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Breast Cancer: Fancy Gadget and Half A Million Ringgit Failed to Cure Her – What Now?
May (not real name) is a 39-year-old-female. In mid-2008 she delivered her child. Two months before delivery, she noticed the hardening of her left breast. Ultrasonography did not show anything wrong. The doctor suggested it could be due to the breast being engorged with her milk. Although she breast fed her baby the breast remained hard. There was no problem with her right breast. She went to consult order doctors and all of them came to the same conclusion – no problem!
Utrasonograhy of her breasts on 1 December 2008 indicated diffused inflammatory process. The left nipple was retracted. Conclusion: probably diffuse mastitis. A biopsy is advisable. Subsequent needle biopsy done did not show any malignancy. Not satisfied, a tru-cut biopsy was done on 29 January 2009. The result showed atypical proliferation of cells suggestive of an intra ductal carcinoma. An open biopsy of the breast lump confirmed invasive ductal carcinoma with high grade intra-ductal carcinoma.
May sought a second opinion from a doctor in a private hospital in Singapore. The histology slide was restudied. It was concluded that it was a ductal carcinoma in-situ, intermediate grade with comedonecrosis and infiltrative ductal carcinoma.
CT scan done on 31 January 2009 showed: a) no metastataic deposits in the liver, b) several rounded sclerotic lesions seen in the thoracic and upper lumbar spine suspicious of metastatic lesions, c) a tiny nodule in the upper lobe of the right lung – probably a solitary pulmonary metastatic nodule. A bone scan confirmed bony metastases at the left scapula, left third rib and sites along the spine.
Histopathology report showed carcinoma cells are immunopositive for oestrogen rerceptors and progesterone receptors. HER2 oncoprotein is overexpressed.
May was advised to start chemotherapy immediately. The first chemo-treatment started on 2 February 2009. A pump was fitted to continuously deliver 5-FU. May also received two doses of Navelbine for each 5-FU cycle. In addition, May was given Zometa for the bone. In total May received 13 cycles of chemotherapy from February 2009 to October 2009.
At this point I asked two questions:
1. What did the oncologist say about the chances of a cure? The answer was: The doctor said there would be no cure. The treatment was only to control the problem.
2. You must have spent a lot for this treatment? The answer: Yes, approximately RM 500,000. That is half a million ringgit – right? Yes, it is.
A CT scan on 27 April 2009 showed: a) a solitary pulmonary nodule in the right middle lobe. This measures less than 5 mm. It shows no change from previous examination, b) multiple sclerotic bony lesions. These were already noted in the previous CT scan.
May went to China for another opinion in May 2009. A PET /CT scan was done. The doctors in China concluded that May’s condition had stabilised and there was no need for treatment.
A CT scan done on 12 October 2009 showed the cancer had stabilised. However, throughout the whole month of October 2009, May complained of headaches, pains in the neck and shoulder. The oncologist said the pains had nothing to do with her cancer!
In October 2009, May completed her 13th chemo treatment in Singapore.
In November 2009, May went to India for further treatment using the Cytotron (Cytotron is the trade name of the device developed in India. It looks like a MRI machine that uses Rotational Field Quantum Magnetic Resonance Generator).
May received an hour of Cytotron treatment per day. While undergoing the Cytotron treatment, May continued to receive the 5-FU-Navelbine regimen (the 14th cycle). The treatment was scheduled for a total of 28 days but after the 20th tretment, May developed bad coughs and chest pain. The doctor thought this was due to pneumonia and she was given antibiotics and cough syrup. An X-ray indicated left pleural effusion (i.e., fluid in the lung). A week later the pains still persisted and the coughs became bad whenever May moved. A CT scan was ordered and revealed pulmonary embolism (blockage of the arteries in the lungs by blood clots that travel to the lungs from other parts of the body). May was put on Heparin, an anti-blood coagulation medication.
May returned to Malaysia in mid-December 2009. May started to have pains again. Her shortness of breath also persisted. She coughed wherever she moved. The oncologist in Kuala Lumpur mentioned that the cancer appeared stable and there was no hurry to continue with chemotherapy but the pulmonary embolism had to be resolved first. May was prescribed Warfarin. Her pulmonary embolism cleared off.
A PET CT scan on 23 February 2010 showed stable results. The oncologist said no further chemotherapy was necessary for the time being. But May had to continue receiving Bonefos (for the bone). In addition May was started on Tamoxifen beginning March 2010.
In June 2010, May’s left breast hardened again. The oncologist did not think chemotherapy was necessary but May was asked to continue with her Tamoxifen and Bonefos.
In July 2010 the skin colour of her left breast turned dark. A PET scan on 29 July 2010 indicated increased FDG avid activity and this could represent an inflammatory process of tumour activity. There was also increased FDG uptake in the thymus. At this point, the oncologist suggested a mastectomy.
On 2 September 2010, May had her left breast removed. There were some wound infections after the surgery and it took two months to recover. The histopathology indicated invasive ductal carcinoma, grade 2 with a few foci of ductal carcinoma in-situ, high grade. Twelve of the 13 lymph nodes were completely infiltrated by malignant cells with infiltration into the surrounding adipose tissue in 4 nodes.
On 20 October 2010, there was a slight swelling in May’s right breast near the nipple. Ultrasonography of the right breast did not show anything wrong. May was prescribed antibiotics. Since there was no improvement, a needle biopsy was done on 27 October 2010. The right breast tissue showed invasive ductal carcinoma.
