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By Dr Albert Lim Kok Hooi
MALAYSIA: HAVE you heard of Kopi Luwak? The name itself will give you a hint. It must be something indigenous to the Malay Archipelago. Kopi Luwak or civet coffee is coffee made from coffee berries which have been eaten and passed through the digestive tract of the Asian Palm Civet, a wild tree cat in our part of the world.
The civets eat the berries but the beans inside the berries pass through the cat's digestive system undigested.
The excreted beans are then washed and lightly roasted so as not to destroy the complex flavours that develop on the journey from the lips of the cat to its anus.
Before you go all queasy and yuck-chy, let me tell you that Kopi Luwak is the most expensive coffee in the world. It sells for between US$120 to US$600 (RM400 to RM2,000) per pound.
Even though the process - the wild cat, the faeces, the collection - takes place in Sumatra, Java and Sulawesi, it is mainly sold in Japan and the US. Most of us simply cannot afford it!
In these dire times of economic and political turmoil, I need a coffee break more than ever. And when I am in the mood to splurge, it's hot, steaming, black Kopi Luwak for me.
Some of us have found a more creative way of ingesting coffee. I am speaking of the coffee enema. An enema is usually plain saline - perhaps with a little additive, barium, for diagnostic purposes or a laxative to treat intractable constipation.
The coffee enema (a big part of alternative medicine, especially Gerson Therapy) is inserted into the anal canal daily and is touted as an alternative cancer therapy.
It is a dangerous therapy in itself and it encourages cancer patients to forgo scientific conventional cancer treatment.
I should know. I have been in the field of oncology for 30 years. I know it does not work as a cure for cancer and I have seen its dangers.
The coffee enema is usually inserted by the patient herself or with the help of her carer or relative.
There is no medical supervision. A tube is inserted into the anal canal and pushed in ignominously and unceremoniously as far as it can go.
Anal tearing may result. Re-used (instead of single use) enema may carry bacteria and result in infection.
Use of hot coffee could result in serious internal burns. Extensive use of enemas (any enema) could result in dehydration.
Electrolyte imbalance may result. If severe enough, it could cause death.
The caffeine in the coffee enema may lead to caffeine addiction.
Overuse of any enema may temporarily excite the nerves of the anus, anal canal, rectum and colon. It could result in decreased function of the bowel. Constipation may ensue.
Excessive coffee - from the top or the bottom - may cause your blood pressure to increase.
The science of the coffee enema is simply not there. A coffee enema is meant to get rid of toxins.
If a toxin causes cancer (and it is not so all the time), it does so by mutating part of the DNA in one of our cells. Genetic mistakes accumulate in the daughter cells.
About 10 to 20 years later after the first DNA aberration, the patient presents to the doctor with symptoms and signs of cancer.
Coffee enemas, even if they truly neutralise the toxins in the lower bowel, are 10 to 20 years too late!
To be fair, we must put coffee enema to the test. Coffee enemas are being studied for the possible treatment of tumour lysis syndrome in pancreatic cancer (a rare occurrence in the subset of a subset of cancer).
This phase III clinical trial is funded by a US$1.4mil (RM4.62mil) grant from the US National Centre for Complementary and Alternative Medicine awarded to Columbus University Rossental Centre for alternative medicine.
This trial has been criticised for its theoretical model of cancer development.
The primary investigator, Nicholas Gonzalez, has "never gone beyond the medical degree, in residences or Board certification" and "had to pay US$2.5mil (RM8.25mil) in damages to a patient he wrongly claimed to have "cured of cancer".
This study has had difficulty attracting patients. Do you wonder why?
I drink copious amounts of a great variety of coffee (no sugar, cream or milk please) because it enhances the quality of my life. I love the taste and it gives me a buzz.
However, I make sure it goes into my body through the proper and intended orifice.
Dr Albert Lim Kok Hooi is a consultant oncologist.
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