Friday, May 08, 2009

if only.....

3 year is a long time in medicine. this is the time period that lapsed since this 51-year-old lady last came to see the surgeon, who had then advised her to remove a lump in her breast. she came back this week for the surgery & this is her chest xray taken pre-operatively.

the multiple coin-shaped opacities seen in both lungs are typically called cannonball lesions. they are most likely a result of the spread from breast cancer. despite surgery to remove the affected breast, she will still need to go for either chemotherapy or radiation (depending on the nature of the cancer), & even then, things don't look promising. she may not see the end of the year.

if only she had agreed to the surgery 3 years earlier....

but, it not too late for most of us. besides maintaining a healthy lifestyle & going for regular medical check-ups, frequent breast self-examination (read here) can detect early abnormalities. further info on breast cancer awareness can be obtained here.


Lee said...

Hi Doc, really sad to read of this lady.
Here in Canada medical is free, includes operations, births etc.

And yet, we had a lady friend, a Malaysian...she never went for her medical many years, always, "no time".
And two years ago diagnosed with breast cancer.
She was given 6 months.
She passed away 7th month.

Here, my wife and I go for our yearly full medical.
The whole works...X-ray, blood test, urine, complete body check, head to toe as well I call it the ice cream test...

it is now mandatory here all people above 50 are given the stool test.
We are given 3 small sticks, like ice cream lollypop sticks...and to take a small sample of our stool 3 days in a row, keep it in special wrapping, on 3rd day post it back to clinic for tests.

I dislike the prostrate test, the doctor pokes his finger you know where, ha ha.

Keep well Doc, have a pleasant weekend, Lee.

doc said...

Uncle Lee,

I agree that once we reach 50, those tests are essential to detect early abnormalities. it's also imperative that the public are aware that screening tests like these could well save lives - their own.

just me said...

Fear of the unknown is what crippled this lady to "inaction".

On the other hand, I recall the case of a doctor who knew so much of his condition and was too afraid to take the "risk" of a heart by-pass, which led to his demise.

msforty5 said...

We all have Imaginary FEAR & perhaps its easy for you medical people to say IF ONLY ... patient listen. We should not judge neither can we read the lady's mind & like most cancer patient I understand her fear.

I started going for yearly medical check in my early 40s & yet I was unfortunate to be diagnosed even if you call it early stage means better survival. Despite telling docs (not 1 but 2) & then being assured my early gynaecological symptoms are all hormonal related, peri menopausal blah.blah.. it was a bit too late when the bigC hits. Your brain somewhat freezes, a sense of DOOM, ANGER, BETRAYAL overcomes the initial shock. You wish to rewind the CLOCK & ask WHY WHY WHY but nobody has the answer except to tell you straight in the face YOU MUST GO FOR SURGERY quickly. WHAT do most people do?

It is mostly out of fear and ignorance plus the lot of dr quacks out there who will make the weak and vulnerable think 100X before going under the surgeon knife. Most doctors or surgeons do not have the time nor the patience I mean most, to reassure the patient. I've been there I know. I go the next step, 2nd opinion and do my own research online.

After the initial scare, then I am confronted with another one, a rarer one I'm told the very next day after CT scan. Your mind goes overtime, and the surgeon tells you DO THIS one 1st, then another surgeon will do the other one. For 2months after the 1st op, I go through some kind of alice in scaryland not knowing what to expect.

And its called imaginary FEAR.

doc said...

Just me,

at that time it was just a "suspicious lump", but yes, she could have been so fearful that she didn't do anything about it.

and yes, doctors make terrible patients.

doc said...


thanks for your frank opinion of doctors.

this post was written retrospectively, so it's 100% accurate with respect to making the right diagnosis. but it's really meant to be a cautionary tale, that is, to take all breast lumps seriously.(other symptoms that should get the alarm blaring include persistent nose bleed or headache, & presence of blood in the sputum, urine or stools.)

conversely, some cancers are notoriously difficult to detect till it's too late, eg. liver, pancreas, colon & other internal organs.

you are absolutely spot-on when you say some surgeons are over-zealous & they are everywhere, but there are really decent ones too. (email me if you seek a 3rd or even a 4th opinion - being in the inner circle, i may be able to assist you)

however, i disagree with you on the issue of imaginary fear, because met with a grave diagnosis, this fear is so real, it's almost palpable. there's a sequence of emotions that a patient goes thru when faced with this difficult situation, which you may have undergone, including shock, fear & sadness, & for this i commiserate with you.

msforty5 said...


Tks & yes I do know there are many decent docs around and from your postings you've gone the extra mile.

The Imaginary Fear I was refering to is what comes next after surgery. For most women, losing a breast is a life challenging issue just like men, prostatectomy means losing power & dignity (that was related by a urologist).

Having undergone 2 major surgeries in a space of 2months last year, I would personally not recommend it to those who are not fit and strong physically and mentally. Stressful.

Sigh... I feel Very OLD sometimes but I'm the positive type. Our journeys in life are not the same, but we all head to the same destination.

doc said...


surgery can be a frightening option for some, but looking at the bigger picture, it is for the greater good to preserve life.

however, only you will know if you have made the right decision.

anastasia said...

educate me.
What's so bad about dying?

doc said...


there's nothing bad about dying - it's a natural process. after all,
the Wise Man said, there's a time to be born & a time to die (eccl 3:2).

most people want to live - to achieve what they set out to do & fulfill their hopes & aspirations, & when their lives are cut short, there is a sense of sadness.

others want to die & take their own lives. remember Samson & Judas?

all i can say is that God created us for a purpose & He has a specific plan in mind for everyone.

For I know the plans I have for you, declares the LORD, plans to prosper you and not to harm you, plans to give you hope and a future (Jeremiah 29:11).

may God bless you abundantly.

Anonymous said...

Hi Doc,

Stumbled across your blog. Great to see practicing Christian docs out there. Was reading the comments and I think it is great that you have offered to recommend doctors to the lady. Most docs will never do that unless you are their patient.

Good blog and may the Good Lord continue to use you to touch lives.

doc said...

dear Anonymous,

thanks for you kind comment.

having been privileged to receive the Lord's calling, i'm trying to repay blessings that i've been richly bestowed.