A letter to NUH cancer hotline

Hi, 

My mum Wan Soo Ha is a stage 4 rectum cancer patient. She was operated on in year 2013 to remove the tumor but the surgeon didn't do a good job in removing all the affected cancerous lymph nodes.

 She is 77 this year. Her doctor is currently Dr Ho Jing Shan from NUH cancer center. She has undergone 6 chemo sessions on folfiri last year.

This year in May, she encountered pain in her pelvis area and Dr Ho suggested to use an expensive targeted therapy drug cetuximab combined with old drug folfiri. She was asked to do 12 sessions of the chemo from July 2015. She did 5 rounds and suffered severe side effects of ulcer and rashes. She lost massive weight and weighed only 35 kg recently. Dr Ho suggested her to use the old drug folfiri for the 6th session. The old drug made her worse. She felt pain again in the stomach and pelvic area shortly 1 week after the CT scan for her 6th chemo. 

Dr Ho has suggested new chemo drugs and immunotherapy. It seems like a trial and error kind of cancer treatment. Can't the oncologist doctor in NUH make sensible decisions based on the patient's condition? It is very frustrating to see loved ones suffering from side effects of trial and error chemotherapy drugs and to know there is not much patient support being received on this advanced cancer. I still remember Dr Ho told my mum : 'What do you want me to do?' when my mum complained to her about her pain. 

My friend who was a breast cancer patient of Dr Ho. She died last year in November 2014. I have seen her lost drastic weight in August 2014 till her last days in November 2014. She went through a newly fully-sponsored chemo treatment which made her condition worse. She suffered from terrible side effects and she stopped the treatment. She went through radiation therapy when the cancer cells spread to the skull in her brain. When I last saw her last September 2014, she was still having chemotherapy. 

I am not against chemotherapy. I only hope oncologist knows when his/her patient should stop the cancer treatment and focus more on providing better patient support. If the oncologist is not sure, shouldn't there be a professor oncologist who can provide more expert advice?

I appreciate your attention to this email. It's saddening to know advanced cancer has no cure and there is no end to chemotherapy until the patient dies.