Sailing the unknown sea of breast cancer

From January to September this year, a total of 25 client-patients (68% below age 50) were mentored by the PBCN. The youngest was 22 and the oldest was 85. They all underwent an intensive period of detoxification and nutritional healing fortified by an in-depth knowledge and understanding of the environmental causes of breast cancer.

Ages 20-29      2                      Ages 50-59      3

         30-39      6                               60-69      3

         40-49      9                               70 & up  2

                      17                                               8

       

Prior to their individual protocol, 15 had been medically diagnosed positive with malignancy while 10 only had abnormal thermal breast imaging.  The PBCN maintains that having inflammations as shown from an abnormal heat pattern is enough reason for early intervention to be able to correct and reverse the condition without invasive and toxic measures. With conventional textbook medical practice, a positive malignancy must be determined thru a biopsy before treatment is done – surgery, chemo and radiation. 

It must be understood that it takes 5-10 years before the first symptoms of breast cancer are manifested. This is a primary reason why mammography has a very high margin of error of 20% to 40% false negative and false positive. In fact, any mammogram result needs to be confirmed with a biopsy. Worst of all, even women with physical manifestations such as engorged breasts, large lumps or nipple discharge are still subjected to mammography when it is clinically clear that breast cancer can already be assumed. History taking even without any diagnostic procedure can further validate physical examination.

  

These particular cases were prevented from undergoing unnecessary surgical procedures:

A 29 y/o was spared from aggressive medical procedures in Singapore.

Biopsy of right lump of a77 y/o was avoided because her left side was more abnormal.

A 66 y/o was prevented from a mastectomy in a tertiary government hospital.

Of the 15 who had been medically diagnosed and or treated prior to contacting the PBCN, none had any understanding at all of breast cancer and all regretted having submitted to invasive and toxic treatments which made matter worse for them and their families. All lymph nodes removed from 3 cases were negative for malignancies while only 9 out of 61 lymph nodes (15%) removed from 5 cases were positive. Their lymphatic systems have now become impaired by the loss of so many clear lymph nodes.  By having been mentored by the PBCN, four were spared from surgery and chemo while seven did not anymore undergo chemo. The three who submitted to surgery and chemo sought the PBCN as a last resort because they already had recurrence and/or metastasis.

Mammogram and or biopsy only---4

Up to Surgery only--------------------8

Surgery and Chemo-------------------3    

The following cases where spared from the debilitating effects of chemo and huge expenses.

After fully completing the PBCN's protocol, 66 year old Luz was so happy that her repeat thermal imaging after just two months showed a vast improvement of her very severe inflammations after her mastectomy. Furthermore, she has not been taking any of her previously prescribed maintenance medications for her scoliosis and hypertension feels great. She and her entire family are now more than ever fully decided not to undergo chemotherapy and continue all they have learned from the PBCN.

A 44 y/o  OFW nurse methodically cut-up in Dubai for a non-life threatening case of DCIS.

An 85 y/o case who has continued not to submit to chemo since her mastectomy in 2008.

No two cases of breast cancer are the same and this is why one should not be made to routinely undergo and submit to medical textbook procedures and treatments. Harm will always be known after the fact whereas utmost precaution reduces probability of harm and complications. To err on the side of caution is always of paramount benefit to a woman's welfare and well being.

Seventeen years of dealing with breast cancer have brought about the following healing perspective.

1. Empowerment of the individual – character, attitude, purpose and spirituality are qualities which strengthen her will and determination to scale the heights of healing and wellness. She must strive to maintain peace and happiness within herself all throughout her journey.  And only by knowing and understanding the environmental causes and risk factors of breast cancer can she learn how to live with the disease.

2. Support of the individual – Family and friends are crucial in lifting up her spirit and cheer her up as she runs the marathon of her life. Though she will seek the opinion of others, she alone must decide the road to take and whatever her decision, for as long as she is fully informed, must be respected and supported. Having her follow whoever provides financial help is NOT support but pressure or even coercion.  This can be also said of health insurance which automatically decides her treatment in the guise of care and support for its clients.

3. Safe Environment – An empowered individual with all the full support around her will be nothing if she works or resides in an environment that caused her cancer or that will expose her to more  carcinogens.  In confronting breast cancer, so many hard decisions have to be made.  She may have to resign from her job, change occupation or even transfer residence.  She needs to act decisively on the external condition in her daily life to reduce, if not eliminate identified environmental factors that can cause or aggravate her condition.

