Wednesday, September 14, 2016

Cost to cancer treatments in Malaysia 2016

Hi all,

It is inviarably costly to treat cancer in Malaysia as with elsewhere in the world.  Best way to overcome this high cost is to be proactive in cancer prevention. Live the good lifestyle, exercise and eat well and of course prayers help. Insurance do help out in the cost but its premium is generally too high as well. Malaysian public health care services does contribute to assist cancer treatments at government hospitals. has an article published recently showing the costs involved for hospital stays, screenings and treatment of cancers in Malaysia. See link below:

However it is a general survey to the costs. The actual cost will depend on a lot of other factors; such as type of cancer, grade and stage of cancer and of course the treatment modality used to treat  / manage the cancer.

Take care all.

Allen Lai

Monday, September 12, 2016

My Story

It is quite a long story, actually 72 years of it. But briefly....

From Malignant to Remission my story.

Year 2009. I had a good life and successful career serving in the Malaysia army for 36 years.  Having retired ten years ago, I was at the prime of my life, fit as a fiddle and with annual hospital certified clean bills of health to boot. I have the normal diseases of Hypertension, Diabetes, Osteoarthritis and High Cholesterol that came with age. All under control with exercises, diet and medication.

I was not aware that I was sleeping with the enemy for the past several years. Sure, I had some urinating problem that came with prostrate enlargement. It was men talk that it was all right and nothing to worry about. It was just an inconvenience; eating pumpkin seeds will solve the problem.

Doing a PSA test and biopsy in late 2009, proved my good health was only skin deep. I should have known better than not to have PSA tests earlier. I paid the price for not listening to the advice of my family members. I was diagnosed malignant at stage three local advance.

I was offered, and opted to undergo my medical treatments for cancer at HUKM Cheras. My oncologist said the magic words “ You are curable.” He then proposed a dual modality treatment for me, comprising Zoladex hormone injections for three years and 32 daily sessions of radiotherapy.

I do not recall if my initial shock and denial stage had caused any trauma affecting myself or my family. My wife and I immediately went on a short holiday in Hatyai, Thailand; knowing fully well, that I would soon be tied down going to the hospital for treatments. I was positive throughout my ordeal. I had clear and objective discussions with my urologist and oncologist during every of my hospital appointments.

I have since then started to do wide readings into cancer on a daily basis. I was particularly interested in holistic and other comprehensive treatments for cancer. It was during my six weeks of daily radiation sessions at HUKM that I had seen and met many other cancer patients. All of them, without exception, were in a state of despair and low morale. They all looked miserable, unsmiling and had abandoned all self-esteem. Such was the profile of most cancer patients.

I am glad that I am strong and positive from day one. My leadership training in the army, quick knowledge acquisition and strong support from family members and close friends were a great help to my confidence and in my fight against cancer.

I had fought back and survived to celebrate life. Having been there and done that, I now have a strong calling to help others who are less fortunate than me. I have the empathy, dedication and skills for my new role in my life.

Today, after seven long years as I tolled in my journey with my prostrate cancer, I beat it. I am in remission. I am thankful to God, the medical team in HUKM and IKN, and everybody who had been part of my journey. I wish to write this article for others to read so that they may be more confident with themselves in their own journey with prostrate cancer. I shall mainly describe my strategy, activities and my personal thoughts for the past seven years.

To begin with I wasn’t really traumatised nor shocked as most people would. I accepted cancer as with any other medical problem. I had believed that our hospitals would be able to cure me. I did not realise its seriousness until I started to read into the disease. My father who was 80 plus years old had actually died from prostrate cancer. I did not relate its genetic impact on me and my siblings. I had left it to the hospital to sort me out so to speak. I could not afford to see any private hospital specialists as I know the cost would be exorbitant. I am really glad that I am a pensioner and would have free medical treatments at government hospitals. 

I left the decision of what treatment was best for me to my Oncologist because I had absolutely no idea. Zero. I am very thankful that my Oncologist in HUKM was quick and decisive. As soon as he had described the problem to me, he had said “you are curable”. I listened to his treatment plan without really understanding fully what it entails. So I just followed faithfully his prescription for EBRT radiation and three years of hormone therapy. I was lucky to have some acceptable side effects. Erectile Dysfunction being the most serious and the constant hot flashes till today. It is OK for that as I am still alive and I did not get incontinence, a side effect I dread most.

