War Against Brain Tumour

In heaven

2011-01-03T15:29:00.000-08:00

On the 17th December, 12.30am the angels came and escorted my beloved husband, my one and only soul mate to heaven. Nothing can describe the pain when I saw him draw his last breath.Nothing can erase the memory of his sufferings all these months.Yes time will make it easier to accept my loss but the wounds in my heart and mind will never stop bleeding. My life will never be the same again. Norman, may your soul rest in peace. Prepare a place for me beside you and I look forward to our reunion and to a glorious, perfect and eternal life together. Amen

Semi conscious

2010-12-15T23:51:00.000-08:00

Norman is getting weaker with each passing day. For him the days and night have melted into unending drowsiness and lethargy. Yesterday his body was cold in the morning and burning hot with fever in the evening! It really sucks! Life is at an all time low now. Today he is semi conscious, he could barely open his eyes anymore. I try to syringe some prosure and steroid into his mouth but it only flows out from the sides. The hospice nurse came and set up 2 sub cutanous line, like an IV line to infuse saline into his dehydrated body.I need to insert rectal panadol regularly to bring down the fever and the rest will be up to God.Please pray for mercy and for peace when the angels comes for him.

The Hypothalamus

2010-12-01T00:46:00.000-08:00

The Hypothalamus is the control center of all autonomic regulatory activities of the body. It has been said that the hypothalamus is the brain of the brain. It is the hub for automatic and endocrine homeostatic systems such as cardiovascular, temperature, and abdominal visceral regulation. It manages all endocrine hormonal levels, sensory processing, and organizing body metabolism, as well as ingestive behaviors. It appears that almost everything the Hypothalamus does is related in some way to the management of brain and body connection, linking the psyche (mind) to the body
Very simply, the Hypothalamus organizes and controls many complex emotions, feelings and moods, as well as all motivational states including hunger, appetite and food intake, and everything to do with the concept of pleasure including satisfaction, comfort and creative activities.
When the Hypothalamus is not working correctly, when it’s not functioning up to par, the wrong neuro-signals are generated and the wrong neuro-messages are received, resulting in an inaccurate integration of all our sensory input.
Some of the physical aspects of Hypothalamic dysfunction are: Disordered sleep, Multiple hormonal dysfunctions, Immune dysfunction, Autonomic dysfunction, Altered body temperatures.

On sunday right till Monday, for more than 24 hours, Norman could not close his eyes! He was very tire but could not sleep! His eyes was open throughout sunday night and monday too. I thought he was sleeping with his eyes opened!! I called hospice and was told to give him 5 mg haloperidol to help him sleep. It work! He slept well on Monday night. On Tuesday morning he appears bearably well till about 9.30am. His hands have turn icy cold, only his hands. His leg was slightly cold but his body was normal.What happened?? The tumor have reach the hypothalamus. As you read above, he is now experiencing hypothalamic dysfuntion. His circadian rythym is out. His body cannot recognize the normal sleeping pattern of night and day,and his body temperature have gone hay wire! Good grief! What is this monster doing to him. Oh God,he have suffered enough! Have mercy. Call your angels and take him home. This is our prayer now.

A slow and heartbreaking decline

2010-11-09T23:33:00.000-08:00

Its now exactly 1 year since Norman had his 3rd surgery and exactly 3 years since diagnose with GBM on Nov 16 2oo7. His last MRI done in May this year have shown extensive growth and edema. Since July he could no longer walk but he could still sit up, eat well with his left hand and was alert and responsive. He could still smile occasionally too! On Sept 4th he could even sing Happy Birthday to my son Benny! We just celebrated my birthday on Nov 3rd but alas he could not even say happy birthday to me. But I thank God he is still with me and he is still my hero, my husband, my man!

Last week he had a big nasty scrotum abscess which rupture and leaks copious amount of pus and blood! It was horrendous!! but that was not the end! He had another abscess again and the hospice dr need to do an incision and drainage. It was done at home and boy, it was painful even with local anaesthetic! Norman was shaking like a leaf! Damn! I don't want to ask why but I couldn't help it.

He can hardly swallow now and chokes easily. Preparing his diet is a momentous task for me everyday. All food needs to be soften, smashed, blended and most juices make into jelly so that he can swallow it easier.

I can't think much these days. Some days are harder and I can sob miserably till i am exhausted, somedays I am thankful that God have given me the grace to plow on. I live day by day, hour by hour. May God bless you.