4. Resources – Expenses cannot be avoided but it is totally untrue and incorrect to think that having so much money and resources can buy a cure.  Nowhere in the entire world can a cure for breast cancer be found or bought, no matter how much money one has. There are only a wide array of treatments and protocols (both conventional and alternative) that have positive and negative results.  Breast cancer would not be a controversy if there truly is a cure.

In mainstream conventional practice,  the order above is reversed where resources is #1 and the individual is last. The more money one has, the more treatments are offered while the patient is given only minimal participation because of absence of full information. She would always be asked if she would prefer this or that, but how would she ever know?

In coping with breast cancer, it is the individual who is the ultimate and final player. And this is why the PBCN was started 17 years ago and continues to exist – to mentor breast cancer warriors.   

    

On natural supplements and breast cancer

In bold prints are my comments on the newspaper article of the Oct 28th issue of the Philippine Daily Inquirer  about the press conference sponsored by the PSMO (Philippine Society of Medical Oncologists) called "Dietary Supplements in Cancer Treatment."

A well-informed cancer patient is an empowered patient. But the barrage of often-conflicting information sourced from the Internet can be overwhelming, and deciding which to believe can be paralyzing.

ON THE CONTRARY, CYBER INFORMATION HAS OPENED THE DOORS THAT WERE PREVIOUSLY CONFINED TO THE MEDICAL & SCIENTIFIC COMMUNITY AND HAS NOW ALLOWED THE PRINCIPAL STAKEHOLDERS TO ACTIVELY PARTICIPATE IN SEEKING THE TRUTH! PARALYZING FOR THE MULTI-BILLION DOLLAR CANCER INDUSTRY BUT EMPOWERING FOR THE GENERAL PUBLIC!

Green tea, malunggay oil, vitamin C, guyabano and even red wine are believed to have properties that can cure cancer. How true are the claims?

“I am telling you right now, guyabano is not an anti-cancer fruit,” said Dr. Ellie May Villegas, the feisty, petite vice president of the Philippine Society of Medical Oncology (PSMO).

IT MAY NOT BE A TRULY ANTI-CANCER FRUIT BUT IF IT EVEN ACTS AS A PLACEBO IN ADDRESSING NON-CANCEROUS SYMPTOMS, THEN WHY NOT? FURTHERMORE, IT CAN DO NO HARM.

“We rely only on evidence. Guyabano is not proven to kill cancer cells, and yet it is marketed as 10 times more potent than Adriamycin, a commonly used drug in chemotherapy. Adriamycin is a very potent anti-cancer drug. Why do you associate it with a fruit? They don’t even know what they’re saying.”

NOT TO SPEAK IN FAVOR OF GUYABANO BUT INSTEAD OF SHOOTING IT DOWN, SCIENTIFIC RESEARCH MUST BE DONE TO INVESTIGATE WHATEVER CURATIVE OR PREVENTIVE BENEFITS WHATEVER FRUIT OR HERB HAVE, NO MATTER HOW MINIMAL. BUT THEN, WHO WOULD FUND THE RESEARCH ON FRUITS, VEGETABLES AND HERBS WHEN THESE ARE WIDELY ACCESSIBLE TO THE PUBLIC WHILE DRUGS ARE NOT!

Confusion

In a press conference sponsored by PSMO called “Dietary Supplements in Cancer Treatment: Investigating the Claims,” Villegas said guyabano, also called Brazilian pawpaw, is confused with the pawpaw tree Asimina triloba (Annonaceae), known as the North American pawpaw.

The Asimina triloba fruit, which in no way resembles the guyabano, contains the natural compounds acetogenins that are proven to help regulate various types of cancers.

“When the North American pawpaw is taken with chemotherapy, patients and physicians noticed an above average amount of tumor shrinkage after the first treatment than normally expected with chemotherapy alone,” she said.

PSMO PRESIDENT Dr. Felycette Gay Lapus

Villegas was expressing concern over networking companies that profit from making bogus claims about natural cures.

