re-inserted once the infection has cleared up. http://www.nhs.uk/Conditions/Breast-implants/Pages/Complications.aspx

Why not solve one problem at a time?

I am fully aware that for some ladies losing a breast is most traumatic. Many patients come to us with rotten breast and they still harbour the hope that I would say herbs can cure their breast cancer. When I suggested removal of their breast, they hesitated. To get the message across I said this: You choose – you life or your breast. In the 16 years dealing with cancer patients, I rarely come across patients who had breast reconstruction after a mastectomy. I also understand some ladies are very sensitive about their body image. They want their breast replaced immediately after losing one.

One lady told us, she only agreed to undergo a mastectomy after her husband promised that she could go for a breast reconstruction. While writing this article, one lady came. She has just had a mastectomy. I asked her: How is it like – the mastectomy? She replied: I don’t know. I went in and when I came out I felt one breast was gone. Then I knew that it was cancerous. This lady just laughed after that! To her saving her life comes first. She and her surgeon had made an agreement that she would not want a needle biopsy but rather the tumour be removed and tested immediately. If it was found to be malignant, the surgeon would proceed with the mastectomy right away.

I just wonder – why does someone want to rush into trying to fix problems all at once – immediately? Removal of the cancerous breast is not a cure. The cancer can recur. Would it not be sensible to wait until everything looks promising first before you move to the next problem of the missing breast? If there is a flare up of cellulitis as in the above case, are you not making your problem more complicated? Why not solve one problem at a time?

Posted in Breast Cancer, Failure Story | Tagged brain metastasis, breast cancer, cellulitis, chemotherapy, mastectomy, reconstructive surgery

Breast Cancer: Herceptin and Brain Metastasis

Posted on 20/09/2012 by CA Care

She Might Have Won Many Battles But Ultimately She Lost Her War

The thick file of SA laid buried on my table for the past three years. Perhaps I should write her story. May be some patients can learn some lessons from her tragic experience.

SA’s problem started in 2006 when she felt a pea-sized, painless lump in her left breast. She went to Singapore for evaluation.

Bilateral mammograms on 6 March 2006 showed an irregular solid mass, measuring 29.4 x 17 x 23.2 mm with abnormal blood flow within it. Ultrasound of the liver showed normal size, configuration and echnogenicity. No focal lesions seen. Whole body bone scan was normal with no specific evidence of bone metastasis.

SA subsequently underwent a total mastectomy on 10 March 2006. The pathologist report indicated a poorly differentiated invasive ductal carcinoma with lymphatic and vascular infiltration. This was classified as T2NoMx (Stage 2A).

The tumour was negative for oestrogen and progesterone receptors. It was strongly positive for C-erb-B2 and moderately positive for P53. These imply that the breast cancer is unlikely to show any response to tamoxifen / hormonal therapy.

After surgery SA underwent six cycles of chemotherapy with FEC (5-FU + Epirubicin + Cyclophosphamide). No radiation or oral medication was indicated.

SA was well after the chemotherapy. She went back to her doctor every six months for routine checkup. Nothing was amiss. But about two years later SA started to have coughs for about a month. SA went to Kuala Lumpur and underwent a whole body PET CT scan on 28 April 2008,

§  Her brain and neck showed no abnormality.

§  There were multiple nodules in both lungs. Possibility of lung metastasis.

§  A 2.5 x 2.6 x 3.2 cm FDG-avid lesion was seen in the right lobe, segment of liver. Possibility of liver metastasis.

§  Extensive hypermetabolic nodal involvement in the thorax and left supraclavicular region.

SA was then advised to have chemotherapy but she decided to return to consult with her Singapore doctors. An ENT surgeon detected vocal cord paralysis. Another cancer specialist performed a biopsy of her left supraclavicular lymph node on 6 May 2008. It showed metastatic adenocarcinoma consistent with a primary from the breast. The tumour was strongly positive for HER-2. SA’s Stage 2 cancer had turned into a Stage 4.

SA consulted another oncologist.

Subsequently SA underwent another round of palliative chemotherapy with Herceptin + Vinorelbine and Xeloda.

A repeat CT was done on 9 July 2008. The result showed a reduction in size of the pulmonary and liver masses and resolution of the mediastinal and hilar lymphadenopathy.