To die once, or to die many times?
This story is for the patient, or a member of the family of reader who is diagnosed with cancer. The aim of my writing here is to reduce the redundant pain and suffering that a cancer patient would have gone through in the later phase of their life. I see that my mother is going through the pain of dying due to the cancer treatment, and it is extremely cruel if she has to go through the second time. So, is it worth to go through the second time of death?
What is cancer?
Put it simply, cancer is a kind of cells that live much longer than the normal cell, and they can proliferate better than the normal cells once they are sitting at a particular site in the body. However, they do not function to help our body. The real cause of cancer is not very well understood, however, it arises when the mutated gene in the cell of the body expresses some functional proteins excessively or lackingly for some kinds of cells in the body.
Are there ways to cure the cancer?
In a scientific term, our skin cell is called the fibroblast. The first cancer cell ever extracted from a human body for scientific research is called the HeLa cell, that is the cervical cancer cell. There is a book named ‘The Immortal Life of Henrietta Lacks’ by Rebecca Skloot, it tells an extraordinary story about the discovery of the cancer cell, the woman who contributed the immortal cell, and the contribution of the scientific research from the cell named after her. So, there are different types of cancer cells, because the cell type from different part of the body are different. The question is, how can one type of cancer cell could spread to other parts of the body? The dreadful reality is, the cancer cells are mutation cells from our body, and hence they have very similar characteristics to the normal cells. To spread to other parts of the body, an induction of the same mutation on the stem cell, must be introduced first. Stem cells are cells that have not been transformed into a specific cell type. In short, there is no effective way to kill the cancer cell without affecting the normal cell.
What is chemotherapy?
As a scientist myself, I feel it is just not intuitive to give all the scientific terms, and explain what specific thing that the treatment does. Again, put it simply, the treatment involves some specific chemicals that just do not kill the cancer cells alone, but have a global effect on all kind of cells in the body, but in a very bad way. Let’s get it straight here, the listed side effects of chemotherapy are only a fraction of major side effects detectable. So bear in mind the side effects of the treatment are affecting the body, and it’s functioning in a more global manner. How do we know about that without going through the scientific reports?
What are the real life stories about chemotherapy?
A few months ago, one of my auntie died after the chemotherapy. She was into her 60s. I gathered more information from my colleagues whom are doing research in the mechanosensing of cells, which including some cancer cells. Here are the stories. One doctor who was leading a research group at a local general hospital in Singapore, passed away after receiving a few times of chemotherapy. The father in law of one of my colleague passed away in the evening after receiving the chemotherapy in the morning. Another colleague’s mother paralyzed, then later passed away after the chemotherapy. There are a few more examples that the cancer patients are either developing a heart attack, failing of some organs like the kidney, and paralyzed due to complication of the chemotherapy treatment.
The story of my mother is as follows, she was having a slight heart attack initially in the first week after the chemotherapy for her lung cancer. In the second stage, she had some hallucinations, and the memory started to fade away. In the following stage, her movement started to slow down, and lost the capability to do some simple tasks with the hand, and the leg. Just before the stroke, she lost the flexibility of her eye sight, and could not remember where are the places at home. In the final stage, she refused to move, and when she laid on the bed, she could hardly open her eye, and move a finger anymore.
What can actually happen after the chemotherapy?
So what was happening to my mother? Let’s go through some reports of the doctor after the chemotherapy. She was admitted to the hospital, and was diagnosed with slight heart attack, The doctor did not have a clue that how could this has happened, even though my mother is getting her cancer treatment at the same hospital. Later when she was hit by a stroke, and was sent to the National University Hospital, the doctor found that the count of the white blood cells was too high, and that part of the kidney function was failing. The doctors there still did not have a clue what was happening, and all they could guess was due to the deterioration of her illness.
Here is my explanation. My mother’s lung cancer is at the advanced stage IV, and the cancer has spread to the bones for a couple of years. The chemotherapy is supposedly targeted at the fast dividing cells, or cells that can proliferate much faster than other cells in the body. However, the cancer cell at the advanced stage might not as proliferate as it should be when it was initially spreading in the body. Therefore this treatment could pose a tremendous risk for the patient, especially for the weak, and the old.
So what was happening is as followed, the treatment has caused a wide spread of cell death in the body regardless of the healthy cells or the cancer cells. This would contaminated the blood stream that burdened the kidney, and triggered the immune system of our body to react to the contamination. When the kidney was overloaded, the contaminated blood would continue its way to other parts of the body, and would exert a load at the heart to pump the blood through the vein. Eventually the contaminated blood would escape through all the filtering system and enter the blood vessel in the brain. The reduction of the blood supply, and hence the oxygen to the brain, and later the clotting of the vein in the brain would result in the symptoms of lack of control of movement, and then develop into unconsciousness.
Can we talk about the statistic of any treatment in a more thorough way?
