Tuesday, September 27, 2011

Living with cancer is challenging

Living with cancer is challenging .
Why ?
Because living with cancer is full of possibility and uncertainty .
Sometime when things looks very wrong and make you worry, looks like there is nothing is possible to help .
Then, some good news happen and bring you OUT OF DARKNESS to LIGHT, bring you JOY , bring you HOPE and let you feel that everything is possible .
But, at times, when things going so well and you have forget about all the negative feel ,
then, out of a sudden, things went wrong and you just do not know how to deal with it .
This happen especially during chemotherapy and make you feel life is so uncertain .
Anyway, it is the possibility and uncertainty make our life of living with cancer more challenging and not so boring .
Let's enjoy our day and live a happy life.
Cheers !

Monday, September 26, 2011

What is the priority , Life insurance or Medical insurance

I am not promoting insurance for any insurance company, but, I think it is important for us to know what is the priority when decided to start invest into insurance plan for ourself or for family , and I wish my sharing is helpful .

My first insurance policy is Life Insurance and follow by Term Insurance.

Thereafter, when I am better financially, agent introduce me to Hospitalisation insurance policy and Hospital income policy .

Reason that I go for Term insurance is basically to get a good coverage amount for Life with minimum yearly premium. The policy give no return to premium paid and it's cover for a period of time, say 10 ; 15 or 20 years, depend on your age and the policy terms and onlycover for death.

The hospitalisation insurance policy help me to settle most of my expenses for my cancer treatment and the hospital income insurance policy compensate me for lost of income when I am admit to hospital .

Then, the critical illness rider to my life insurance policy, pay me a lumpsum amount once insurance company accepted my diagnosis report .

Today, with the escalating healthcare expenses, my suggestion is to have hospitalisation insurance policy as first priority . As this will keep us from the main worry ...
" medical expenses ", when something happen and we need to be hospitalise for treatment.

It may not cover everything ( depends on the sum insured and type of policy your purchase ) , but, it'll be a good assistance .

If my information is correct, for a person at age between 20 to 30 years old, the premium for maximum coverage upto about Rm 500k to a million life time coverage, should be between Rm 1 to 2 K yearly, or Rm 100+ per month. But, please take note that when you have Rm 500K to a million coverage per life time , do not mean that you will be paid for full amount if your expenses when hospitalise is less then the maximum coverage ( say Rm 500 K)

The policy normally come with terms n conditions for limit per year or per confinement . Most of the policy also with condition of 10 to 20 or 30% of co-insured amount, where , the policy holder have to pay the co-insured amount as per policy term .

The other issue to take note is the maximum per day hospital room expenses. Some policy work this way ; example ... if the maximum room per night allow is Rm 300.00 , please ensure you stay in a room not exceeding Rm 300.00 per night, or you have to pay for the differences of the room charge, then, you also have to pay for the purata of the total expenses. Example , maximum room per night Rm 150 and you stay in room for Rm 300.00, you may have to pay for 50% of the total expenses.

So, it is very very important to read and understand all the terms and conditions of the policy before you sign up and also to read the terms and condition printed in your original policy once you have it from Insurance agent , any discrepancy, should check and verify immediately.

Next is the proper declaration of your previous health record and declare your record properly, to avoid any dispute when you submit claim against insurance company, as insurance company have the right to search and check your record with all clinic and hospital to confirm whether you have made false declaration to them.

Last is to take note of the grace period , most policy have grace period for some illness for 3 months to one year from the policy effective date . It is important to understand the policy terms.

Note : Some of you may say that your company have arranged medical/hospitalisation insurance
policy for you . Yes ! You are lucky and some also extend the cover for your family . But, you have to take note that when you are working there, you are under the protection of the cover , when you leave the company, you are no more under the cover. So, it is important to have your own cover and take the company cover as bonus . When there is claim, you should first claim against the company cover, for any amount exceed the maximum claim amount, you can claim the balance against your own insurance cover. Also should take note that most of the company work on group cover insurance and the insurance company will review the policy before the yearly renewal . Some of the policy come with terms that insurance company may not accept renewal for employee already have claim for critical illness in previous year, or they will charge heavy loading for premium and not accepted any further claim for the same illness.

