The medical director of Parkway Cancer Centre has been treating
cancer patients for nearly 20 years.
In 1996, he was awarded Singapore's National Science Award for his
outstanding contributions to the medical research.
He has also published a book on patient
stories, Doctor, I Have
Cancer. Can You Help Me?, which has been translated into 9
other languages.
When she took off her sunglasses, I had to work hard not to let the
shock show on my face – she was scary sight – her eyes were
literally popping out of their sockets, there were dark purple
bruises over her eyelids and eye-bags.
Her neck, armpits and groin were swollen. She had lost a great deal
of weight. Her passport photograph showed she was a once attractive
lady with a pleasant smile.
This 54-year-old Indonesian lady first noticed the lumps in
2004.
Doctors suspected that she had malignant lymphoma or cancer of the
lymph nodes. She had been advised to have a biopsy to confirm the
diagnosis and then go for chemotherapy.
For the past five years, she has resisted this one hard truth. From
Indonesia to Singapore, from USA to China, doctors told her she was likely
to have lymphoma. She refused a biopsy and was adamant that she did
not want any treatment.
Instead, she tried alternative therapies – herbal treatments,
dietary changes, spiritual healing. Meanwhile, the swollen glands
spread from one area to another and eventually affected both
eyes.
The space behind the eyeballs was packed full of tumour tissue,
resulting in her eyes being pushed out of the sockets.
I knew she was in denial and fearful of the disease, so I used the
“soft” approach to put her at ease. Her cancer was in fact highly
treatable.
After an hour of listening to me talk, she got up, thanked me and
said that she’d consider my proposal. I knew that I had failed.
Nurse counsellors followed up, but despite several calls to her
Singapore mobile phone, she declined to meet up. We lost contact
with her and after a week, I knew that I had failed to convince
her.
It was a moment of true loss because I knew for a fact that we
could help her. I wanted the joy, thrill and satisfaction of
watching her tumour melt away and seeing her restore her looks and
not have to hide behind her sunglasses. In fact, with her
permission, I had already photographed her “before” pictures so
serve as a record of how she appeared before treatment.
Curious as always, I called up some of my colleagues to enquire if
any of them had seen her. As luck would have it, she did indeed
consult one of my colleagues, who like me, has a special interest
in lymphoma.
“Oh yah! I saw her,” he said gleefully.
“I shouted at her and bullied her into submission. I told her that
her stupidity and stubbornness was going to kill her. The nurses
could hear me scolding her in my consultation room. I literally
dragged her to the surgeon to get the lymph node biopsied so that
we could confirm the diagnosis.”
I was relieved – and realised belatedly I should have been “bad
cop” instead of “good cop”. Whatever it took, I am glad that she
was finally getting the appropriate treatment.
The psychology of the patient’s mind is one of the key things to
her recovery, but as this patient’s story has shown, it is clearly
a doubled-edged sword. What is disturbing about this story is that
there are those who would take advantage of her ignorance and
fears.
There were Chinese physicians who sold her herbs, knowing fully
well that it would not help. Worse still, there is a clinic set up
in a posh medical centre that “treated” her with bio-resonance
therapy, which claims to be able to cause cancer calls to die
through electromagnetic oscillations. The claims are shrouded in
medico-scientific jargon, but there remains no conclusive evidence
that such therapies work.
I must say that I do not forbid my patients from using alternative
therapies as complements to conventional treatment –I do not close
my mind that some of these may indeed in the future be proven to be
helpful. But the key word here is “proven”.
Everyone who cares for the sick – whether a trained medical doctor,
a traditional healer or a new age therapist – should work towards
getting him well with clear and well-reasoned care, rather than
trading on the patient’s emotional state.
Cancer is almost always a matter of life and death, and in these
matters, the mind is a powerful instrument that can make a defining
difference. But the mind is emotion as well as reason. Patients
themselves should not forsake the benefits of science for mere
psychological comfort.
This article first appeared in "Mind Your Body", a
Straits Times Supplement.