CONCERN MUST NOT BE ON PROFITS OF NETWORKING COMPANIES BUT ON THE BENEFITS OF ANY SUPPLEMENT. TRUE THAT A LOT OF EXAGERATION IS DONE TO SELL THESE SUPPLEMENTS BUT THAT IS EXACTLY WHAT BUSINESS AND MARKETING IS ALL ABOUT! EVEN SODA IS BEING ADVERTISED TO HAVE VITAMIN C!  IT MATTERS NOT IF THE PHARMACEUTICAL INDUSTRY RAKES UP BILLIONS OF PROFITS FOR AS LONG AS THEIR DRUGS CAN CURE CANCER!

PSMO believes in the multidisciplinary approach: surgery, radiation, chemotherapy and, when proven safe and effective, dietary supplements to complement the treatment.

“With the proliferation of scientifically unsupported alternative cancer treatments, PSMO has established that there is a need to educate the public on how to address the cancer problem. We put together a position paper to help guide fellow oncologists, doctors and patients in making correct choices,” said PSMO president Dr. Felycette Gay Lapus.

THE NEED IS TO EDUCATE THE PUBLIC ON THE CAUSES OF BREAST CANCER AND NOT ON SURGERY, CHEMOTHERAPY AND RADIATION. THE MEDICAL APPROACH IS NOT NECESSARILY THE CORRECT CHOICE. WHAT MATTERS MOST IS THE PATIENT’S FULLY INFORMED DECISION AND NOT THE DOCTOR'S. THIS IS THE REASON FOR THE PROLIFERATION OF WHATEVER ANTI-CANCER SUPPLEMENTS – BECAUSE PEOPLE DO NOT WANT TO GET CANCER AND FOR THOSE AFFLICTED WITH CANCER, THE FEAR OF MEDICAL APPROACHES HAVE BEEN MOUNTING DUE TO THE FAILURE OF MEDICAL SCIENCE TO CURE CANCER.

Scientific evidence

In a PowerPoint presentation, Villegas said commonly used supplements not supported by high-level scientific evidence include homeopathic products, high doses of oral multivitamin supplements, vitamin C + collagen, high doses of oral vitamin C, oral stem cell enhancers/fibroblast growth factor enhancers, ozone therapy (IV), and heavy metal chelation therapy that removes heavy metal toxins supposed to cause cancer.

“Randomized controlled trials in advanced cancer patients taking 10 grams per day of oral vitamin C did not demonstrate any significant benefits. These can, in fact, interfere with the action of chemotherapy and radiation therapy. That’s why we always advise our patients to tell us what they’re taking,” Villegas said.

ON THE OTHER HAND, CHEMO AND RADIATION RENDERS NATURAL SUPPLEMENTS USELESS! IN FACT, TO APPEASE PATIENTS IN COMPLYING WITH TOXIC AND INVASIVE TREATMENTS, SUPPLEMENTS ARE BEING ALLOWED AS SUPPOSED COMPLIMENTARY MEASURES. BUT THE TRUTH IS THAT CONVENTIONAL AND NON-CONVENTIONAL APPROACHES CANNOT EXIST ALONSIDE EACH OTHER.

Villegas said that metabolic therapies such as nutritional therapies, Gerson Regimen, Kelley Therapy, Gonzalez Regimen, Contreras Therapy and Manner Therapy—also known as detoxification/cleansing regimens—do not work.

They can even cause nutritional deficiencies, she said, while some entail potentially toxic doses of supplements or agents. Coffee enemas, for instance, can cause sepsis, dangerous electrolyte deficiencies, and even death.

“The colon or large intestine is there for the stool to pass through. Why do you have to clean an organ that is supposed to be dirty? It is supposed to facilitate the removal of toxins via the stool. The American Cancer Society strongly urges cancer patients not to seek treatment with metabolic therapies. No published evidence supports their claims,” she said.

UNFORTUNATELY, VILLEGAS IS HIGHLY UNINFORMED AND MISEDUCATED. HAD SHE ATTENDED THE WORLD CONFERENCES ON BREAST CANCER IN CANADA SINCE 1997, SHE WOULD HAVE NOT HAVE STOOD HER GROUND. IN FACT, THE AMERICAN CANCER SOCIETY IS A VERY POOR AND BIASED SOURCE OF INFORMATION.

Lactic acidosis

Commonly used supplements supported by very limited scientific evidence, but not enough to suggest use, include transfer factor, malunggay oil, intravenous hydrogen peroxide, mangosteen extract pills, guyabano extract pills and resveratrol/grapeseed extract (provided they are not used with Tamoxifen).