Next question will be " I would like to have something for my family, if something happen ? But, financially I can not afford the high premium of Life insurance . "

What you can do is to go for term insurance. I agreed that there is no saving return , but, what we want is the coverage and some fund for our immediate family . I am not sure what is the premium now. The premium for my first term insurance for Rm 100,000.00 , when I am before 30 years old, is something less than Rm 400 per year and it cover for 15 years.

You may go for life insurance with saving plan when you are financially okay and do not forget to
look into the rider for critical illness ( it is normally cover for 36 illness ) , cover for critical illness will pay you the lumpsum amount once diagnose and confirm . Just take note that Insurance company will arrange to verify the report , upon confirmation, you will receive the lumpsum amount.

What I am sharing is just base on my experience and suggest you to contact your insurance agent to have better understanding of the product they offer and you may have policy product from different insurance company to make comparison , then, choose the one suite to your requirement.

Always take up insurance policy cover when you are healthy , not, when you suspect something is wrong .

Thursday, September 22, 2011

Chemotherapy Selection for 1st line Non-Small-Cell Lung Cancer ( NSCLC )

Today, I read this posting in Cancer GRACE and feel that it is good to share with you.
It's posted by Dr Weiss on April 16th , 2011 .

Chemotherapy selection for 1st line Non Small Cell Lung Cancer ( NSCLC ) , The importance of getting it right the first time.

Introduction: Why Chemotherapy?

Every cancer therapy has two purposes:
to improve duration of life, and to improve quality of life.
Every other measure of chemotherapy success, such as response rate or
progression-free-survival, is a surrogate to these two true goals.
I am using the broken record as my pseudo-apology for repeating this mantra repeatedly on GRACE, to my colleagues, and in my mind every time I make a treatment decision.
Chemotherapy is the most important treatment for achieving these two goals in stage IV disease.
Stage IV means that the cancer has spread and is no longer curable.
Incurable is not the same as untreatable.
Cure means eliminating every last cancer cell.
Treatment means providing real benefit, in the form of achieving these two goals.
Cancer cells are microscopic. The tip of a pen is the size of more than ten billion cells.
So, if a single cell has spread to a site, say, the liver, you won’t be able to see that cell on a CT or even the most sophisticated PET/CT.
So, once you see the cancer having spread to distant sites, it becomes systemic-in more sites than you can see; we call this “metastatic” or stage IV disease.
To achieve our two key goals, you need to knock down the cancer everywhere-the places that you can see and those you can’t.
Chemo gets almost everywhere in the body and is therefore the best and most important way to do this for most patients with metastatic disease.
Chemotherapy’s effect on the quality of life question really is a balance.
Chemotherapy can cause side effects, including nausea and fatigue.
However, on the flip side, in addition to prolonging duration of life, chemotherapy also provides a quality of life benefit when successful.
That’s because cancer causes symptoms that chemotherapy can delay or prevent.
For example, when cancer spreads to bone, it can cause pain and fractures.
When it presses on airways, it can cause shortness of breath and pneumonia.
Cancer causes fatigue, organ failure, blood clots, and numerous other problems.
When chemotherapy prevents more symptoms than it causes there is a net gain of quality of life.

....... to continue , please click the below link to the original posting in Cancer GRACE

Wish this sharing will help you to undertand more about chemotherapy and type of drug for treatment of Lung Cancer .