Hopelessness, fear and uncertainty started to set in slowly during my journey as I meet other prostrate cancer patients and as I read more into it. Sadly I began to loose a friend or two to prostrate cancer now and again. I feel for them and their families. They deserved more from life. How did I cope ? It was so hard to get by. I kept thinking on how do I balance Fear with Hope? I dreaded each quarterly appointment for my PSA tests, particularly on the day before and prayed that my PSA would not rise. I am thankful that my PSA held on well albeit rising in small quantities.

I began to have a personal understanding of prostrate cancer. I understand that, whilst prostrate cancer is life threatening, it is a very slow growing disease; but there are exception. The PSA reading is not a prostrate cancer marker per se. An exceptional rise may be caused by cancer, but many other activities can rise or lower the PSA reading. I had learnt not be intimidated by our PSA reading. I had learnt the significance of my cancer staged at 3 local advance and of my Gleason score of 3 plus 4. In the course of my journey, I read intensely from books purchased and also from the libraries.I also browsed the internet relentlessly, I find there are as many theories as there are writers and most of the studies presented conflict and are sometimes confusing. I also very thankful and grateful to family members and friends giving me comfort and telling me what is good or not good. But sadly whilst they mean well, these advice comes from people who do not have prostrate cancer, nor do they know much about the disease.

Conventional primary medical treatments are very effective to treat and manage prostrate cancer. Survival rates are almost 100% for the first five years after treatment. Secondary treatments for prostrate cancer relapse get more complexed and difficult, particularly when the prostrate cancer had spread out to distant sites. I am hopeful and confident that should I have a relapse later, there would be new medication and approaches to tackle the problem. I am already 72 years old and I cannot expect too much.

I believe and affirm fully to our Sarawakian Ranger Regiment’s battle cry “ Agi Idup Agi Nglaban” if there is life there is fight. With knowledge and confidence I decided to have my personal plan to maintain a status quo with the remaining prostrate cancer cells which I believed had survived my primary treatments. I am now responsible to myself to fight the prostrate cancer. I know that exercises and toning my body would be top priority, eating well and getting a balanced diet are just important and also that God will answer to our prayers. I write a personal blog to keep track of my knowledge related to prostrate cancer. I joined and participated in prostrate cancer support groups to share and contribute whatever I can. The hardest part of my plan is still personal discipline to do what I need to do daily. How do I regain my penchant for life again? How would anyone with prostrate cancer? I will try my best to live my life as best as I can and I will try my utmost to forget about my rising PSA reading. I am now into remission and I feel fine. My new PSA baseline for 2016 is 0.18 and it has plateaued out at 0.19 for the past nine months in 2016.

You may read more about my personal battle with cancer in my posts herein. It is purposely and appropriately written in military speak and in real combat situations.
Do not deny yourself or your charge of help needed. Fight back. Join your local support groups.

Not the Last Goodbye

''I knew the prognosis. Sooner or later, it would come back. I could slow down the inevitable; I could gain a few years. But there was nothing I could do to make this cancer disappear forever. So this was it. This was the relapse. The Big One.'' - David Servant-Schreiber, MD, PhD

We had lost an icon who had fought his cancer in the brain well for nineteen years. David Servant- Schreiber passed away in 2011 after a relapse of cancer in his brain. David's first book "Anti Cancer" has become mainstream reading on cancer management and coping with it. We had learnt to accept cancer, learnt how to look after our terrain and learnt all his deep insights and passion to help cancer patients.

David wrote another best seller "Not the last goodbye - On life, death, healing and cancer " just before his passing. All cancer survivors should read this book. David had put a lot of his thoughts and experience on his relapse. How did it ever happened despite he was an avid follower of his own prescriptions in anti-cancer? What went wrong? But still he had survived for nineteen years, given that cancer in the brain is somewhat more difficult to manage and cope. Thank you David for your last goodbye to us. You have made the difference in all of us cancer survivors. RIP.

Farewell Dr David Servant-Schreiber. The world shall remember you always. 

Allen Lai

I do my biannual checkups with my Urologist in HUKM. My recent visit on 05 September 2016 confirmed that my PSA had maintained its base at 0.19. Yes it looks good. I did not have a slow and steady rise in my PSA readings. My PSA has plateaued out. Hopefully it will allow me more quality time before I face a relapse, if ever. My Urologist said that I am doing well and that I should continue to do whatever that I am doing.

Yes looking after our terrain is paramount to cancer management and coping. After cancer treatments, the ball is on our feet. Our Oncologist had done their part well, we are to do the necessary to maintain our health. We cannot afford to face another battle. That will be too much.

Take care.

Allen Lai