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Anna /M241, is a 50-year-old female from Acheh, Indonesia. She had a lump in her right breast sometime in 2000. She refused medical treatment. Instead she went to Jakarta to seek alternative treatments. These did not help her. The breast lump grew bigger and in December 2004, it developed into a lacerated wound and bled. She went back to Acheh and enlisted the help of a medical doctor to take care of her wound. At the same time she continued with other alternative treatments. Unfortunately, this doctor had been swept away by the tsunami that struck the city not long ago.

In February 2007, Anna came to Penang to seek medical treatment. Due to the advanced stage of the disease, no radiotherapy or surgery was indicated. Anna was asked to undergo chemotherapy. She underwent four cycles of chemotherapy at a private hospital. She suffered total hair loss but no other adverse side effects. Each cycle of chemotherapy, given at three-weekly interval, costs RM 3,000. However, each trip to Penang for this treatment would come to about RM 7,000. It is indeed difficult to imagine such financial burden endured by a family who had lost their home to the tsunami. Because of this, Anna's husband explained that they could NOT effort further chemotherapy and asked if they could turn to our therapy instead.

Anna came to see us on 5 August 2007. She appeared healthy and did not have any problem. The chemotherapy had helped her. Her lacerated wound had dried up and the tumor had shrunk significantly. The pains that she suffered earlier had subsided. She had gain weight and felt much better than before the chemotherapy.

A CT scan done on 9 May 2007, however, was most disappointing. It showed extensive metastasis to the pectoralis muscles and ribs. There were numerous well defined 4 to 25 mm nodules scattered in both lungs. The cancer had also spread to the lymph nodes. I asked Anna if the oncologist had told her the results of the scan. Her husband replied: "No. The hospital gave us the films and we went home. We did not understand what it was all about."

I asked them: "What did you expect when you came to the hospital for chemotherapy?" Both of them replied: "I expected to be cured."


It took me a while to regain my composure after looking at her scan. I was unsure if I should explain the results. I did not want to make her life miserable by telling her the bad news - after all, is this not the responsibility of her oncologist? I hesitated but her husband probed me to tell them the truth, which I did. The metastases in Anna's lungs were too numerous to count. While chemotherapy had helped her with the lacerated wounds, it was obvious that the treatment did not help her lung metastases.

Chemotherapy had helped make Anna's life better. The lump has also shrunk. If four cycles were good for her, does it mean that more chemotherapy (up to eight cycles) would be better? Indeed this is debatable - more does not necessarily mean better! While chemotherapy did not hurt Anna, it certainly hurt the pocket - I would not say "bank balance" because I am not sure if there was any bank left after the tsunami.

I pointed out to Anna that it was a mistake not to remove the lump (or her breast) when she first detected it. Surgery could have saved her all the miseries that followed. In this regard, I would advise women to have the lumps in their breasts removed if possible. I asked Anna's husband why they still continued with the ineffective treatments after knowing that the lump had gone bigger. Why wait for so long? Common sense should tell us that if after trying an alternative therapy for a month or two and it does not work or the condition deteriorates, patients should reevaluate their strategies - move on to something that is more effective or evidence-based.

However, I also highlighted the good side of what she did. I know of numerous patients who died within two to three years after doing what their doctors told them to do -- mastectomy, chemotherapy and radiotherapy. Some even suffered severe pains and had bloated stomach before their death. So, undergoing medical treatment would not guarantee that everything would be fine.

Anna had breast tumor in 2000 and it is now 2007 and she is still alive and did not suffer any difficulties. She ought to be grateful for this blessing. I am reminded by what I have read. At a lecture at the American Cancer Society Conference in New Orleans on 3 July 1969, Professor Hardin Jones, University of California, Berkeley, was supposed to have said: "My studies have proved conclusively that untreated cancer victims live up to four times longer than treated individuals. If one has cancer and opts to do nothing at all, he will live longer and feel better than if he undergoes radiation, chemotherapy or surgery."

In Malaysia, like elsewhere too, doctors often blame the herbs when things go wrong. Doctors want to have the first shot at cancer using their chemotherapy or radiotherapy. And if these fail they advise patients to go home and seek "hospice help" or go for herbs. Over the past decade, CA Care is the recipients of these terminally ill and medically give-up cases. I began to have the impression that going for invasive treatments at the first sign of cancer need not be a wise move. Sometimes, patients die because of the treatment rather than the cancer. Anna took the less traveled road. She sought alternative treatments and when these failed she turned to the invasive, toxic medical intervention - perhaps dealing out her last card. It has been seven years and she is still alive. I repeat, many who took the well-trodden road barely manage to live three to four years. So, Anna's adventure is not wrong, no matter how "foolish" doctors may think it is.

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Breast Cancer - When Chemotherapy Is Necessary