Wednesday, September 21, 2011

More younger age cancer patient

When I was diagnosed with lung cancer , the pathologist decided to make a second test of the tissue to ensure the result is correct . As he feel that lung cancer for my age 45+ is too young, as lung cancer normally detected around the age of 60 .
Then, when I meet up with the visiting lung cancer specialist in Singapore, he told me it is true that lung cancer is normally detected about or after 60 years old, but, the sad news is that more younger patient now.
Recently, I notice that most of the new cancer patient I get to know is all between 30 to 50 years old , be it in Malaysia or in USA cancer support forum .
Feel sad of the trend and just wonder what is happening .
Another sad news is that many young lung patient is non smoker, especially lady patient.
Also there is some cases where the patient is between 20 to 30 years old only.

It is time for everyone to seriously look into the matter and take steps to change lifestyle with healthy living , healthly food , less stress , regular exercise and say " TAK NAK " ( " NO " ) to smoking .

It is never too late to make changes to our lifestyle and give opportunity to our body to detox , to recover and regain our health .

Let's start work on it , for yourself , for your family , for your love one , no more delay .

Lord, I pray for your blessing for all of us, please bless us to have wisdom and guide us to live our life the way you want us to live . And guide us to change our lifestyle.
In Jesus name I pray . Amen.

CT Scan today 21st Sept 2011

It is a long wait today .

Blood test at 9.30 am . Doctor advise , Blood count all in order . Liver ; Kidney function is okay , CEA not much changes, still about 2400.

CT Scan at 10 + am and finish by 10.30 am. Result finally ready by 3 pm .
Result with Radiologist summary as follows :
Ca lung on chemotherapy with mixed response.

1) Previously noted mass in right upper lobe is almost similar in size 11.9 x 6.9 cm ( compare to previous scan 11.3 x 7 cm ) .
Large metastasis, the largest is at the mediastinal border measuring 5.1 x 4.1 cm ( previously 5.4 x 3.3 cm )
Another large subpleural nodule is seen abutting the right transverse fissure measuring 3.3 x 3.3 cm ( previously 4 cm )
There are multiple lung nodules in both lungs.
These nodules appear unchanged compared to the previous scan.There are several new nodules seen in left lungr ( Note : after going thro' my scan with oncologist, we found that there is no differences as those so call new nodules did show up in previous scan )

2) Mediastinal lymph nodes are smaller and fewer

3) Right paratracheal node ( now measure 1.1 cm , previously 1.7 cm )

4) Anterior carinal node now measures 1.0cm ( previously 0.9 cm )

5) Liver , the previously noted in segment II lesion, now measures 0.6cm ( previously 0.6 cm) , segment VII measures 0.6cm ( previously 0.7 cm )
The previously noted segment IV cycts are unchanges.

6) The adrenal metastases are smaller.
Right adrenal metastasis measures 1.3 x 1.6cm ( previously 2 x 1.5 cm )
Left adrenal metastasis is also smaller measuring 1.8 x 1.6cm ( previously 2 x 1.6 cm )

7) The sclerotic bony metastasis to the spine, ribs and scapula are unchanged.

Oncologist say the result show my condition is stable , as there is no major changes after the 2 cycles of Taxotere.

Suggest to have another two cycles before making any decision .

As next week he is not available, I suggest to schedule the 3rd cycle on 3rd Oct .
Means it is like the 1st cycle , 4 weeks between each cycle ( instead of the 3 weeks ) ,
it is also for me to see whether I have the same problem like 1st cycle, where my blood pressure suddenly become low for 3 to 4 days on the 4th week .

After two cycle, as of today , I have less cough and less phlegm ( and sinec 2nd cycle chemo until today, no more phlegm with blood )
Overall body energy is not as good as before chemo , I accept it, as during chemo I normally feel tire and start recover once I take a rest from chemo .
Breathing is not as good as before chemo, a fast walk will make me breathless , unless is after some light exercise and have a brisk walk for 30 minutes, then, I feel better with fast walk It is something like I need to warm up, before any fast walk . I think it is because I feel weak during chemo and should get better once my body recover.

Well ! I accepted the result without much complain, since condition remain stable . As this is the usual result I get for the last 3 years , for all the previous chemo I did .

Thanks Lord for his blessing and healing that keep my condition stable and better . Praise the Lord .