AGAIN, THERE HAVE BEEN NUMEROUS SCIENTIFIC EVIDENCES WHICH ARE NOW SLOWLY BUT SURELY ENTERING MEDICAL JOURNAL IN NORTH AMERICA AND EUROPE. THE BREAST CANCER DRUG, AVASTIN CARRIED SCIENTIFIC EVIDENCE WHEN IT WAS RELEASED TO THE MARKET, ONLY TO BE PULLED OUT BY THE US FDA BECAUSE IT WAS LATER FOUND TO BE INEFFECTIVE!

“We cannot promote malunggay oil to be used as an anticancer agent because this has never been used on humans. What you can eat in a diet, eat it. Do not put it in a capsule or tea,” she said.

HUH? AND THE FOOD CAPSULES TAKEN BY ASTRONAUTS IN SPACE IS NOT NUTRITIOUS? HELLO, THERE IS SUCH A THING AS FOOD TECHNOLOGY!

  

Severe lactic acidosis was reported with mangosteen juice daily for 12 months, and patients eventually died not from their cancers, but from the lactic acidosis from mangosteen, Villegas said. Mangosteen may also interfere with certain chemotherapy drugs, and must be used with caution by diabetics due to its high sugar content.

AGAIN, VEGETABLE AND FRUIT JUICES ARE EVALUATED ON HOW THEY INTERFERE WITH DRUGS! SO WHY ARE NATURAL FOODS VIEWED FROM THE PERSPECTIVE OF CHEMO? BUT OF COURSE, DIABETIC CASES HAVE RESTRICTED FOOD INTAKES – AND SO ALSO DO HYPERTENSION, OBESITY, PREGNANCY AND ALL OTHER HEALTH CONDITIONS!

Resveratrol, which can be found in red wine, is also consumed as a dietary supplement for its purported antioxidant and anti-inflammatory properties.

“Because resveratrol exhibits estrogen-like properties and activates transcription by both the estrogen and androgen receptors that lead to stimulation of cancer cell proliferation, patients with hormone-sensitive cancer should use it with caution,” she said.

ALL SUPPLEMENTS JUST LIKE DRUGS ARE TAKEN FOR THEIR RESPECTIVE INDICATIONS AND ACTIONS. THIS IS THE REASON WHY THERE CAN BE NO ONE SUPPLEMENT FOR ALL INDICATIONS AND AILMENTS.

It may also protect against chemotherapy-induced cardiotoxicity, although more studies are needed to confirm its effect on humans, Villegas said.

“I caution breast cancer patients taking Tamoxifen not to take these supplements with resveratrol or grapeseed,” she said.

DO NOT TAKE TAMOXIFEN IN THE VERY FIRST PLACE! TAMOXIFEN CAN EVEN LEAD TO SECONDARY CANCERS!

Scientifically supported

Among the commonly used supplements supported by high-level scientific evidence are CoQ10 (decreases cardiotoxicity in Anthracycline chemotherapy); R-alpha lipolic acid (decreases neuropathy); American ginseng, rhodiola, ashwanga (decreases fatigue); calcium citrate/carbonate (bone support); ferrous sulphate (anemia support); vitamin B12 (anemia support for gastropathy and post-gastric resection in patients with B12 deficiency); whey protein/L-glutamine and branched chain amino acids (protein support for patients undergoing surgery); and polyglycoplex (viscuous fiber for patients needing weight loss and modulation of body mass index).

As for omega-3 fatty acids, although studies on their role in cancer prevention are inconclusive, Villegas said, they may reduce colon cancer risk, improve immune response in patients with colorectal cancer, and are associated with reduced occurrence of renal cell carcinoma in women.

Fish oil supplementation may reduce the risk of breast cancer, she said, although high-blood concentration of omega-3 is associated with increased risk of prostate cancer.

Other commonly used supplements supported by high-level scientific evidence include vitamin D, beta glucans, bio-available curcumin, green tea, pomegranate, acetogenin molecules and bio-available silymarin phytosome.

SO NOW THERE ARE SUPPLEMENTS THAT ARE SCIENTIFICALLY SUPPORTED? OH WELL, LET THE PUBLIC WAIT AND SUFFER UNTIL SCIENCE COMES TO THE PUBLIC’S RESCUE WAITING FOR SCIENTIFIC BREAKTHROUGHS IN CANCER CURE. BUT WHEN YOU HAVE CANCER, YOU CAN NOT WAIT! ONE WILL HAVE TO DECIDE WHAT ROUTE TO TAKE. 

