Cancer Treatment & Future Support Plan

In September 2021, my wife was diagnosed with metastatic carcinoma, a Stage-4 cancer. According to a local oncologist, it cannot be cured. All they can do is, to prolong her lifespan and improve her life quality through necessary treatments. 5-year relative survival rate is at around 14%, according to the doctor.

Due to cancerous tumor affecting her right leg bone, she has to walk with crutches.

She started her chemotherapy in KPJ Specialist Hospital (private hospital), but is transferred to Likas Government Hospital after the 5th chemotherapy due to insufficient life insurance coverage.

What makes thing worst was that, she is unfortunately allergic to Paclitaxel, one of the main drugs use in chemotherapy. So the only option left was to use the more expensive Abraxane, which costs around RM5000 per treatment.

During her 1st chemotherapy in KPJ Specialist Hospital, oncologist introduced the use of Avastin. From the Internet, it says "Avastin is used with chemotherapy and hits your cancer from another angle. Avastin is a tumor-starving (anti-angiogenic) therapy. The purpose of Avastin is to prevent the growth of new blood vessels. This includes normal blood vessels and blood vessels that feed tumors."

Cost, however, is the main concern. If Avastin is to be used during chemotherapy, it will be RM18000 for the doses she needs for two session (they provide buy-one-free-one package, so the cost of RM18000 is for two chemotherapy sessions). She had it for the 1st two sessions. Although it is proven to provide better efficiency, our wallet just does not allow us to continue using it.

After the 5th chemotherapy, although still lame, she was able to walk without crutches. Simple daily activities can be performed without much issues. However, the condition did not last long. She was back on crutches roughly a month after her 6th chemotherapy.

The 6th chemotherapy session was delayed due to medical team from the government hospital need to restudy her case and re-examine her condition. Not to mention the government hospital medical staffs who were in charged of her 6th chemotherapy, do not have any experience in handling Abraxane and thus wasted 1/3 of the drug. On top of that, Carboplatin, the 2nd main chemotherapy drug, dose provided was only 1/3 compare to treatment sessions in KPJ Specialist Hospital.

Couple weeks after her 6th chemotherapy session, medical team from the government hospital had a review on her condition. Initially they planned for 30 radiotherapy sessions including 3 brachytherapy sessions with additional 1 chemotherapy session once a week. However, chemotherapy sessions were later taken out from the set schedule.

While waiting for her radiotherapy session, which was again delayed from set schedule date, her condition was slowly degraded. The pain has caused her difficulty to walk, to stand for short period, getting in/out from car, even when sitting.

Due to the severe pain which has caused inconvenient in her daily life activities, she started to take the Morphine Sulfate tablets after the 2nd radiotherapy session, which were prescribed for her earlier. At this point, ordinary pain killers such as Panadol or Paracetamol just do not work as efficient anymore.

She has to use wheelchair during her visit for 3rd radiotherapy session due to difficulty to walk from hospital entrance to the radiotherapy reception hall. And at the time being, due to inconvenient to walk up/down the stairs, she can only stays in the bedroom. The Morphine Sulfate tablets do help to reduce the pain, at least now she is able to sit properly and go to toilet without issues.

According to oncologist's planning, she will receive 6 chemotherapy sessions, follow by 30 radiotherapy sessions. Medical team will then do another review and plan for next step. So far she has done 3 radiotherapy sessions.

(9th April 2022)

TO BE CONTINUED...