Wednesday, September 14, 2011

Praise the Lord ! Feel great !

Praise the Lord ! Lord is great .
The management of side effect for this cycle is great , thanks Lord .
Feel so much better and start to be have better sleep thro' the night for until atleast 4 or 5 a.m.

Rash ( all over my bald head , hahahaaha ) and some over my face , start to subside since yesterday. Actually not so bad in comparing to the rash I have when I am on the targeted drug " Tarceva " . This time, it is more like pimple over my face and head .

Stomach feel much better also, with the experience of 1st cycle side effect and well prepare ahead of the chemo, I manage to cope well with it and manage to stop the back pain . ( Because of very bad stomach upset , the pain in stomach extended to my back and end up need to use pain killer to stop stomach pain , then, go for traditional massage for my back to relieve pain) . Small serving per meal and do some light stretching exercise and brisk walking in living hall about 15 minutes after food , it help . Meantime, gastric and anti acid reflux medicine help me too .

Constipation happen as expected, right after the 1st day of chemo. Try my best to deal with it and fail . On the fifth day , decided to ask doctor for some medicine , as my piles is giving problem and already start bleeding . After two round of the medicine, the next day feel better and now resolve. Piles is still giving me problem, but, under control. For next chemo, I should start taking the constipation medicine on 2nd day .

Bone pain take effect on 5th day and getting worst on 6th and 7th day . This is expected, because steroid finish on 4th day . It happen the same for 1st cycle chemo, bone pain and all kind of pain strike on 5th day . Worst pain in my neck area . Because of good management of stomach problem, so, the bone pain not really big issue for me .

Fatigue , yes ! very very tire on 5th ; 6th and 7th day . Just want to sleep , rest . getting much better since yesterday . But, have to close monitoring, as during the 1st cycle, on 4th week after chemo, I just suddenly feel very weak and blood pressure getting low for about 3 days . So, seriously need to monitor and hopefully it will not happen again. I am now taking boiled red date
water ; boiled red beans and also black bean soup , to help in increasing my Red Blood Cell .

Taste change . Yes ! it's a problem with taste change. But, it is normal side effect for chemo treatment, so, have learn to deal with it .

Dehydration . Yes ! quite bad, same as the 1st cycle . Have to drink a lot of water everyday. As when I wake up during mid night, I will drink atleast one bottle of water, watch TV for a while , before back to bed . Actually, it is quite difficult to drink so much of water, as the taste is flat or weird ,but, to stop body from dehydrate, have it take it without fail. Actually, I am lucky that do not have problem with water retention , so, should not complain about it , hahahahaha .

Nausea , very light nausea , not an issue .

Appetite -- not bad , thanks my wife for cooking food that I request with taste suit to me .

Overall -- Not so bad .

Chemo drug . 1st cycle : Taxotere (Docetaxel ) + Zometa , 2nd cycle : Taxotere ( Docetaxel )only

Wish my sharing can be a good guide to other cancer patient .

God bless

Sunday, September 11, 2011

Overall seems better than the 1st cycle

I have the 3rd booster for white blood cell as per schedule on last Friday .
Then, start to deal with side effect without the support of Dexamethasone ( a type of steroid drug ) .
Bone pain/ tire / dehydration / gastric / gassy stomach , as expected start to strike .
With the experience of last cycle , I am better prepare myself to deal with it .
Not really have a good night rest , every 3 hours have to wake up to drink water and have some snack. Then, back to sleep again. But, overall not so bad .
Right till now , Sunday afternoon , overall control of the side effect is much better than last cycle.
I wish side effect will go away within the next two days and also wish that I can continue to eat well .
God Bless