Safe, efficacious

“We’re not saying no to supplements. We just want to direct patients to those which work and how to safely combine them in a complementary fashion with chemotherapy drugs in a safe and efficacious manner,” said Dr. Omid Etemadi, a board-certified integrative medicine doctor who trained at the National Cancer Institute in the US.

Etemadi said no supplement has been shown to cure cancer on its own.

YES, NO SUPPLEMENT CAN CURE ON ITS OWN. AS A MATTER OF FACT, CANCER HAS NO CURE. ONE THING FOR SURE THOUGH, CHEMOTHERAPY WILL MAKE MATTERS WORSE. AND BY THE WAY, TRAINING IN THE US NATIONAL CANCER INSTITUTE DOES NOT MAKE ONE A GURU.

“There are anecdotal reports, case reports that patients have been cured through very significant lifestyle changes, but these are very rare—more the exception than the rule. More than 99.9 percent of them will not benefit from diet and supplement alone,” he said.

I BEG TO STRONGLY DISAGREE!

He said surgery may cure stage 1 cancer, while surgery or radiation with chemotherapy or targeted therapy may cure stage 2.

IN MANY INSTANCES, STAGE 1 CANCER CAN DO EVEN WITHOUT SURGERY AND WILL EVEN BE AGGRAVATED WITH RADIATION AND CHEMO.

“For stage 3 and 4, we prolong the lives of patients if we use standard care. The cancer doesn’t completely regress, but it doesn’t grow anymore.”

PROLONG LIFE? MORE OF EITHER HASTEN DEATH OR PROLONG UNDUE SUFFERING.

“Dietary supplements may help reduce the side effects of standard care, may help survival rate and prevent cancer recurrence. But I would not recommend that patients use them alone,” said Etemadi.

SURGERY, CHEMOTHERAPY AND RADIATION WILL NOT HELP SURVIVAL RATES NOR PREVENT RECURRENCE.

Read more: http://lifestyle.inquirer.net/133877/guyabano-and-supplements-alone-wont-beat-cancer-doctors-say#ixzz2jC2v5v00

Breast cancer does not have to happen

March 3^rd would have marked my 40^th year with Rosa who passed away in 2000, a month after her 48^th birthday. Rosa died 4 years after she was medically diagnosed with breast cancer at age 44.

That morning, I received the journal of a woman who died 10 years after her diagnosis of breast cancer at age 50. In the afternoon, I received a call from a 41 year old woman whose breast tumor had already burst and was seeking assistance. In one day, I faced two cases which I have become most familiar with in my more that 15 years of breast cancer advocacy. Two different cases which mirror the unacceptable breast cancer epidemic situation in our country today where one of 13 will get the disease within their lifetime.

The 1st woman had submitted herself to all medical interventions at the Chinese General Hospital and total expenses reached a total of around P2 million pesos. The 2nd  woman was so poor that she could not even afford a P3,000 biopsy at the East Avenue Medical Center. Rosa however, did not submit to chemotherapy and radiation by choice.

The 1st woman wrote in her journal that her medical breast exam a year before her diagnosis was just fine. The 2nd woman first noticed a breast lump 10 years before medical diagnosis. This brings forth what I have long been saying that there really is no such thing as early detection because it takes 5 to 10 years before the first symptoms of breast cancer are manifested. Moreover, 80% of lumps are normal in the course of a woman’s reproductive life and not all of the remaining 20% are necessarily a malignancy. Furthermore, not all malignancies are of the aggressive type and this is will only be known after the fact.

During Rosa’s time, we had zero knowledge and understanding of the disease and neither was thermal imaging available then.  I am very sure that if the 1st woman had undergone thermal imaging a year before her diagnosis, a severe breast abnormality would already have been seen as against her being told that all was fine. She could have had the benefit of avoiding the harrowing experience of chemotherapy. In her journal, she wrote that, “Chemotherapy was the most painful treatment I experienced in my whole life”.

