Cancer Post Mortem

This blog is dedicated to my beloved mother Ng Soo Choo who passed away on 20 May 2006 after losing her battle with breast cancer after five years.

 

I do not have a success story to share. What I have are a handful of things that I know now I could have done better. It is my hope that a "post mortem" of our story can help those in similar situations.

 

- Tian Shek, June 2006

Sunday, July 30, 2006

My "Tipping Scale" theory

Many times people assume that cancer is a disease. We started of the same. We thought that if it is a disease and it is a matter of finding the right "cure to kill it. We visualized it as a battlefield where you choose the right weapon to eradicate your enemy (the Cancer cells). It is only later that I realised that with such an approach, you can never win the war. At best you can prolong the battle.

Why is that so?

As defined by Wikipedia, "Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to invade other tissues, either by direct growth into adjacent tissue through invasion or by implantation into distant sites by metastasis. Metastasis is defined as the stage in which cancer cells are transported through the bloodstream or lymphatic system....."

In other words, cancer is a condition where our very own cells loses control of themselves and started to multiply uncontrollably and start to harm our body. It is like fighting a war against guerillas in your own country. History tells us that in such war, when the focus is to crush the resistance, it only means more destruction to the country.

It is because of this that I realised that instead of visualizing it as a battlefield, it is more useful to see the body as a "Tipping scale". When a person is healthy, the "Tipping Scale" is in balance. Although at this point no one can pin point exactly what causes cancer, but I think it is quite safe to assume that some thing that we eat, we breath, we drink, we touch and our genes got to do with it. Each of this factors, good or bad will affect the balance of our "Tipping scale". In most people, the scale stays in balance until too much of "bad" stuff tips the scale over and Cancer would then occur. From that point onwards, the cancer cells would continue to grow as long as the scale remains tipped.

If you only focus on killing the bad cells, the situation would be you kill some, the grow somemore, you kill more, they grow more, you kill more. The only problem is that like conventional warfare, we usually kill more than we intent to and your good cells get killed along with the bad ones too. As your body gets weaker, more bad cells would appear.

If there is any chance to recover from the condition long term, I would think the best way is to focus on restoring your "Tipping Scale" ultimately. Reducing the bad cells can only be a short term solution to buy you more time. The root of the problem was never the cancer cells themselves. You need to restore the "Tipping Scale" to balance again.

Friday, July 14, 2006

Our journey

It all started in Jan 2001. A routine checkup discovered a tumour in my mother's right breast. The recommendation from the doctor is to operate on her and remove her right breast together with the tumor. That is to reduce the chance the the cancer cells would spread to other parts of the body. She did just that. The operation was declared a success and she was discharged with no need for chemo or radiotherapy. The initial healing was slow due to some infection of the wound but over few months, she was back to her old self.

Following the op, my mother had to go back for routine screen to make sure there was no signs of the cancer cells spreading to her other breast. Her last scan was Sep 2004. She was declared cleared. No signs of the disease and that is of course good news to all.

Despite this, she had earlier since June 04 started coughing. What sounds and looks like normal cough turns out to be more than meets the eye. After numerous doctors failed to determine the cause of the cough, a young family doctor recommended for my mother to do an x-ray of the chest and be admitted to the hospital for further tests. That was in Jan 05.

A CT scan of the chest confirms the suspicion of the doctor. Despite getting a all clear from the Cancer doctor only 3 months earlier, my mother actually has tumors growth on her lungs and that was the reason behind the coughing.

That's bad news, very bad one. How can this have happened? The doctors that attended to her was not optimistic about her condition. To them, this is last stage of cancer, it has started to metasize, to spread. The only option left is chemotheraphy.

The family decided that it is best to seek a second opinion and we trust that we can find a better oncologist through recommendations from friends. After some running around, we settle for one of them running a private practice. My mother was comfortable with him and so are we.

2 months of chemotherapy went by. The side effects was obvious. Lost of hair, appetite etc. It is agonizing watch my mother go through it and I can imagine how much worse is it for her to be going through it. An assessment after that shows that that only manage to reduce the tumor by 30%. No bad but no cause for celebration. She was still cough a lot and had to have liquid removed from her lungs. At one point there was more than a litre of liquid just in her right lung!

On the third month, we received some good news. The lab test has shown that my mother's tumor will response to a new drug call Herceptin. This drug has little side effect except that in 1% of the patients, there is a chance to cause heart failure. We opt for the new treatment despite the high cost.

Another 3 months went by. My mother's condition began to show visible improvements. Another scan was done and we were all hopeful that she will recover. Her tumor had reduced by a good 80%! However, before we could celebrate, more bad news. The echo test on her heart shows that she was having a heart failure already. This only means that Herceptin despite being effective for her tumor could no longer be an option at least for some time until the heart recovers.

My mother was admited for a few days to stabilize her heart. Chemo was discontinued temporarily the next 2 months. During this time, my mother switch to Chinese medicine to help with her heart. By Oct 05, a checkup showed that the tumors continues to be reduce in size and can hardly be picked by on the scans. We were still hopeful then.

By Dec 05, the cough is back. A scan in Jan 06 shows that the tumor has started its growth again. It was back to 30% of what we started with. With Herceptin out of bounds, we had little choice but to continue with the other chemo treatments.

After changing the drugs a few times, the growth seems to be kept at check. However, by then, my mother's body having gone through a year of chemo was weakening very fast. She started losing weight very fast and went into depression in Mar 06.

A failed suicide attempt in Apr 06 weaken her body even more. My then, the family was on 24hrs survelliance around her. Chemo was stopped and we brought her to a pyschiatrist. She was also breathless throughout the day and requires a oxygen tank to help her breath. She never really got out of that state and passed away in her sleep on the 20 May 06.