Wednesday, September 7, 2011

UF Lung Cancer Center unites experts for patient-focused care

How nice is it , if we have such a well organise cancer centre in Malaysia

UF Lung Cancer Center unites experts for patient-focused care

Patient Gary Love with daughter Katie Love Hobbs (left) and wife Susan Love.
Gary Love had been retired two years when he first noticed the strange, draining feeling in his head. He went to the doctor, thinking it was a sinus infection. It wasn’t.
An MRI revealed a brain tumor, which doctors eventually traced back to a type of lung cancer called adenocarcinoma. The news was shocking for Love and his family, said his daughter, Katie Love Hobbs. He’d never smoked. He didn’t drink. The former sheriff’s deputy had never even been in the hospital before.
Already being treated at Shands at UF for his brain tumor, Love met with the University of Florida Lung Cancer Center team, who devised a plan of attack. Between August and November of 2010, he went through 37 lung radiation treatments, as well as chemotherapy.
“I never thought I would be going through this with my dad,” Hobbs said. “They gave us hope. There was never a doctor we had who did not act like they would do everything they could to help us. They all work together and they are amazing every day.”
No patient ever wants to hear a doctor utter the word “cancer,” and a diagnosis of lung cancer is particularly scary. Lung cancer is responsible for more than one-quarter of all cancer deaths, has a five-year survival rate of about 15 percent — for patients with stage 4 disease survival hovers at just 2 percent — and has few symptoms, often going undetected in the early stages. Quick, efficient care for these patients is a necessity.
Established in July 2010, the UF Lung Cancer Center is a multidisciplinary clinic that brings together all the experts involved in caring for a patient with the disease. Each week, pulmonologists, surgeons, medical oncologists, radiation oncologists, a social worker and other experts meet in one location to see patients, relieving the need for families to trek from office to office for appointments. And every Friday, these experts gather with a radiologist and pathologist at 7 a.m. in a conference room to discuss patients together. As they look over pathology reports, X-rays and CT scans, they agree on treatment plans, talk over concerns and weigh in on different patients’ conditions.
“For cancer patients in general, the two most important concerns is a lack of communication among doctors and a lack of streamlined process and timeliness,” said Frederic Kaye, M.D., medical director of the Lung Cancer Center. “What the multidisciplinary clinic strives to do, and we think it is doing a good job so far, is giving us direct lines of communication and streamlining the process.”
Michael Jantz, M.D., director of interventional pulmonology, said patients also feel more confident having seen a multidisciplinary team.
“They know their case has been reviewed by multiple disciplines with a cohesive plan formulated amongst us,” he said.
A key part of the team, Kaye said, is nurse-coordinator Andrea Penley, R.N., who works closely with every family, setting their appointments, referring them to resources and giving them a familiar person to call anytime they have questions.
“These people need an informed voice, someone they can call up who can help them,” Penley said. “Patients are starting to expect a higher level of coordination. I think all cancer care is headed in this direction.”
In addition to the clinical care the center provides, researchers are working diligently to find better ways to detect, treat and cure lung cancer, specifically looking into the genetics and molecular basis of tumors and developing better ways to screen at-risk patients for the first signs of lung cancer. In Love’s case, a specific genetic mutation could not be identified, but the lung cancer team hopes more effective and less toxic treatments based on new genetic biomarkers will be available for all patients in the near future.
Almost two years after doctors first found his brain tumor, Gary Love is feeling about 75 percent back to normal. He’s traveling again with his wife and spending time with his family. The couple just got back from a trip to Las Vegas, said their daughter.
“Cancer is never fair. It never happens to someone who deserves it,” Hobbs said. “But I cannot say enough about UF and Shands and what they have done for my dad.”
— April Frawley Birdwell

GRACE - Global Resource for Advancing Cencer Education

Share with you the following from GRACE :-

Dr West's TEDxOverlake Talk on Self-Educated Patients and the future of cancer
care .

Meantime, the link to GRACE as below :-

Weather is bad with haze coming back

Not having very good sleep yesterday night also, Wake up by 3 to 4 am . But, still can cope with it.
Have my white blood cell first booster today and until now all goes well.
With the haze coming back, looks like have to stay indoor for time being for my light exercise .
Anyway, will continue to maintain my daily exercise to keep my body fit and have good blood circulation .

