Suicidal Cancer-Fighting

Earlier this month I returned to my hometown. The daughter and son-in-law of a patient there reached me through my sister-in-law, hoping I could see their elderly parent. The old person has late-stage cancer along with hepatitis C, and has already developed drug-induced liver injury. Not long ago, the couple took the elderly parent to Wuhan to see a TCM doctor they had heard was famous, who prescribed a large pile of Chinese herbs and told them to go home and decoct them for the old person to drink.

I reviewed all of the elderly person's examination reports, as well as the targeted drugs and antiviral drugs prescribed by the hospital, then told the family to stop all the Chinese medicines and not give the elderly person any more decoctions for a year. Apart from suggesting some liver-protective drugs, I did not add any further medicine; instead, I reduced as many of the drugs they were using as possible, keeping only the essential treatment medications.

These are very filial children who, for their mother's illness, have sought doctors and medicines everywhere. After seeing one doctor, whenever they hear of anyone in their acquaintance circle who also treats tumors, off they go. Some doctors who follow basic professional ethics will not casually add drugs for such an elderly patient, but others do not worry so much — or their knowledge is limited and it simply does not occur to them.

I told the patient's daughter and son-in-law that drug-induced liver injury is a very serious problem, and that if they continued endlessly finding new doctors and adding drugs, their mother would not live much longer. I asked the patient herself what she felt was wrong. She said she had not really felt unwell before, but since drinking the Chinese medicine she had uncontrollable diarrhea, a very poor appetite, and constant nausea and the urge to vomit.

I advised the old person to stop the decoctions and observe; if these symptoms eased or disappeared after stopping, no medication would be needed. If they did not disappear, then briefly use some symptomatic patent medicines and stop once the symptoms cleared. I also told her to have a mind of her own in future — not to swallow whatever medicine whatever doctor her daughter and son-in-law found prescribed, since that would only shorten her life and make her quality of life very poor. The old person looked relieved on hearing this; she had taken so many drugs that her body was already overburdened.

This is typical suicidal cancer-fighting: the patient already has drug-induced liver injury and yet medication is still being abused, which easily leads to premature death. Usually such patients do not die of cancer but of liver failure. I am not sure whether the TCM doctor she saw had carefully and completely reviewed her records; according to the son-in-law, that doctor's clinic was packed, and in my hometown such doctors usually treat patients very hurriedly. This old patient had quite a lot of medical records; without careful reading, one would overlook her various underlying diseases.

Many people, without realizing it, are engaging in suicidal cancer-fighting. Another form is bankrupting-the-family cancer-fighting, which I have also seen a lot of over the years. Just today, the sister of a middle-aged lung cancer patient told me their family is prepared to sell their house to raise funds for her brother's treatment, determined to use the very best drugs.

Because of the rising number of cancer patients, the cost of cancer treatment — whether Chinese or Western medicine — has been climbing year by year. On top of that, there is an endless stream of expensive new treatment regimens, many of them not even mature yet but already full of hype. This has turned cancer into a bottomless pit for patients' families and into a piece of meat in the eyes of many.

I kindly reminded the sister to consider balanced, sustainable medical decisions and to prioritize treatments covered by medical insurance. If she gets carried away in her eagerness to save her brother, her whole family could easily fall into one trap after another, ultimately shortening her brother's life. In fact, many mature anti-cancer regimens are already covered by medical insurance. Cancer is a chronic disease; patients do not die that quickly. Those who are already in the terminal stage at diagnosis will not live long even if the family spends everything.

Most cancer patients and their families have ample time to choose a treatment plan their family can afford and sustain. If you rashly sell the house and take on debt at the outset, the whole family will be dragged into a quagmire from which it is hard to escape. When money is genuinely needed later, you may have nothing left. So adopting a balanced treatment plan that does not severely disrupt family life, and carrying out long-term treatment steadily, lets the patient live longer and feel relatively more at ease. Otherwise, the whole family bears mental and financial pressure, and the patient feels guilty too — which instead lowers the quality of their final days.

Overly aggressive treatment decisions also break up many families. I have seen many cases where relatives had cancer and the family finally fell apart. We often say that when disaster strikes, each flies off on their own. Faced with major illness, relatives ultimately refusing to help, couples turning against each other, and kinship bonds breaking — while human weakness plays a part, aggressive medical decisions are also a major contributing cause.

In a crisis, emotions tend to be amplified and reason easily lost. At such times, rational persuasion from other family members is seen as coldness, which triggers quarrels. Many cancer-ridden families finally erupt into domestic conflict over exactly this: tormented by illness yet living in chaos, even broken apart. This is most unreasonable; it could even be called extended suicidal treatment, affecting not only the patient's continued treatment but also destroying a family's happiness.

Doctors should be the rational bottom line for patients and their families, helping those caught in a fevered state to calm down. In reality, many doctors hold this line, but many genuinely do not — and this has produced many tragedies. Perhaps because I am getting older, or because I have seen too many tragedies, I now cannot bear to watch patients and their families jump into every pit. I always kindly remind them: be cautious about what enters the mouth, and also hold on to your wallet, planning for the long term. The road of cancer-fighting is very long; don't take a great fall at the very start.