Day +46 : Misconcept about Cancer

The urine pain still bother me. Hope to get improve in the next few days. Yesterday, Teck Ann drove me to Selayang Hospital to attend the Sosco's Doctor Panel Interview, we waited for 2 hours, the interview session took 5 minutes only and wait for Sosco letter in two weeks time.

Visited the web page of Malaysia oncology, it talk about the common misconcept about cancer, like to share

Common Misconcept about cancer :
Mention the word “cancer” to Malaysians and three words would probably pop into their heads: incurable, pain and death. About a third of cancers are curable yet few people (including doctors) know this. Pain is not inevitable when cancer strikes. And even when there is pain, much can be done about it.Many other misconceptions about cancer abound. "We don't know what causes cancer." Of course we do. "Food has everything to do with cancer." Wrong again! In this article, we will ask (and answer) common questions about cancer:We don't know what causes cancer.The human body is made up of billions of cells. Cells have nuclei, which house their reproductive apparatus, i.e. DNA. Mistakes are made when cells reproduce. Occasionally, such mistakes accumulate and eventually the daughter cells form new blood vessels, invade neighbouring tissues and spread throughout the body. Consequently, vital organs get disrupted and the patient (if untreated) dies. We know the big picture. We are still fleshing out this picture with details.Does smoking cause cancer? And is cancer a lifestyle disease?There is no doubt whatsoever that smoking will increase your chances of contracting lung cancer (and half a dozen other types of cancers). Excessive alcohol consumption may lead to cirrhosis, which may lead to liver cancer. Beetle quid chewing (fortunately a dying habit) causes mouth cancer. Unfortunately, at least two thirds of all cancers cannot be linked to a particular lifestyle or causative agent. That does not mean we should not count our calories, load up on fresh fruit and vegetables and hit the gym. In any case, a good lifestyle will do wonders for your heart, psyche and sex life.

Doctor, what food should I avoid?
Food is not the most important cause of cancer. Neither is it an important modality in the treatment of cancer. It is important that cancer patients observe a diet high in protein, calories and vitamins while undergoing treatment. However, that is a far cry from saying that "this food will prevent cancer" or "that food will cause cancer!"I don't want to undergo cancer treatment because 'good' cells are killedCancer treatment is a judicious combination of surgery, radiotherapy, chemotherapy and molecularly targeted therapy. There is no such thing as medical treatment (for any disease, including cancer) that is devoid of side effects, just as there is no such thing as a free lunch. However, most side effects of cancer therapy are temporary, reversible and manageable. Much progress has been made in the control of nausea and vomiting, which is a frequent side effect of treatment. 'Growth factors' (G-CSF, erythropoietin) are available to combat bone marrow suppression, which is another common side effect of cancer therapy. And the list goes on… If cancer is left untreated, there will be great suffering. Death will ensue within two years in most cases.

What about alternative therapy?What about it? There is no alternative civil engineering, no alternative computer technology and no alternative chemistry. Any treatment for cancer has to be subjected to the rigours of scientific enquiry. This inevitably means a slow, laborious, intellectually honest process that starts in the laboratory, proceeds onto animal studies and finally studies on humans. There is only medicine that works and has been proven, and medicine that is not proven and may not workIs cancer contagious?The simple answer is no. You cannot 'catch' cancer from a patient by touching him or by sharing his utensils and personal effects. Cancer is not spread by air, water, injections and other vectors. Certain cancers are linked to viruses, such as the Human Papilloma Virus and cancer of the cervix, and cancer of the liver. Immunisation plays an important role in the prevention of liver cancer and clinical trials are on the way for the former (cervix). That certain cancers are causally linked to viral infection does not at all make cancer patients infectious. Cancer patients need all the care and compassion they can get. They should not be shunned. On the contrary, a hug and a kiss will go a long way to alleviate their suffering.