The 1st woman mentioned of how kind, gentle and approachable her doctors were, especially that her surgeon was considered the “king” among breast cancer surgeons.  All I have to say is that they have to be such because of how unkind and terrible their treatments would be. The ill effects and irreversible damages done by invasive and toxic procedures are known only afterwards. But because of the hope of extending life, patients will “bite the bullet.”  Unfortunately the often said “5-year survival rate” is in the USA and not in the Philippines where I have observed to be much, much lower.  As far as the doctors were concerned, she had already surpassed the 5-year period.

The 2nd woman went to the provincial hospital in Sta Cruz, Laguna more than 10 years after she her lump first surfaced. She was then referred to the East Avenue Medical Center but could not afford treatment, no matter how negligible the costs. Her breast has now worsened because she did not do anything at all – but, she is "staying alive" without medical intervention. Breast cancer is not a disease that our Lord God Almighty created and neither can its resolution be given to His hands. Neither is the supposed cure a question of money.  

These two women had no prior information, knowledge and understanding of breast cancer. The 1st one died 10 years after diagnosis and medical treatment while the 2nd one is still alive after 10 years of non-diagnosis and non-treatment. Unlike many others, Rosa and I had learned tremendously from attending five World Conferences of Breast Cancer which is how the Philippine Breast Cancer Network was founded in 1997.

Had I then the knowledge and experience that I possess now, Rosa would most possibly be with me today continuing the advocacy for the eradication of breast cancer.  But then, if not for her battle with breast cancer, I would not be able to do what I do now.

The Philippine Breast Cancer Network continues its most difficult task in honor of Rosa, the 1st woman, the 2nd woman and countless victims of this most dreaded woman’s disease. The PBCN strongly believes that breast cancer does not have to happen.  

Happy "would-be" 40th anniversary, dearest Rosa!

Over-diagnosis and over-treatment of breast cancer

The PBCN is deeply concerned with the absence of precautionary measures in the government’s Philippine Health Insurance Corporation’s Type Z Benefit Package, particularly in the over-diagnosis and over-treatment of breast cancer.

It has long been a reality in our country that poor or uninsured breast cancer patients receive little or minimal medical attention. This is the reason why the Department of Health launched in May 2011, the Patient Navigation Program to promote early breast cancer screening particularly among poor women and providing assured access to chemotherapy. The program is meant to show that breast cancer is a curable disease when detected, treated and managed early.

With the launching of the Type Z Benefit Package in the presence of President Noynoy Aquino in Malacanang Palace on July 2nd, members of PhilHealth will now be entitled to a package rate of P100,000 for the entire treatment course for early breast cancer. Coming from PhilHealth’s huge reserve fund of Php 30 billion, just 10% could easily cover 30,000 cases (more than double of government estimated cases in 2010). The opposite could then be the scenario for insured breast cancer patients who may likely be over-treated (receive drugs and procedures that can cause real harm) and even misdiagnosed.

Numerous studies have shown that early detection of breast cancer does not necessarily translate to saving more lives. Finding ever smaller cancerous lesions, even down to small clusters of cells can lead to over-diagnosis for if left alone but managed and observed over a period of time, would never have grown to endanger a woman’s life. Of the most common type of breast cancer, at least 50% of ductal carcinoma are non-invasive and can be safely managed without surgery or chemotherapy. Over-diagnosis leads to over-treatment.

For more than 15 years, the PBCN has seen all forms of misdiagnosis and mistreatments – unnecessary surgeries, chemotherapy and radiation. As a matter of fact, even among the ranks of medical practitioners there are varied, even opposing opinions in the diagnosis and treatment of breast cancer. To address this, the leading breast cancer practitioners have just recently formed their own society to educate doctors and hopefully arrive at standardized protocols and treatments among themselves precisely to avoid misdiagnosis and mistreatment of breast cancer cases.

Today, one out of 13 women will develop breast cancer in her lifetime and not three out of 100 as stated by the Department of Health. In fact, one out of 49 is likely to die and not one out of every 100 as stated again by the DoH. This is why the Philippines is not only among the countries with the highest incidence rate of breast cancer in Asia but the highest!

According to the Department of Health, the breast cancer survival rate in the Philippines is below 40 percent but according to PhilHealth’s Robert So, MD – one of the reasons for selecting Jose Reyes Memorial Medical Center as its Reference Hospital is its experience of an 80% cure rate. This will be the lead hospital and along with the UP-PGH and the Philippine College of Surgeons will provide the standards and guidelines in the treatment of breast cancer.

