Forsaking science for mere comfort
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Dr Ang Peng Tiam
for Mind Your BodyThe medical director of Parkway Cancer Centre has been treating cancer patients for nearly 20 years.
In 1996, he was awarded Singapore's National Science Award for his outstanding contributions to the medical research.
He has also published a book on patient stories, Doctor, I Have Cancer. Can You Help Me?, which has been translated into 9 other languages.
Forsaking science for mere comfort
When she took off her sunglasses, I had to work hard not to let the shock show on my face – she was scary sight – her eyes were literally popping out of their sockets, there were dark purple bruises over her eyelids and eye-bags.
Her neck, armpits and groin were swollen. She had lost a great deal of weight. Her passport photograph showed she was a once attractive lady with a pleasant smile.
This 54-year-old Indonesian lady first noticed the lumps in 2004.
Doctors suspected that she had malignant lymphoma or cancer of the lymph nodes. She had been advised to have a biopsy to confirm the diagnosis and then go for chemotherapy.
For the past five years, she has resisted this one hard truth. From Indonesia to Singapore, from USA to China, doctors told her she was likely to have lymphoma. She refused a biopsy and was adamant that she did not want any treatment.
Instead, she tried alternative therapies – herbal treatments, dietary changes, spiritual healing. Meanwhile, the swollen glands spread from one area to another and eventually affected both eyes.
The space behind the eyeballs was packed full of tumour tissue, resulting in her eyes being pushed out of the sockets.
I knew she was in denial and fearful of the disease, so I used the “soft” approach to put her at ease. Her cancer was in fact highly treatable.
After an hour of listening to me talk, she got up, thanked me and said that she’d consider my proposal. I knew that I had failed.
Nurse counsellors followed up, but despite several calls to her Singapore mobile phone, she declined to meet up. We lost contact with her and after a week, I knew that I had failed to convince her.
It was a moment of true loss because I knew for a fact that we could help her. I wanted the joy, thrill and satisfaction of watching her tumour melt away and seeing her restore her looks and not have to hide behind her sunglasses. In fact, with her permission, I had already photographed her “before” pictures so serve as a record of how she appeared before treatment.
Curious as always, I called up some of my colleagues to enquire if any of them had seen her. As luck would have it, she did indeed consult one of my colleagues, who like me, has a special interest in lymphoma.
“Oh yah! I saw her,” he said gleefully.
“I shouted at her and bullied her into submission. I told her that her stupidity and stubbornness was going to kill her. The nurses could hear me scolding her in my consultation room. I literally dragged her to the surgeon to get the lymph node biopsied so that we could confirm the diagnosis.”
“The good news is that she has a low-grade lymphoma and I have started her on chemotherapy,� he said.
I was relieved – and realised belatedly I should have been “bad cop” instead of “good cop”. Whatever it took, I am glad that she was finally getting the appropriate treatment.
The psychology of the patient’s mind is one of the key things to her recovery, but as this patient’s story has shown, it is clearly a doubled-edged sword. What is disturbing about this story is that there are those who would take advantage of her ignorance and fears.
There were Chinese physicians who sold her herbs, knowing fully well that it would not help. Worse still, there is a clinic set up in a posh medical centre that “treated” her with bio-resonance therapy, which claims to be able to cause cancer calls to die through electromagnetic oscillations. The claims are shrouded in medico-scientific jargon, but there remains no conclusive evidence that such therapies work.
I must say that I do not forbid my patients from using alternative therapies as complements to conventional treatment –I do not close my mind that some of these may indeed in the future be proven to be helpful. But the key word here is “proven”.
Everyone who cares for the sick – whether a trained medical doctor, a traditional healer or a new age therapist – should work towards getting him well with clear and well-reasoned care, rather than trading on the patient’s emotional state.
Cancer is almost always a matter of life and death, and in these matters, the mind is a powerful instrument that can make a defining difference. But the mind is emotion as well as reason. Patients themselves should not forsake the benefits of science for mere psychological comfort.
This article first appeared in "Mind Your Body", a Straits Times Supplement.