Sometime in early August 2007, Swee (not real name, 71-year-old woman from Indonesia) coughed up blood-stained phlegm. He consulted a general practitioner who ordered an X-ray, suspecting that he might have tuberculosis. The x-ray showed a tumor in his lung. Later, she was referred to a specialist who performed a computed tomography scan and found “a soft tissue mass measuring 4.8 x 3.9 cm with lymphadenopathy of the right lung.” It was a 3A cancer. A biopsy was recommended, but Swee refused and decided to go to Penang for a second opinion.
In Penang, a bronchial biopsy was performed and the result confirmed the previous diagnosis. It was a “poorly differentiated, infiltrating carcinoma.” Swee was referred to an oncologist for chemotherapy.
The day before Swee was scheduled for chemotherapy, she received a phone call from a relative telling her to go for treatment in China. This he did without hesitation.
Swee was treated in a private hospital in China for 28 days. He underwent the following treatments:
1. Chemotherapy with Navelbine.
2. Argon-helium cyroablation. Three cryoprobes were inserted into the lesion and the entire freezing process was monitored with computed tomography until the “ice ball” completely covered the target mass. After two freeze-thaw cycles, the cryoprobes were removed.
3. Implantation of radioactive iodine seeds. Under guided computed tomography, 15 radioactive iodine-125 seeds were implanted in the tumor mass.
Doctors concluded that these treatments were successful. Swee was allowed to return home to Indonesia.
In November 2007, Swee returned to China for his second round of treatment. This visit lasted fifteen days. He underwent the same treatments: chemotherapy with Navelbine, cryoablation and implantation of iodine seeds. According to the doctors, the second procedure was carried out successfully and the patient’s condition improved.
According to her, who accompanied her to China, Chinese doctors suggested that Swee undergo a total of six treatments. Her son said: “The doctors assured us that the tumor will disappear, but at the same time they warned that the cancer can spread to other parts of the body. There is no guarantee that it will not spread. He told which part of the body it will spread to.”
After Swee returned home, his family members faced a dilemma. They did not have the funds to continue additional treatments in China. The cost of her first treatment was 87,000 yuan. The second treatment costs 57,000 yuan. Swee wanted to sell the house the family is staying in to finance his treatment. His five children (two sons and three daughters) weren’t sure if this was the right thing to do. This is because there is no certainty that Swee is fully healed.
Swee’s son came to see us in December 2007 and wanted to know the following:
1. What should they do?
2. If it is possible to take our herbs and at the same time undergo the Chinese treatment, in case they decide to return to China. This is in the hope that the herbs can help Swee in some way where medical treatment cannot.
I told the son that the main point to seriously consider is the possibility of the cancer spreading to the brain. Nobody can stop that and the possibility of this metastasis is very high. To this, the son said: “Yes. While I was in the hospital in China, I have seen some patients who suffered like my mother and who underwent similar treatments. About six months after the treatment, the cancer spread to the brain. doctor also said to me that the type of cancer my mother has is very aggressive and there is a 90% chance that it will spread to other parts of the body. There is no guarantee that it will not spread. “
Comments
It is very difficult for me to advise in this case, except to say that based on my reading of the medical literature, lung cancer is fatal and the chances of a cure are nil. But how can I get this message across in a way that is not traumatic for patients and / or their families?
Alexander Spira and David Ettinger (Multidisciplinary Lung Cancer Management. New England J. of Med. 350: 379-392) wrote, “Despite years of research, the prognosis for lung cancer patients remains dire.”
According to Stephen Spiro and Joanna Porter (Lung Cancer: Where are we today? Amer. J. Respiratory and Critical Care Med. 166: 1166-1196): “Although chemotherapy may be a logical approach, there is practically no evidence that it can curing NSCLC. The monetary cost … is high. The other cost of chemotherapy is its toxicity and its potential detriment to quality of life. Disappointing as it may sound, this sums up the reality of the situation. “
Even if what I say (lung cancer has no cure) may be true, generally patients would not take it kindly or believe me. They want a cure and they hope for a cure with the treatment that is offered to them. If we offer them herbs and teach them to change their lifestyle in hopes of prolonging their lives or promoting the quality of their lives, they still insist that we communicate the possibilities of healing to them.
This email for me is a good example to illustrate my point. “Patients have total confidence in doctors to prescribe the best treatment methods, that is, to put their lives in the hands of doctors. Those big drug companies … prove to be quite convincing in their scientific explanation to this day. That is why a Many patients still prefer their medications. In contrast, herbal treatment does not offer an explanation of how herbs work and to what extent they can help patients. In other words, there is also no guarantee that taking herbs will make you feel better. Similarly, if I must ask you personally how and to what extent your herbs can help the patient, I don’t think I can expect a concrete answer. Again, you could say that it is up to the person to decide and put his / her faith in whatever decision is made. It is like telling the patient to choose what they think is the correct drug. I don’t think this is very correct. If I know for a fact that something works, be it herbs or drugs, I wouldn’t be scared to compromise and defend the fact that it will work.
