Wednesday, October 20, 2010

Meeting with my oncologist

Those who advocate food and nutrition to manage cancer are not in the mainstream, including Dr. T. Colin Campbell, who is now an esteemed professor at Cornell University in the U.S. But this alternative view is slowly catching on. Unfortunately, my oncologist is in the mainstream and follows a strict protocol on what a kidney patient should do. When I consulted her last Monday 18 Oct, at National Cancer Centre, she insisted me to go for a CT scan to establish a new baseline immediately, so that she could put me on a regime of standard adjuvant systemic treatment. My confidence in her eroded when she denied any health risk involved when exposed to a second CT scan within three months of the first (CT scan is a kind of 3D X-ray and of higher dosage than the typical 2D chest X-ray). When I asked her whether there are other ways to detect tumours in my body, she said yes but did not explore that alternative. She repeated to me that she had to establish a new baseline based on a new CT scan. My recent tumour markers (from blood test) taken last week show my major organs to be free of cancerous cells but she did not incorporate this data in our discussion. My urologist Prof. Cheng did an ultrasound scan on my abdomen for presence of tumour two weeks ago and there was none, but this was not mentioned in our conversation either.

I wanted to know why my white blood cell count is still normal inspite  of the cancerous cells in my body and she suggested that kidney cancerous cells could not be detected from blood test. She made me more puzzled by scheduling me for another blood test before my next appointment with her. I was also curious how Prof. Teh (a kidney cancer researcher)'s research on my tumour cells would affect my chemotherapy and she told me she was unaware of the outcome and I would be prescribed the standard treatment plan. As I am still young, the treatment will be intensified, i.e. instead of taking one pill per day, I will be taking three pills per day. I might experience side effects such as low immune system and/or low red blood, but she did not inform me of the possible peeling off of skin on hand and feet which happened to 30-50% of the patients given this drug in the U.S.

I felt frustrated talking to my oncologist. She was giving me standard answer and following a standard guideline on what she should do. I would have been more comfortable if she had been honest with me about what she knew and what she did not know, and was willing to explore alternative with me. It seems like she was representing the interest of medical establishment and I was more like a digit to her. My consultation with her was a far cry from my urologist who presented me with choices, was honest with my risks, the types of risks and the percentage of risks. I managed to postpone my coming CT scan to three weeks later (on 8 Nov) instead of one week from now, and my next appointment with her falls on 15 Nov (Mon).

I am not sure whether to proceed with the CT scan. If I do proceed and if the scan shows my cancerous cells to be localized in one area, i.e. my neck lymph nodes, should I still go for chemotherapy or should I wait for the cells to shrink by themselves? Chemo is usually for cancerous cells that have spread beyond primary site and not ideal to remove by surgery. If indeed my remaining cancerous cells are not localized, is chemo really the best option? Should I seek another opinion? If yes, which oncologist? I am praying for the inner peace to make the most appropriate decision.

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