I read through some search results about the statistical surviving rate (let’s put it living for average of 5 years) after receiving the chemotherapy. The percentage can be anyway between 4% to 40% depending on the types of the cancer, the stage of the cancer development, and the age of the patient. This means 60% to 96% patient would die in 1-2 years after they were diagnosed with the cancer, in the most pessimistic estimation. However, the statistic did not reveal the percentage of fatality due to the complication just after the treatment. This is one big caveat of the scientific report.
Often, due to the advancement of the medical treatment, a misleading concept is that the newer treatment is often the better one. An article in the Science Daily, dated 6 Sep 2012 shows that the experimental chemotherapy treatment is no more effective than the standard treatment that was developed decades ago. After all, statistic only speaks about numbers, and life, especially our love one, is not just a number.
Let’s come back to the question, to die once, or to die many times?
I talked to a patient who has been into all the major hospitals in Singapore due to her cancer treatment for the last 20 years. She has two kids to feed, and to support them for their education. Even though she has gone through several chemotherapy treatments, but her cancer still spread to other parts of the body. She has been through a lot of suffering and pain, and what keep her mind strong is the love for her children, and to support them for a better living. She was physically strong due to the nature of her work and business, but the chemotherapy has deteriorated her health extensively, and now she is weak, and not able to walk properly.
I told her about my Mother’s chemotherapy treatment, and explain to her how the treatment could affect the health and the quality of life of a patient. Firstly, the treatment has a very slim chance to cure the cancer. Secondly, there is a very low percentage that a patient would live a much longer life. Thirdly, due to the effect of the treatment, there is a very high percentage that a patient’s health would be affected, and cause some serious consequences, and might result in death in a much shorter time. She told me that it is time for her to have a second thought whether to continue the chemotherapy treatment since her children now have grown up, and lead a good life themselves.
There is a simple question pertaining to go or not to go for the chemotherapy, that is, is there anything extremely important in life that the cancer patient has not accomplished yet? For my Mother’s case, it is not advisable to go for the treatment because she is now 76 years old, and she has been living a happy life with my sisters and I. As the child, we have also giving her our best to love, and to take care of her. There is no doubt that my sisters and I want her to stay with us as long as possible, but it is not a good idea to see her suffering great pain, and the lost of all of her freedom at the final stage of her life.
Can we prolong the life by not going through the heavy treatment?
Apart from a small percentage of cancer being due to the heredity, most cancer arises due the life style of a person, and the living environment. My mother is able to live for more than two years with the stage IV lung cancer, in which she slipped through the opening of the 3% surviving rate for the lung cancer, is largely due to the careful diet, and the mild anti cancer pills that she has been taking after she was diagnosed with the cancer. Without the chemotherapy, I firmly believe that she would still thrive in the next 1-2 years, and live a quality life.
It is therefore essential to have a healthy diet for a cancer patient (assuming the environmental factor is lifted), for two reasons. Firstly, to stop introducing the agent that will continue to induce mutation in our cell, and cause further wide spread of the cancer to other parts of the body. For example, the disease hepatitis B could increase the chance to obtain a liver cancer to 300%. The same thing would happen for carcinogenic chemical compounds to induce mutation in the cell when consume in high concentration, and this could happen if we are consuming the same kind of food everyday so that the body would not have time to clear the unwanted chemical compounds in our body, and cause an accumulation of the toxic substance. Secondly, vegetables, and fruit like apple are extremely important to help the body to counteract the toxication in the body due to the high concentration of medication taken everyday in the cancer treatment. It is thus very important for the patient to avoid food (especially any processed or packaged food) that will cause a further burden or overloading of the body system.
When a person has a strong will to live on, like to continue to love someone, or accomplish a goal in life, probably it is unavoidable to go thorough all the suffering and pain, such as Randy Pausch who wrote the book ‘The Last Lecture’. In this case, it is very important to take a proper dose of medicine, and to carefully assess whether it is enough for our body to take the medicine without causing further complication. In most cases, the doctor is unlikely to help us without the strong request from the patient, since most clinical doctors are not expert in research of cancer cell, and it’s treatment. They only follow the standard protocol given by the medical scientists, and they would not take the risk and responsibility for any consequence for not following the protocol.
Cancer, a bless or a curse?
It is important for life to live to the fullest, and with love, rather than to dwell on without a purpose, and without the family of the patient being able to give all the necessary care and love. It is thus important for the family members of the patients, to help them to achieve the best living the patient could have at the final stage of their life. Cancer, is a curse, and can be a bless too, for the patients and their family, depending on the path we are choosing for our love one.
May Heaven bless those who are suffering from the illness, to live a happy life till their very last second.
1 Oct 2012, Singapore
Role of Taxane-Based Chemotherapy Drugs May Be Underestimated, Especially Against Prostate Cancer, Study Suggests, http://www.sciencedaily.com/releases/2012/09/120917172911.
Standard Chemotherapy Provides Higher Survival Rate Than Experimental in Lung Cancer Patients, http://www.sciencedaily.com/releases/2012/09/120906144827.htm