There are questions that patients may ask when considering their herbs as an alternative treatment, such as: Can you safely say that your herbs work much more effectively than modern treatments? “
I fully understand that patients want a guarantee or promise of cure. But our experience tells us that there is no cure for cancer, either in an early stage or in a terminal stage. Telling patients otherwise is cheating by misleading or misinforming them. For us, curing (note the use of the word cure, not cure) cancer is not just about taking herbs. Most patients did not understand that they must first learn how to help themselves by changing their lifestyle, diet, and mindset if they want to find the cure. Unfortunately, this change is a very difficult thing for patients to do. In this case, your son told us that Swee is not a person who is willing to change. She is not ready to change her diet and believes in eating everything she likes. The argument is: “Why can’t I eat anything I like? I’m going to die anyway.” It did not occur to Swee that it could be the unhealthy lifestyle and diet that led to her husband’s death (complications of hypertension, diabetes, etc.) from cancer (NPC).
Second, the herbs are not going to taste good and the son has no hope that Swee will want to drink them. In short, most patients like Swee are only interested in finding the cure on their own terms. They seek that elusive magic bullet to heal them.
Drs. Richard Deyo and Donald Patrick, professors at the University of Washington, Seattle, USA, in their book, Hope or Hype: The Obsession with Media Advances and the High Cost of False Promises, wrote:
1. We are born “with our own blind trust in a medical establishment that feeds on our deepest fears, while pretending to come to our rescue with” miracle cures. “
2. “The combination of industry greed, media hype, political expediency, and our own ‘techno-consumer’ mentality is increasingly leading to a reliance on expensive treatments that are marginally effective at best. and sometimes downright dangerous. “
3. “When the options involve new treatments, the assumption is almost always that more and newer can only be better. Conveniently, this position almost always coincides with financial self-interest.”
4. “It is said that physicians are always too willing to prescribe the latest drug without even looking at the evidence that makes them happy, makes patients happy, and makes drug rep happy.”
We do not believe there is a magic bullet for cancer. We are not faithful to our cause and we betray our mission if we say or act as if we have one. It is difficult for many to understand that we are here trying to help. We don’t feel like pushing our herbs. We do not set any sales targets and we do not intend to conquer new markets. Our work is driven by love and compassion, not profit. If there is ever any assurance or assurance that patients get from us, it is this: “Try the herbs for a week or two. If the patient does not improve, stop taking our herbs and find someone else to help you.”
Let me conclude with this story. Lung cancer was previously treated with Iressa. When Iressa was first launched, the media hailed it as: Tomorrow’s Drug; The miracle drug; The smart drug; Miracle Cure: the drug that rises from the ashes and several other superlatives.
The message to the world was clear: “A breakthrough is at hand, there is great hope and great anticipation. Lung cancer patients no longer need to die. A miracle drug is finally here.” The US Food and Drug Administration has approved its use. This makes it even more compelling. This is the kind of assurance cancer patients around the world want before they swallow their first pill, including the author of the email above.
In an article: Iressa should never have been original original ([http://npojip.org/iressa/iressa] ISDB-Feb-2.html) Rokuro Hama wrote: “An estimated 23,500 people in Japan have been administered Iressa so far, 644 of them suffered adverse reactions. Of these 183 have died. The drug was approved in July 2002 in Japan and at the end of January 2003, just six months later, the death related to the adverse reaction to Iressa had reached 183 “.
In western countries, Iressa withdrew and was shown to be no longer effective despite the previous big media uproar. But in Eastern countries, Iressa is still prescribed to many cancer patients, even today. The patient must spend between RM7,000 and RM8,000 for a month’s supply of Iressa. With the removal of Iressa, some oncologists turn to another drug called Tarceva, a sister drug to Iressa. A Tarceva pill costs RM 270, which is estimated at RM 8,100 for a one-month supply. Is Tarceva effective? The company’s website said it has been shown to have increased overall survival by 37% and shown significant benefits in symptoms by prolonging the time to symptom progression. Doctors and patients love that security. The scientifically generated statistic cited is truly impressive. But what does 37% mean? The truth is, if you take Tarceva, you can live 9.5 months and if you don’t take Tarceva, you only live 6.7 months. In real terms, Tarceva only increased survival by 2.8 months.
What do patients think of this insurance? Do patients know or are they informed about this? Remember, this promise of being able to live 2.8 more months comes with a price tag of RM 8,000 per month.