Isn't cancer a very painful disease?Cancer can be very painful, especially if cancer tissues directly infiltrate bones and nerves. However, this is not inevitable. More important is knowing that pain management has come a long way. Most pain can be controlled by following an algorithm (a logical stepwise sequence to achieve a goal) recommended by the World Health Organisation. Many new analgesic preparations and adjunctive drugs (or drugs used in parallel) are available. Pain is much less of a problem today.

Is cancer inherited?Only about 10 per cent of cancers can be inherited. Even if you are unfortunate enough to have parents afflicted with this subset of cancer, you may still not get cancer. Remember, you inherit the risk, not the cancer. What you really need is counseling and preventive measures.My sex life is over now that I have cancerFar from it! We aim to fully rehabilitate a cancer survivor. And sex, being the sublime expression of human love and emotion, is so very important. There is absolutely no reason why a cancer survivor cannot have a fulfilling sex life with counseling.

Finally, can we find a cure for cancer?Let us re-phrase that question: Can we find a cure for the two thirds of cancer that are not cured at present? Remember, one third of cancers are cured. Most patients who have their cancer diagnosed early in stage I (confined to the organ of origin) or stage II (only the first station of nodes are involved) are cured by existing modalities and technologies. We are talking here of 70 to 90 per cent cure rates. What about the rest, i.e. the two thirds of cancer patients who are not cured? Researchers now know a lot about the genetic basis of cancer and consequently the chemical messages cancer cells send to other cells. In the future, instead of telling someone 'You have liver cancer', we may say to that person 'Your cancer has a defect in the ras (an oncogene) pathway so you need compounds that are effective for this pathway.' The other theme is (molecularly) targeted therapy. We already have drugs in Malaysia that specifically target receptors (mainly growth factor receptors) found on cancer cell surfaces. These drugs are effective and have few side effects. Only a few patients in a few clinical scenarios are suitable candidates for such therapies. However, the future is bright and many more such therapies are in the pipeline. The wisest approach to the cancer problem is prevention, early diagnosis, appropriate therapy and palliative care. So much is available and so much more is expected in the coming decades.

CHINESE VERSION AVAILABLE. Please download here... The full article can be viewed here. If you have friends or relatives who are diagnosed with cancer, please refer this to them. I believe this would help them to clear a lot of unnecessary doubt.The MOS website is at http://www.malaysiaoncology.org/.

Day +45 : Chen Yoong's New House

I am not felling well today, encountered the urine pain. Checked with doctor, likely due to GVH, I have the urine culture and profile test done this afternoon. Results show be available in three days. Doctor also prescribe me some URAL to neutralize the urine acid, comfort during passing the urine.

Today, Chen Yoong is moving to his new house in Bandar Puteri Puchong, welcome Chen Yoong ! a 400 feet above ground ( Don't worry, it is not located at Bukit Antarabangsa), next to Ayer Hitem forest reserve, fresh air and good view.

Day +44 : Welcome to father club

Ka Kin promoted to father . Congratulation to Ka Kin and his wife , their first new born baby.
I just know from Ka Kin himself, a bay boy, 4 months old.

Day +43 : KL Tan left

I am fine today, just feel a little bit tired, I don't sleep well last night . I received SMS from Betty, KL Tan has left and rest in peace on 12 Dec. KL Tan recently have the transplant at SJMC, but relapse few months later. We learn the Su Lang Yi Xi Gi Giong together, he gave me a lot of courage. He plan to attend his son graduation on March in Perth. His son study medical in Perth. My deepest condolences to Betty and his family.

Day +42 : Total White Blood Count (WBC)

I am fine today, just back from 45 minutes morning walk. Yesterday, Teck Ann was my driver, I need him to drop me at SJMC, and Ah Siew will pick me up later .

