CANCER CARE MANAGEMENT

Cancer is a dreaded life threatening disease that is affecting more and more people lately. There are some factors contributing to cancers namely, genetic predisposition, environment, diet, lifestyle and habits, infections and some other unknown causes.

Most patients would go for conventional cancer treatment at the hospital that offers chemotherapy, surgery or radiotherapy. And these are the recognized medical therapies that are covered by medical insurance. Despite the advances in medical therapy, the fact remains that the 5 year survival rates for most cancers have not improved significantly over the past 50 years. I must agree that chemotherapy, surgery and radiotherapy has saved, helped and benefited many patients. Therefore whenever appropriate, I would encourage patients to go for such treatment if such treatment would help improve survival rate and enhance quality of life. To advise against such possibility is simply wrong.

However, there are many patients who has succumbed to such treatment. I shall not go into why chemotherapy, surgery or radiotherapy has failed to help patients especially in advanced Stage 4 cancers. Suffice to say that conventional cancer therapy has it successes and failures just like any other medical therapies. To claim that any medical therapy has succeeded 100% all the time for all patients is nothing short of charlatanism.

In this age where information technology is so assessible, patients are able to google for any information they want, just like how you have arrived here reading this blog. Of course there will be conflicting opinions on any subject on the internet. It is important for patients to make medical decisions with medical professionals for their own safety. Do not believe blindly everything you read on the internet. Do your own research. Talk to your doctor, then make a decision.

In my practice, I have encountered 3 categories of cancer patients who has made a decision not to go for conventional cancer treatment namely surgery, chemotherapy or radiotherapy.

The first group of patients are those who are diagnosed with advanced Stage 4 cancers where conventional cancer therapy would be futile. These are the patients who are 'given' 3 months or 6 months to live by the oncologist. They are asked to go home and make preparations for their imminent death. So I was sometimes involved in the palliative management of these patients in terms of providing whatever medical assistance necessary in terms of pain management, wound care, bed sores, feeding tubes, nutritional support and etc. so as to provide comfort and minimize pain as much as possible. The aim here is to improve quality of life whenever possible and not cure.

The second group of patients are those who have started chemotherapy or radiotherapy and half way through the treatment protocol, were unable and unwilling to continue further because of the side-effects. When such patients come to see me at this point, as a primary care physician, it is my obligation to encourage patients to continue their treatment at the oncology centre if the evidence is showing that their cancers are improving significantly. I would appreciate much when my highly esteemed oncologist colleagues would give me a medical note with the plan to strategize the return of these patients back to the hospital to continue treatment. Quite often, I have patients who do not have any idea what they are having and what treatment they are going through in the hospital. All they cared about is that the treatment is unbearable and felt that they are not getting better. In fact it is making them worse and they do not wish to continue knowing fully that they themselves are accountable for the decision. At the end of the day, it is up to the patients to decide what is the best for themselves.

The third group of patients are those who had completed surgery, chemotherapy and/or radiotherapy and are declared 'cancer free'. And so they are told that they can eat anything they wanted because they are cured. Unexpectedly, they were shocked with the discovery of cancer relapse not long after completing treatment. As though that is not disappointing enough, the cancer has spread and became Stage 4. The first thought that comes to the patient's mind is, "How could this be?! I have gone through so much suffering and side-effects and thought I was cured." There are patients who are offered more chemotherapy which they adamantly refuse. Usually those who refuse would have realized by now that a Stage 4 cancer relapse has little hope for cure. Treatment is now aimed at maintaining quality of life as much as possible.

All the 3 categories of patients have valid reasons to refuse conventional therapy. The question is what options do they have? I could see their desperation and helplessness at this point when they become vulnerable to all suggestions of 'cure'. They would come to me and seek for opinion about some direct sales supplements or diet introduced by their friends and relatives. They would come for reassurance about the safety of herbs that they are taking from traditional healers. They would bring to my clinic some gadgets claiming to shrink cancer cells in the most extra-ordinary way. I realized that these patients are doing all sort of things suggested by all sorts or people. It is so disorganized and so confusing to the patient and the doctor.

The doctor can either rubbish off everything that seems foreign and unexplainable and continues unperturbed in his comfort zone. I seemed to attract these patients not because I am any better than my colleagues. I simply gave them my precious time to listen to their sufferings, hopes and fears. This is the least that I could do without being judgmental about the supplements or herbs that they consumed and the routine Qi gong that they practiced or the bio-electric chair/bed that they sleep on or the Bioresonance treatment course that they have committed. I am contented to see them preoccupied with something that they perceive as useful. My part as a medical practitioner is to provide an objective assessment of improvement or deterioration clinically. Their energy level, appetite, weight, pain level, quality of sleep, bowel and urinary habits, range of movements, mobility and mood are assessed clinically. An objective feedback is given to them to gauge if what they are doing on their own as an alternative to cancer treatment has a positive or negative effect. And because there is nothing more that my esteemed oncologist could offer this group of patient, the least that I could do is to 'pour cold water' on their effort to get well, no matter how hopeless it may seem. If there is anything that could be done for them from the conventional cancer treatment point of view, please let me know. If it really helps my patient, I would be a very willing partner to advocate to my patients to do what is right and helpful for my patient's reversal and remission form end stage cancer.

Otherwise what harm does it do to patients by advising them to eat right, improve oxygenation, improve blood circulation and assist body detoxification systems eg. liver and bowel detox. Patients should be given the choice and not condemned when opting for alternative therapy when conventional therapy failed.