Feeling unable to cope

2010-10-07T08:09:00.000-07:00

It is now getting difficult to transfer Norman from bed to wheelchair or the commode chair even just next to the bed. He is even getting weak on his good side(the left side). The right side is completely gone and we struggle to balance him on whatever strength he has on is left side. Most of the time I get that kind of vacant look or cold stares from him as though he doesn't know who I am or what I am doing. The physiotherapist describe him as in a state of stupor or a poor state of mental fogginess. As of a few days ago he have stop calling for me which is what he usually does when he needs my attention or when he is in discomfort. To add on to all these problems Norman is now unable to swallow and eat well. He chokes easily even on porridge and water. While sitting up he evens chokes on his own saliva. Preparing his meals and feeding him is a big challenge for me every day.
My body is weary and my heart is burden. At time i feel unable to cope, I feel so helpless, so sad. Please keep us in your prayers. I need more strength and courage from God.

Incontinence and urine catheter

2010-09-09T00:41:00.000-07:00

Norman was put on Haloperidol (to calm him) and Sertraline, an anti depressent since late July. The haloperidol was mildly effective but I feel the sertraline didn't really helped him. All drugs are with side effects and these two "happy pills" that Norman is taking contributed to his urine incontinence. No matter how hard he tried, he just could not control his bladder muscles. He need to wear adult diapers day and night and in spite of that he still leaks and gets thoroughly wet at night. His skin is red and moist and he needs constant cleaning all the time. Hospice nurse put in a urine catheter which need to be change once in 2 weeks. Yesterday I change it to a silicone catheter which can last up to 2 months without changing. It was very painful for Norman when the hospice nurse inserted the cath and he was tense and screaming! My poor beloved have been so brave all these while but I can see him crying and breaking down silently, his tears just roll down at the corner of his eyes. This crazy disease is like a roller coaster. Some days I fear that he is slipping away and some days he is more alert. All these fluctuations keep me on my toes and even keep my hopes up!
I live one day at a time and continues to ask God for mercy. God bless you all.

Personality change

2010-08-20T08:22:00.000-07:00

Norman is not the same anymore. Its still him, but the light from his eyes is not there anymore. Its almost gone! His character, his personality have change completely.His attention span can be measured in nanoseconds! He shouts and scream in frustration most of the time! Sob! I wonder if he understand us at all now. He does not comprehend time and place anymore but he can still recite the alphabets or count 1 to 30!He repeats whatever I said over and over again for hours!!
It's hard but I try my best to let him know I love him no matter what. When I hug him he could still put his good hand around to hug me too!
Will the lights come back? Will it at least brighten a bit? Can God give us a miracle? Please pray with us. By his stripes, we are healed. Amen.
Dorothy

Hospice role in allevating emotional stress

2010-08-01T06:59:00.000-07:00

The unbelievable suffering this cancer is doing to Norman and my family is overwhelming. We did everything possible but still could not stop its aggressive attack. Nobody who have not experience this type of cancer can actually understand the mental and emotional torture he is going through.The exhaustion and mood swings along with the depression is just too much for Norman to bear.It breaks down his fighting spirit and he just give up!I was very glad when hospice arrange for a psychiatrist to evaluate Norman's metal status.
A major focus of hospice care is on the emotional effects of the illness on the patient and his family. Helping Norman to recognized that his fears, anger, frustration,etc are normal reaction to his illness would help us understand him better. The psychiatrist said that it is perfectly normal for him to lash out at me or the children during an emotional outburst.It will be good for him to be able to release his tension by shouting or even crying. In fact we should encourage him to cry aloud or even for me to cry together with him. I usually remain calm outwardly but my heart bleeds inside. Life is so cruel to him.

Hospice Care

2010-07-20T18:27:00.000-07:00

Norman had a fall on Monday, 12^th July and since then he was unable to walk or to stand on his own. This is a big blow to him as he was still able to walk about the house slowly on his own prior to his fall. Now he is wheelchair bound and need assistence round the clock. Even basic toilet routines and showers is a struggle to me now. I need help! Due to the constant stress and my insomnic nights, I suffered a vertigo attack on 18^th, Sunday night, It was so bad that I could not get up as the room was spinning like crazy. I was vomitting, having diarrhea and felt like collapsing at any moment! My children manage to get some medication from our family Dr and I improved after taking them. Will need to continue taking the medication for a few more days.

Dr Ibrahim refered us to Hospice and the hospice nurse and Dr came to see us at our home. They are very kind and helpful and highly specialize at looking after terminal patients. I was given medication to stand by in case Norman have an epileptic seizure and also emergency phone number when I need help urgently. The hospice physiotherapist came today but Norman was in such a foul mood, he wouldn’t let them come near him. He was shouting NO NO NO at them!! I was exasperated, disappointed and sad! They will come again and I pray I can pacify him to have some form of exercise. His muscle is so flabby and have started to degenerate over this 2 passive weeks!

I would like to thank Dato Jeffrey for the I pot.Now whenever Norman is angry or depress we get him to listen to some soothing music to ‘cool’ him down. Many thanks to all my lovely girl friends who came to help and support me in this painful times. Thanks to Moi, Irene, Annie, shirlin, Yew Ai and Dorcas. May God bless you all.