The doctor suggested mastectomy of the right breast. This would be followed by radiation treatment for the left breast. There would also be radiation treatment for the right breast after the wound has healed. Bonefos would be changed to Zometa.
A PET scan done on 10 November 2010 showed cancer activity in the right breast.The bone lesions which were stable before had now become active. In view of this, the oncologist suggested more chemotherapy.
May underwent 3 cycles of chemotherapy using a combination of 5-FU, epirubicin and cyclophosphamide (FEC) together with Zometa. The 3rd FEC cycle was completed on 14 January 2010.
How CA Care Got Into the Picture
On 3 November 2010, we received this e-mail:
I am Don (not real name) and came across your website while searching for some alternative cancer treatments. My wife was diagnosed with breast cancer stage 4 in February 2009. She had undergone chemo and just recently did a mastectomy of her left breast. Unfortunately now her right breast is also affected. Last week the biopsy shows it is an invasive ductal carcinoma. Doctor is suggesting another mastectomy but we are worried as we don’t think it can help.
Can you help us? How good is your treatment? Can I send you the reports for review?
Hope to hear from you soon.
On 14 January 2011 was another e-mail:
I would like to come to Penang and meet you to discuss regarding my wife. I have got the latest scan results with me. What are the days and time convenient for you to see patients?
Actually before these e-mails, Don came to our centre to collect some herbs but did not take them due to lack of confidence. Then she started to receive her first chemo treatment and suffered severe side effects. She had headaches, felt nauseous and was dizzy.
Before receiving her 2nd cycle of chemotherapy, May started to take our Chemo-tea. The side effects of this second chemo treatment were reduced by about fifty percent. This built up her confidence in our herbal teas. When May had her 3rd cycle of chemotherapy, she felt even better.
The War Has Not Ended Yet – perhaps a “surge” is just about to begin
May was scheduled to receive three more cycles of chemotherapy. This time the drugs to be used are Taxotere plus Herceptin. May is supposed to receive Herceptin indefinitely once every 3 weeks (but at least a year). May is also to receive Zometa once every 3 months.
From March 2010 to end of July 2010, May was on Tamoxifen. According to the oncologist since there was a recurrence, Tamoxifen was therefore not effective. He is of the opinion that May should switch to another drug – the newer generation of aromatase inhibitor. But for the aromatase inhibitor to be effective patient must be in her menopause. So to achieve this menopause, the oncologist suggested removal of May’s ovaries.
Don (husband) came to our centre in Penang and told us the above story on 18 January 2011.
1. The Breast Cancer War – fancy gadget plus half a million ringgit
Most patients (especially those who never had the experience of having a family member undergone medical treatment for cancer) have the misconception that after surgery / chemotherapy, their cancer will go away. Unfortunately, this is far from being true. Read the following two quotations.
Amy Soscia, a cancer patient said: There is no cure for metastatic breast cancer. It never goes away. You just move from treatment to treatment.
A renowned oncologist in Singapore wrote: Oncology is not like other medical specialties where doing well is the norm. In oncology, even prolonging a patient’s life for three months to a year is considered an achievement. Achieving a cure is like striking a jackpot.
In a review entitled: In the End What Matters Most? A Review of Clinical Endpoints in Advanced Breast Cancer (Oncologist, January 2011; 16:25-35), Sunil Verma et al, wrote:
– Many agents are being studied for the treatment of metastatic breast cancer (MBC), yet few studies have demonstrated longer overall survival, the primary measure of clinical benefit in MBC.
– Of the 73 phase III MBC trials reviewed, a strikingly small proportion of trials demonstrated a gain in overall survival duration (12%, n = 9).
From the very beginning May was told the treatments she received were to only control the situation – and in this case, where is the control? Almost half a million ringgit has been spent but May was not getting any better. In fact her condition became worse. She is starting the second phase of another battle now that the cancer had spread to the other breast, after one had been removed. The war will go on. Based on the review paper published in The Oncologist a week ago, the overall survival advantage due to chemotherapy could just be an illusion.
Can we not learn a lesson from May’s experience? Albert Einstein said: Insanity is doing the same thing over and over again and expecting different results.
2. Total Commitment – do you really believe in herbs?
Not all patients who come to seek our help believe in what we do. We are firm in saying that It is not for us to “influence” you to follow our ways. This has to be entirely your choice.
We are fully aware that after spending thousands of ringgit on the so-called scientific, high-tech treatments provided by the best brains in medicine, it is hard to believe that some roadside weeds could help your cancer. To the educated mind it seems like a big joke. So believing in what we do is an important ingredient for success. Past statistics showed us that only 30% of those who come are really committed or believe in what we do.
3. Chemo-Tea Helped Her – she gained more confidence
I told Don that I would be writing this story. Otto von Bismarck wrote: A fool learns from experience. A wise man learns from the experience of others. So the main aim of writing this story is to share May’s experience with others – perhaps those who wish to learn would not have to experience similar bitterness.
Some patients believe even before they experience, but others need to experience before they can believe. It is a choice.
4. Cancer War – In a war, no one ever wins!
Tragic stories about breast cancer war abounds. But all is not lost. There are some patients who have the guts to say: “Chemo? No thank you!” Many of them survived to tell their sweet stories.
Let me close by quoting Dr. Bernard Jensen (in Empty Harvest): “While the situation is dire, should fear be the correct catalyst for change? I don’t think so. For fear is a disease in itself – a disease of the mind. Therefore, it is not out of fear, but courage, that mankind will be most effective in restoring health and harmony.”
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