Feel good yesterday to read about sharing of 4th stage Lung Cancer patient with good recovery and now 11 years free of cancer .
And few days ago, read about Lung cancer survivor for over 5 years .
All this good news and sharing give us hope and move on with our life .
Just great !

May Lord bless all of us good health and continue to touch us with his healing power for full recovery.


Tuesday, September 6, 2011

Home sweet home

Discharge and back home this morning, feel great to be home .
Have a nice 2 hours sleep after lunch , feel much better .
Last night not sleep well, I think about two hours only from 3+ am to 5+ am, so , quite tire.
Metalic taste quite bad today, but, still manage to eat as much as I can .
Constipation start and hopefully can settle done by tomorrow .
In general, all under control for until now and overall feel more tire in comparing with the first cycle .
Pray for good night rest tonight and wish all well to start the white bood cell booster tomorrow .
Always feel good when reach home after away for hospital stay or travelling.
My bed is the best , hahahahaha , even the best hotel bed can not compare .
After business travelling for so many years, I am still not really get use to hotel room, maybe , it is because of when you finish your work , back to room, basically you are facing the 4 walls , so, the feeling is not good. This year, I try the hotel apartment with two rooms and living hall, feel much better . But, the pricing is consider a bit high against the facilities, for one person staying .
But, certainly feel better, as can stay in the hall and have my light exercise in the balcony or living hall , with fresh air ( not like in hotel, where I hv to exercise in aircon room be in my room or the gym ).
Whatever is it , back home is sweet , feel good !

/ SK

Monday, September 5, 2011

Second cycle with Taxotere ( Docetaxel ) 5/9/11

After a good rest for 4 weeks from the 1st cycle ( on 8th August '11 ) , my body is more or less ready for it for today chemo.

Basically feeling not so bad for the last one over weeks , except feel tire most of the time and some days feel good and can drive . But, towards late afternoon, will feel very tire .

Blood pressure is on the low side , most of the time is Below 100 ( 90+ )/ Below 60 ( 50+ ) , I think this is the reason why i am feel weak and tire.

Been taking boiled red dates and black bean soup to help in increase my red blood cell.

Last Friday, I took blood test and have good result for Total WBC - 9.8 ( very good , as normal is between 4 - 11 ) and Platelets - 434 ( normal is between 150-450).
But, RBC is on the lower side , Total RBC - 3.8 ( normal between 4.7 - 6.1 ) and Haemoglobin - 11.8 ( normal between 13.5 - 18 )

One good news is tumor marker reading for CEA hv reduce .
CEA - 2407.10 ( previous 2948.20 )
CA 125 - 895 ( previous 887 )
CA 15.3 - 55 ( pevious 63 )
CA 19.9 - 6 ( previous 4 )

After discussion with doctor about the side effect for the 1st cycle, we decided to drop Zometa for 2nd cycle and just concentrate on Taxotere . Since I can have Zometa anytime after I complete chemo with Taxotere. I think this should be a good decision, as I am now not sure the bad side effect is due to which drug . By dropping Zometa for time being, the side effect will be either from Taxotere or the booster for white blood cell .

Like the 1st cycle, I am doing well on 1st day ( today ), can eat well and feel okay , except feeling a bit tire ( quite normal )

Pray for Lord's blessing for me to have a good nite rest and all goes well .

If all well, will discharge by tomorrow afternoon and back on 3rd / 4th and 5th day for the injection for white blood cell booster.

With the experience for 1st cycle in dealing with side effect, just wish that I can cope well and manage it better for this time and have a faster recovery .

I am bald about 1 1/2 week ago, when hair start to drop . But, just few days ago, hair start growing again ... :).

I think it will drop again, so, shaving it everyday to maintain bald for time being .

Less phlegm cough out after 1st cycle, but, some blood still show up in phlegm, not everytime and not serious, it is less in compare to before chemo treatment .

God bless.