Though standard treatment protocols/clinical guidelines shall be adopted from the current state of the art- internationally accepted treatment guidelines (such as the NCCN Cancer Treatment Guidelines updated each year) based on scientifically-sound body of evidence depicting the lowest recurrence rates, survival rates must be over a 5-year period and not only two years as stated - especially that early stages are mostly to be addressed. 

The Type Z Benefit Package will be implemented nationwide by contracted government hospitals in each region - all of which are training hospitals largely lacking in funds and personnel. The world's 3rd leading pharmaceutical, Paris-based Sanofi-Adventis agreed to extend an 83% discount for their chemo drug Docetaxel (from P40,000 to P6,930). With the advent of PhilHealth members availing of the P100,000 breast cancer package, these government hospitals can now expect a significant market share previously dominated by private hospitals. No longer hindered by costs, their doctors will not think twice in performing mastectomy, chemotherapy and radiation.

Precautionary measures must be instituted in the Type Z Benefit Package, particular to cases of breast cancer. These must include among others:

   1. How is a woman said to have breast    
       cancer?  Invasive or non-invasive? 
       Aggressive or not?

  
   2. How is a woman’s case said to require 
       surgery, chemotherapy and radiation? 
       

    3. When surgery is necessary, will it be a lumpectomy? 
    Modified or radical mastectomy? 

4. When chemo is considered necessary, how is a drug chosen? (by availability?) Will it be single or multiple chemo drugs? Will it be done before or after surgery? Will there be an oral maintenance chemo drug to be prescribed or not?

5. When radiation is considered necessary, will it be by linear    acceleration or cobalt?

6. And most important of all, has the total course of treatment been thoroughly explained to the patient (including limitations, risks and adverse reactions), not simply having her sign a lengthy form of consent without being fully informed?

These precautionary concerns are meant to prevent the over-diagnosis and over-treatment of breast cancer cases from the expected surge of patients resulting from the P100,000 package of PhilHealth’s Type Z Benefit Package launched on July 2nd, 2012. Only by the end of President Noynoy Aquino’s term in 2016, will it then be known whether or not PhilHealth’s well-meaning intervention in an economically and medically “catastrophic” disease like breast cancer will have realized better health outcomes or resulted in shorter survival rates and higher mortality rates.

.

A gamble, a test or a sign?

The scenarios of newly diagnosed women with breast cancer are almost always very similar. With shock and fear dominating the woman and her entire family, there is a rush for quick answers and solutions to a crisis never thought to come their way.

A visit to the hospital and a cancer specialist becomes the first step in the confusing web of breast cancer. Decisions are hurriedly done, assured by the most recent advances in science and medicine. The patient mainly relies on her attending physician.  But as the days and weeks go by, more questions arise and doubts of cure start trickling in. Entering the hospital for a sure cure has become like entering a casino to win a quick fortune. Having sufficient funds, whether savings or insurance is likened to having enough capital to gamble....and what first appeared to be low risk turns out to be high risk!  As they say, the casino never loses.....it's the gambler who will lose his shirt! A woman and her family bet all their money on perceived odds that surgery, chemotherapy and radiation would work.

For other patients though, they would rather not "gamble" but opt to try various options and alternatives that have been said to be of real benefit. This places much of the burden on the patient and her family. It will be a continuing search for positive experiences in curing breast cancer. With so much information from so many resources, the patient will test one after another for as long as her resources can manage to. From one experience to another, she will hope to conquer breast cancer with whatever may come her way and for as long as she does not turn for the worse. At the very least, testing non-toxic and non-invasive methods will not complicate or compromise her. "No harm - No foul!"

Yet in either scenario, it is only what is clear and visible to one's heart which will spell her journey in the unknown depths of breast cancer. There will always be events that will happen - good and bad - and most often it will be the sudden and unexpected ones beyond her control which will become crossroads for her. To resign from a job or not. To relocate residence or not. To let go of a troubled marriage or not. To continue chemo or not. To continue alternative treatment or not. To fight or to surrender. To live or to die.

There always will be signs.

A woman with breast cancer will have to reach out in the deepest bottom of her heart and soul for the very purpose of her life, that she may find strength and courage to confront the disease with full honor and dignity. Breast cancer is an environmental disease which is preventable. Like so many other victims today, she has become the one in thirteen women in the Philippines to get breast cancer. It was never her fault.

                       Breast Cancer is a sign of the times!