Monday, February 16, 2009


I felt very sad and helpless when some of our patients and their loved ones faced the side-effects of their chemotherapy and radiation course. While undergoing chemo + radiation treatment, the patients experience terrible depression, have extreme mood swings, are often bad-tempered and angry, become 'crazy' and forgetful, erratic feelings and behavior that seems abnormal to their loved ones and caregivers.

It is at these times that our group members counsel their loved ones to have lots of patience and tolerance and sometimes to walk away to avoid arguments and quarrels or to leave the patients alone for a while.

This will go on not for a few days or a few weeks but months and months of the chemo +radiation treatment course. Just when the patients feel well, sane and recovered, the cycle of these terrible roller-coaster feelings will start again with the next treatment.

Usually there are 2 sets or phases of 30 times chemo+radiation treatment (total 60 times)
One set or phase of 30 times means 6 months x 5 times treatment . e.g. In every month there is a full cycle of 5 days non-stop chemo+radiation therapy treatment course followed by a rest of 21 days ( 3 weeks). Then in the next month, the cycle starts all over again.

If I phone the patients during their treatment days, I could sense their anger and frustrations in their talk. Some even cut short abruptly or hang up their calls. It is at these moments that I worried and prayed for them and their loved ones + caregivers. But during their rest days of in-between periods of treatment, the patients sound normal + their usual self.

There is one patient (43 years old) from Kajang. He went for 3 times chemotherapy in KL before his operation. This is to shrink the size of the tumour. His wife told me that during those 3 days of chemo, his temper was awful. She just walked away to the garden.
Now he is recovering well in HTJS (Hospital Tuanku Jafaar Seremban). He had partial of his stomach (60%) + oesophagus cut off and the remaining part of his stomach ( about 1/3 left ) + oesophagus joined together and placed up into his chest cavity ( Ivor Lewis Oesophagogastrectomy operation) .

I admired his strong fortitude and positive mental outlook. On every visit he had a cheerful smile. Once he told Iris, my daughter, that he is blessed and lucky to have Dr Ramesh and survived the operation when compare to the fate of those victims trapped in the China earthquake incident.

He even helped to give encouragement to a new patient ( an 80 year old man from Kuala Pilah)
I brought this old gentleman (before his operation) to this Kajang man as they were in the same ward in HTJS, for him to learn how to use the spirometer ( a gadget with 3 balls to suck up and exercise the lungs after the operation)

Today, this old man is recovering well from his subtotal gastrectomy operation ( Bilroth 2 with 70% of his stomach cut off and remainder 1/4 stomach joined to the intestines ) + his bed is opposite the Kajang man. It is good and nice to see these 2 gentlemen recovering well and I thanked God and ask Him to Bless them always.

Some people asked me why should an 80-year-old man had to undergo a major operation. I believed and trust my surgeon, Dr Ramesh. He has his reasons and I know that he is a very careful surgeon. He will make sure that his patient is fit enough to be operated on and usually warded the patient a few days earlier in HTJS to go through some necessary tests. When everything is well, then the patient will be operated. Life is precious and worth saving ! If a patient can't eat well and is in pain all the time, how can he live without eating + drinking ?

Last month Ms Goh and I met the Mersing patient from Johor in HTJS. He is the patient with the sponsored stent in his oesophagus. He looked well and cheerful and was happy to see us. He told us he could eat well. We asked him about his children's welfare and his eyes shone when he narrated about their mischievousness and children's play. Ms Goh has an anonymous benefactor from KL who is ready to take care of the children's welfare and needs when the time comes. He understood and will look into it. He has some relatives but they stay far away in Muar and has lost contact...not really close with them. His ex-employer's family is now looking after them, sending the children to school in the mornings and cooking meals for them. At least now, the Mersing patient has some MAKNA Bursary assistance ....monthly income of RM200 for a year. Ms Goh's friend from KL also gave him a big "ang-pow" to celebrate the Chinese New Year (CNY) festival with his children. There are many 'guardian angels' still around. God is great !

The young doctor and architect are now tolerating their second phase of chemo + radiation treatment. Other stomach-cancer survivors are doing well. Positive attitude, hope and good nutrition are important to beat this cancer.

When I started to help the surgeon Dr Ramesh in March last year (2008), my first patient who refused to be operated and was given a few months to live, is still alive . During my recent phone call on CNY this year, she sounded strong and cheerful and could eat well. I was very happy to hear her but she still refused to meet me. I prayed that one day we will meet.

A few patients passed away. When their cancer cells has spread to other parts of the body, when they have problem eating and keep losing weight, when they lose hope and are unhappy.......
My surgeon tried his best to save them, but when the spread is too advanced , only palliative care and pain-killer drugs or radiation are given.Through the Hospice and Unit Palliative, we try to give as much comfort and care to the patients and their caregivers. Faith and prayers can give them hope or acceptance/ deliverance from their pain.

We always try to advise patients not to give up hope, think positive, eat well and maintain their weight especially after surgery. Do light stretching exercises, go for walks, make short attainable goals, contact friends and family, get new hobbies to avoid boredom and enjoy living.

We as stomach-cancer survivors can "train" whatever remaining portion of our stomachs or intestines (those who had total gastrectomy Roux-en-Y operation= that is whole stomach cut off) to expand in time. At first we eat little amounts but often as many as 6 to 7 times a day. Others may remark that we are greedy as we eat non-stop but in time we can put on weight like some members in our support group. Only we must eat wisely and healthily, more protein food and fresh fruits + vegetables and drink high-protein milk.