On 28 September 2006, I received an e-mail from a man seeking help for his wife. This is what he wrote:

I write this e-mail to you in order to seek your suggestion regarding my wife’s illness.

My wife had been diagnosed with Acute Myeloid Leukemia (AML) type M5 in late December 2005. I brought her to Singapore General Hospital (SGH) on 1 January 2006 for further management and chemotherapy. She had 3 cycles of chemotherapies in the first 3 months. Later she underwent a Bone Marrow Transplant procedure (BMT) in late April 2006 until mid May 2006. But unfortunately, on the 75th day after BMT, the leukemia cell relapsed. After that my wife had another cycle of chemotherapy and also received donor lymphocytes.

Due to financial consideration, I moved my wife for further treatment to Malaysia in mid August 2006. She was admitted into the Subang Jaya Medical Center (SJMC) until today. At SJMC she got another cycle of chemotherapy and received another donor stem cell on 12 August 2006.

But a week ago the leukemia cells were shown to be active again and they developed quickly before donor stem cells even could work. Five days ago my wife had another cycle of chemotherapy in order to reduce the white blood cell count.

I would like to find possible therapy and treatments that will be suitable for my wife. My wife and I are Indonesians. Within the next few days, I must make a decision whether to bring back my wife home to Jakarta or stay in Malaysia. I really need your help.

Comments

The above is a 33-year-old lady. Before her diagnosis she presented with the following symptoms: fevers for 1 to 2 weeks, gum pain and bleeding, headaches and diarrhea.

Over the years I have encountered many cases of bone marrow transplant (BMT). And all the cases that I know of resulted in death. There was this young lady of eighteen. She underwent BMT in Singapore. After spending so much money, her parents had to bring her home in a coffin. At her wake service, her mother said to me: “If we knew it is like this, we would have stuck to your advice!” She realized her mistake a bit too late!

I know of a person who had to spend well over 1.5 million ringgit (US$1 = 3.5 ringgit) to save his wife from leukemia. She too died. Then there was another young lady who just started to work after graduating from her studies in Australia. She had leukemia and she too underwent BMT. I was told (rightly or wrongly) that she died while on the “operation” table.

Tham is my patient who suffered from kidney lymphoma. After undergoing some initial chemo-treatment he decided to give up chemotherapy due to severe side effects. He opted for herbs. Within nine months, the cancer went into remission. Soon after he was pronounced cancer-free, his doctor suggested that Tham undergo BMT. According to the doctor with BMT he would live ten years longer. Tham declined after consulting me. The question I posed to Tham at that time was: “The aim of the doctor was to prolong his life for ten more years with BMT, but what was not taken into consideration was the risk of dying from BMT due to various complications.” It has been eleven years since Tham was diagnosed with cancer. He is very much alive and well today. Tham is still taking the herbs.

In the case of the lady above, fortunately she did not die from the BMT procedure, but it did not cure her either. Much money had been spent on medical expenses. I only have this to say: Your life is in your hands. Decide wisely!

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Diagnosis of mesothelioma is a difficult procedure. It is to analyze the symptoms in the initial stages. The symptoms of this rare disease make the diagnosis very difficult even to a doctor, since the symptoms would be very similar to other common diseases in the early stages of this deadly disease. Delay in the diagnosis is very common in most of the cases. As a matter of fact these symptoms can appear as non-specific to both the patient and their doctors.

A careful assessment is needed in the diagnosis of mesothelioma which relates both the clinical and radiological findings. The tissue biopsy is also confirmed carefully along with the above factors. The reviewing of the patient’s medical history can be very helpful to diagnose mesothelioma. Observation of the disease and the history includes details such as the patient’s asbestos exposure, the complete physical examination, x-ray results of the chest and abdomen, and the lung function tests.

A Computerized Tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan may also be taken at this level. If the preliminary test results prove suspicious, then a biopsy is performed for confirming the diagnosis. The location of the cancer can be determined with the help of performing the biopsy. If the biopsy test confirms the presence of mesothelioma, the stage of the cancer is then determined. A series of tests are performed to determine the amount of cancerous cells that have spread.

If the test shows that the cancerous cells are not developed beyond the membrane, then the disease is considered to be localized. During this diagnosis procedure, various tests are performed such as the imaging tests, which includes the use of x-rays; CT (Computed Tomography) scans; MRI (Magnetic Resonance Imaging); PET (Positron Emission Tomography); bronchoscopy or mediastinoscopy, used to look into the affected area; cytology, used to test the pleural fluid after it is removed by a needle; thoracoscopy, used to look directly into the tumor; needle biopsy; and open biopsy. Those are the major tests that are performed during the mesothelioma diagnosis.

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