Blood Counts Results :
12 Dec 2008 versus 9 Dec 2008
Red Blood Count (RBC) = 11.9[12.7](Normal 13.0-18.0)
Platelet = 111[113](Normal 150-400)
Total WBC (TWBC) = 2.9[3.5](Normal 4 - 11)

Calculated ANC = 2.2 (Normal 1.5 - 8.0)
Neutrophils = 77% ( Normal 40 -74 )
Magnesium = 0.51[0.44](Normal 0.74 - 0.99).
ALT : 162 [147]( Normal 30-65)

The white blood count drop further from 3.5 to 2.9, doctor commented this may due to some of drug I consumed. The magnesium level increase a little bit, but still below the normal range. I think the calcium magnesium tablets from AMWAY Nurtrile work well, and it is relatively economic with RM40+ for 180 tablets. While waiting for the bloods count results, I have a plate of fried key koay teow at cafeteria ( This is the only chance I can have outside food), The nurse have ring me asking where am I , she have to give me magnesium infusion. I reached home at 7:00pm

Doctor said even my WBC dropped, but still manageable. He have change my blood count to once a week. My next blood count will be 19 Dec 08.My Absolute Neutrophil Count (ANC) is 2.2, which is within the normal range1.5 to 8.0 . ANC is the actual number of neutrophil in the white blood cells. Neutrophil is one components of the white blood cells that helps to kill and digest microorganism. The other components are macrophage, basophil and eosinophil. We wouldn't know if a person is proned to infection just by looking at the white blood count alone. We have to calculate the ANC of a person to determine the risk of infection.ANC is calculated by multiplying the white blood count with the percentage of neutrophils in the white blood cells. Based on the blood report, my neutrophil percentage is 77%, therefore my ANC is equal to 2.9x77% = 2.2 . The risk of infection based on ANC is as follow:

Neutropenia = ANC < 2.0 (slight risk of infection)
Mild Neutropenia = 1.0 < ANC < 1.5 (minimal risk of infection)
Moderate Neutropenia = 0.5 < ANC < 1.0 (moderate risk of infection)
Severe Neutropenia = ANC < 0.5 (high risk of infection)

DAY +40 : Magnesium

I am fine today, I have 10 minutes jogging and 30 minutes walk exercise this morning. Yesterday , Teck Ann have brought me calcium and magnesium tablet. Three tablets provide 600mg calcium and 400mg of magnesium. Hope this will help to boost up my magnesium level to require range of 0.75 to 0.99, then I don;t have to infuse with liquid magnesium. The magnesium helps our body to metabolise carbohydrates, calcium helps in formation and maintenance of bones and teeth. Adequate calcium intake is important, but the daily intake above 2,000mg are not likely to provide any benefit.

Day +38 : Follow up

I am fine today. Today the blood counts show almost the same as previous, except TWC slightly drop and ALT increase. Doctor said he is satisfied with my progress, but need me to have blood counts twice per week. Today, Boon Tiam is my driver, helped to pick me up at SJMC.

9 Dec 20008 blood counts versus 4 Dec:
HB : 12.7 [12] ( Normal 13.0 to 18.0)
Platelet : 113[113] ( Normal 150 to 450)
TWC: 3.5 [3.8] ( Normal 4.0 to 11)
ALT : 147 [119] ( Normal 30 to 65)
Magnesium : 0.44 [0.55] (0.74 to 0.99)

Expected I need magnesium infusion for today follow up. Presently magnesium is available in liquid form. But Dr Alan said oversea you probably can get oral magnesium. These will help to save cost and time. As very time , magnesium infusion, it need about 2 hours. Let me know if you find any table form.

Today, I met young patient , Andy Gan, he have transplant for leukaemia in May 08, but relapse after 5 months, and he went for second mini transplant in October 08. Currently have GVH on skin, bowel and liver. His ALT figure shot up as high as 900. So, I presume as long as my ALT below 900, I should be OK. Andy introduce me to drink MONA.VIE, fruit juice comprise of 19 type fruit. Andy said it help to boost up the blood counts. By the way Andy is the International Distributor for MONAVIE. Those interested can visit the web : www.monavie.com