How To Help Your Doctor Control Cancer

It takes two to fight cancer
Dr Ang Peng Tiam
Jun 09, 2008
The Straits Times

One patient recently wrote me a note, intriguingly entitled How To Help Your Doctor Control Cancer.

'Psychological confidence is a very important factor towards healing,' Khaled, who came to Singapore from the United Arab Emirates, wrote.

Chemotherapy doses, he said, helped to control his disease by 60per cent. The other 40per cent was due to his confidence in his doctor in controlling the disease.

Now, I am not sure about the scientific basis of this division but I definitely agree that the patient can make a substantial difference.

Each time I hear him use words like 'sheer force of will', I remember the young commando, now in his 30s, whom I looked after for more than 15 years.

When I first saw him, he was tired-looking and quite frail as he had just completed radiotherapy for nose cancer and was suffering from cancer relapse in his liver and lungs.

I told him: 'You are going to fight the toughest battle of your life.'

I was about to treat him with a terrible chemotherapy programme which was very toxic. Each cycle comprised five consecutive days of treatment given every four weeks.

The treatment meant complete hair loss, severe nausea, vomiting, loss of appetite and mouth sores. But it had a 70per cent chance of killing the cancer cells, shrinking the tumour and controlling the disease.

His tumour responded well. But what amazed me was that he put on 15kg during the first three months of treatment. This weight gain was not fat but big bulging muscles. When asked, he said he had gone on a high-calorie, high-protein diet which included milk shakes taken by body-builders. He also worked out in the gym with weights and aerobics.

He explained to me that when I told him to prepare for battle, he prepared for it the only way he knew. By getting his body as fit as possible - by eating well and training hard.

By the time he had completed six cycles of chemotherapy, he was in remission.

Cancer treatment is easier now, compared to 15 years ago. However, it is still not free from side-effects. It is important to get the cooperation of the patient to comply with the treatment plan and schedule. There are 'naughty' patients who delay treatment for frivolous reasons. They have to know that poor compliance may lead to poorer outcomes.

I need a patient's permission before I can proceed with a particular course of treatment. The amount of weight I put on an issue like hair loss is entirely dependent on how much importance a patient puts on it. Some just ask as an aside if they will lose their hair. Others tell me they will not continue with the treatment if their hair falls out.

If the doctor succeeds in winning the trust of the patient, then fighting the common enemy becomes easier. At the beginning, some patients may take an 'If must die, die lah' attitude, but few readily give up without a good fight.

So, what can patients do to help their doctors? I have three wishes.

Stay positive. It is far easier to treat a patient with a positive outlook. When you tell two patients that the tumour has responded with a 50 per cent reduction in size, one will rejoice. The other will ask: 'Why is the cancer still there?'

Eat well. Don't listen to old wives' tales. Cancer patients often think they cannot eat dairy products, meat or sugar because these will make the cancers grow faster. Some start taking only organic food or become vegetarians. I tell them a balanced diet is especially important when they are undergoing chemotherapy.

Live each day to its fullest. Many of my patients have advanced stage cancer. They should be encouraged to do the things that they enjoy, be it a night out with the family or a mahjong game with their 'kakis'. Life has a purpose and we need to remember this even as we are working at keeping death at bay.

I will let Khaled have the last word as he's taken the journey and writes to light the way for others.

He says: 'I am 35 and my advice to every cancer patient out there is that you should accept the disease which has fallen upon you and follow the saying, 'For every ailment, there is a cure.'

'Instead of letting the world come tumbling down on you, continue your daily life as usual. By creating such optimism, you will be giving yourself, as well as your doctor, an increased opportunity of your recovery from the disease.'

Dr Ang, 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 medical research.

This article was first published in Mind Your Body, The Straits Times on June 4,2008..