Have You Been to a Chemotherapy Room?

I accompanied my mother for her monthly Bisphonal drips to Cagayan De Oro Medical Center this week.  The Bisphonal will preserve her bones which was damaged due to bone disease (osteoblas…something) and as adverse effect of her  anti cancer medication.

The Bisphonal ampule is injected to a dextrose solution set to drip for two hours and it could very well be administered here by the local oncologist.  Unfortunately, my mother’s medical oncologist in Philippine General Hospital is not comfortable with our oncologist here because she is relatively “new”.  He instead insisted that my mother go to Cagayan De Oro City and have a certain lady oncologist there continue the Bisphonal treatment of my mother.  He said he’s confident with this lady oncologist because he trained her at PGH himself.  My sister also knows this lady oncologist because the latter was one of her instructors during medical school.

Immediately upon arrival in Cagayan de Oro City, my mom and I went straight to the hospital to see her OB-GYN Oncologist for her annual check up.  Developing uterine cancer is one of the adverse effects of her anti cancer meds (very, very small percentage only), so yes, she had to go.  Thankfully, everything is in order down there, hehehe.

The next day, we visited the Medical Oncologist referred by my mom’s doctor in Manila.  After laughing when we related to her why we were there when she commented there was an oncologist in our city, she told us she cannot administer the dose impromptu because it’s not readily available and she had to call Zuellig Pharma to have it delivered to her clinic.  Although she said it would be possible to do it in the afternoon, we told her we prefer it administered in the morning because immediately after, we will be driving back home (we did not want to travel in the dark).  My mom had low grade fever after her first dose of Bisphonal (a common side effect) within 12 hours after the drip and with this in mind, I wanted her safely tucked in bed back home when the fever comes.  So, we agreed it will be done the following day, Friday, between 9 to 10 in the morning.

We marched down the hallway towards the Chemo Room at quarter to nine in the morning.  Though my mother is a breast cancer patient, she did not undergo chemotherapy because her cancer was stage IC, Estrogen(+) Progesteron (+) and HER2 (-).  She was only put on hormonal therapy (Tamoxifen, Aromasin, Arimedex).  Thus, chemotherapy room sounded lethal to me.  Poison.  Toxic.  Dangerous.

When I opened the door, I was in for a big surpise.  We walked inside and two nurses brightly greeted us.  We stepped in a cozy room.  It did not look and feel like a hospital.  Instead of glaring, flourescent lights, the room was subtle, a bit dark and lighted with incandescent lights.  One portion of the wall was painted red orange with picture frames, the rest was painted cream.  A Samsung Plasma TV was plastered on the wall together with a Samsung DVD Player.  There was an office table slightly hidden at the corner of the room.  Several leather recliner seats lined up.  Except for the I.V. poles standing beside the recliner seats and the two hospital beds at the further end of the room, I would have thought we were just seated at someone’s entertainment room.

We were the first ones to arrive, but we were told the Bisphonal was not yet there.  They told my mother to settle in one of the recliner seats.  We still had to wait for the secretary to bring the medicine.  After a few minutes, three elderly cancer patients scheduled for their chemos arrived.  They were already chummy with the nurses and were chatting like old friends while the nurses prepared their medications.  I was curious why the nurses had to cover the Ringer’s solution with black celophane.  They went a little further by covering the entire I.V. line with black electrical tape.  Then, the oncologist arrived, brought the chemo drugs (with boxes screaming CYTOTOXIC) and instructed the nurses to inject the drugs in the I.V. line.  The nurses then wore gloves when they very carefully did so.  I so wanted to ask the doctor why the black covering.  So that the patients can’t see what is happening behind it?  Maybe the color was terrifying that they need to cover it?  Seriously, why???

An hour and a half had to pass before my mother’s Bisphonal arrived.  The secretary said Zuellig has already changed their procedure and it is no longer possible for the medical representatives to deliver that particular drug – the secretary had to go to Zuellig together with the medrep and collect it herself.

The Bisphonal ampule was then injected to my mother’s I.V. solution and set to drip for two hours, more or less.  Right after my mom’s drug was administered, another breast cancer patient arrived and this time, her chemo therapy drug was of a different kind.  Her solution and the I.V. line were not covered in black.  The chemo drug was pinkish in color and I could see it freely dripping the whole two hours she was there too.

While waiting for their medications to fully drip, the patients comfortably sat back, relaxed and watched movies the entire time.  They were free to eat too.  Looking at them, none of them were in pain.  The nurses were also watchful of their welfare and catered to their slightest needs – lowered the temperature, gave them blankets, etc.  After the drips were completed, the patients brushed their hair, powdered their faces, put on lipstick and bid goodbye to the nurses.  As if getting the treatment was the most ordinary thing to do.

When my mom’s time was up, she did the same thing and though she was not there for chemotherapy, I was still proud of her when we walked out that dreaded room.

CDO Medical Center Chemotherapy Room

CDO Medical Center Chemotherapy Room

What Went Wrong

The recurrence of my mother’s cancer got me thinking really, really hard.

She was a stage one grade c patient (tumor size 2.0cm, lymph nodes 0/14), Estrogen/Progesterone Positive and HER2 Negative.  Meaning, her cancer is fueled by estrogen and her genetic make up does not produce a certain protein which multiplies aggressively.  It was supposed to be the “safest” cancer to get.

Since her cancer is not chemo sensitive, she is under hormonal therapy.  To stop fueling the cancer, she took TAMOXIFEN for 18 months.  When adverse side effects of the medicine affected her liver, she switched to AROMASIN.  Her recent condition prompted her doctor to change her hormonal therapy to ARIMEDEX.

“Some breast cancer cells require estrogen to grow (as in my mother’s case). Estrogen binds to and activates the estrogen receptor in these cells. TAMOXIFEN is metabolized into compounds that also bind to the estrogen receptor but do not activate it.  It prevents estrogen from binding to its receptor. Hence breast cancer cell growth is blocked”.

“In women who have had their menopause the main source of oestrogen is through the conversion of androgens (sex hormones produced by the adrenal glands) into estrogens. This is carried out by an enzyme called aromatase. The conversion process is known as aromatisation, and happens mainly in the fatty tissues of the body. Aromasin is a drug that blocks the process of aromatisation, and reduces the amount of estrogen in the body”.

AROMASIN is steroidal which INACTIVATES the aromatase in her body permanently.  ARIMEDEX on the other hand is non-steroidal which INHIBITS the aromatase in her body.  Since ARIMEDEX only inhibits the aromatase, it is thus temporary, unlike AROMASIN which inactivates it permanently.  Unfortunately, since the cancer recurred despite her intake of AROMASIN, her oncologist ordered her to start taking ARIMEDEX instead.

Having cleared the slight difference of Aromasin and Arimedex, I was more alarmed by what I read further.  Tamoxifen, Aromasin and Arimedex (and the rest of those hormonal therapies) only block, inactivate and inhibits the estrogen PRODUCED by the body and NOT THE ESTROGEN THAT IS DIRECTLY TAKEN INTO THE BODY.  I read more and I discovered that there are actually foods which have natural estrogens.  So I searched thoroughly, and to my horror, the list includes the following foods:

Animal flesh
Dairy Foods – Eggs
Olive oil
Papaya – Pomegranates – Plums – Apples – Cherries – Dates –
Red beans – Split peas – Chickpeas – Cowpeas (black- eyed peas)
Red clover – Sage – Parsley – Garlic – Hops – Licorice – Clover – Alfalfa
Rhubarb – Pumpkin – Potatoes – Peppers – Peas – Tomatoes – Yams – Olives – Cucumbers – Beets – Carrots – Eggplant
Sesame seeds – Sunflower seeds – Fennel – Flaxseeds – Anise seed
Soybeans – Soybean sprouts
Wheat – Oats – Rice – Barley – Baker’s yeast

OH MY GOD.  My mother’s “healthy” anti –  cancer diet is mainly rice, papaya, potatoes, tomatoes, carrots, oats, eggs, cucumbers, eggplant.  While these are generally anti-cancer foods, these are not good for breast cancer – estrogen positive patients because their cancer rely on estrogen to survive.  It’s like my mother directly fed her cancer cells to recur.  Aromasin failed because it cannot inactivate the estrogen not being produced by the her body.

I want to cry, I want to cry, I want to cry.  I had strictly imposed upon my mother to eat loads of raw tomatoes and carrots every meal, oats for breakfast, red rice for lunch and dinner.  It’s like we brought her cancer back.

Instead to dwelling on this frustration, I read on to learn that there are also food that naturally inhibit estrogen in the body:

Berries – Citrus Foods – Figs – Fruits (except apples, cherries, dates, pomegranates) – Grapes – Pears – Pineapples – Melons

Cabbage – Corn – Green beans – Broccoli – Onions – Squashes

Millet – Buckwheat – White rice – White flour

Tapioca

So, starting last night, my mother’s diet had drastically changed to a narrower choice as listed above.

She is also taking lemon grass water now.  Lemon grass, or tanglad, is known to cause the cancer cells to self-destruct.

My husband’s friend was diagnosed with prostate cancer.  He was on treatment for six weeks but his condition did not improve.  He later drank lemon grass water and a month after that, he got cured, his prostate returned to normal.

Our aunt’s neighbor in Bohol was poor and was not able to avail of the usual treatments and only drank tanglad water and she’s still alive.

Aside from lemon grass, my mother will also devour malunggay.

My brother in law’s aunt had cancer in the advanced stage.  Her breasts had turned hard like stones and turned yellow, grey and violet.  She did not undergo surgery.  Her armpits had lumps all over.  Since she was also poor, she did not undergo treatment but only ate malunggay.  That was in 2006.  It’s already 2009 and she’s still alive.

Die, cancer, die!