Terminal Brain cancer and steroid management

2010-06-19T00:25:00.000-07:00

When a patient enters stage IV of brain cancer there is no more a hospital can possibly do to rehabilitate him and the patient is told to return home. Stage IV is the final and most invasive, extreme and painful stage. In this stage the tumor has metastasized out of control in the brain, swelling the tumor until it can no longer be reversed.

In this stage, the cancerous cells creating the brain tumor metastasize wildly, producing more and more deadly cells in the brain, causing the tumor to swell intensely and overtake the brain. The tumor quickly begins to effect cognitive functions such as thinking patterns, thought processing and abilities to grasp abstract concepts. Motor skills will fail as well and the patient may fall, be unsteady and uncoordinated, and possibly suffer muscle spasm. The patient's speech patterns will deteriorate along with thoughts and he may be incoherent, stop in the middle of sentences or relate stories or sentences with no logical reason.

I spoke to Dr Lee and he suggest I increase Norman's steroid dosage as he had 2 epileptic attacks and his condition is "very serious".

There are several ways that Decadron increases at this stage can mean good palliative care for the patient...although sometimes with a mixed bag of results.

Edema elsewhere in the body has the luxury of pushing soft tissue outward or into other structures with far fewer ramifications than in the brain.There just isn't much room when swelling occurs in the brain.This swelling results in increase intracranial pressure and can cause a number of effects that begin to impact quality of life and comfort.

Occasionally, depending on the location of the tumor, this swelling will cause midline shift. The midline is a central boundary separating the left and right hemispheres. Even when tumor hasn't crossed over from one hemisphere to the other, the edema caused by the tumor's presence can still push the midline out of alignment, causing new tumor-like symptoms from this second hemisphere. When this happens, it's known as mass effect. When the midline shift is caused by swelling rather than tumor, and when the degree of shift is minimal to moderate, an increase of the steroid dose may be able to help shrink the swelling and restore the position of the midline.

How can you tell that swelling may be severe or may be under-addressed by the current dose of steroid?

The patient is sleeping excessively. When the patient is sleeping 20+ hours per day, is falling back to sleep soon after meals, dozes off even in the midst of full stimulation (eg, a room full of visitors), and seems too fatigued to enjoy things that had been previously enjoyable to him or her, this is a red flag for edema. Norman gets tire easily now and takes 2 naps in the day time.

The patient seems off the mark or fuzzy in several areas of function. One of the best indicators of swelling is when there are new symptoms or an increase in symptoms across the board, in several categories. For example, when the patient is newly incontinent, seems more confused than he or she did just days ago, is now slurring speech or leaving sentences unfinished, is fatigued, and has had a couple of falls while getting around the house, Norman fall off the chair once.

The patient is complaining of headaches, especially upon awakening. Head-ache is an easy indicator of swelling, particularly after the patient wakes up.

The patient is nauseous or vomiting. When swelling is severe, the three red flags are excessive sleep, headache, and nausea.

Maintaining an adequate steroid dose during this period can keep the patient comfortable and high-functioning for as long as possible. As the signs indicate that a previous dose is no longer adequate, requesting an increase can bring about improvements often within 48 hours.

With increases in the steroid dose, unfortunately, can come several side effects.

Mood/personality changes: Some patients experience a worsening of their mood or negative changes to their personality as the steroid dose goes up. Typical may be impatience, rudeness, sarcasm, childlike behaviors and anger.

Insomnia: Steroid perks a person up and difficulty to sleep is very common

Atrophy of the leg muscles: As the steroid dose is raised, keeping the legs moving becomes even more important, in order to keep a patient mobile for as long as possible. Physiotherapy here will help greatly.

Increased appetite: Many patients on "higher" doses of steroid experience a great increase in their appetite. Norman is eating quite well and is getting very rounded in the middle!

He is now fighting every step,refusing to give in to his skinny legs, hugh belly, swollen feet,shakiness, depression, anger, confusion, exhaustion, anxiety and poor coordination. May God gives us strength and courage to overcome this excruciatingly painful times.

Summary of tumor size and treatment

2010-05-28T02:07:00.000-07:00

Date	Size of Tumor (cm)	Treatment
Year 2007

16-Nov-07	4.4 x 4.5 x 3.5	Surgery, Radiotherapy 30 fraction
Year 2008
1-Mar-08	1.9 x 1.2 x 0.9	Temodar - 6 cycles
3-May-08	1.9 x 1.2 x 0.10
13-Sep-08	1.9 x 1.2 x 0.11
30-Dec-08	1.9 x 1.2 x 0.12
Year 2009
4-Feb-09	3 x 3.5
16-Feb-09		Surgery, Glidel Wafer
30-Mar-09	3.4 x 3.3 x 4.8
1-Apr-09		CAAT DIET
9-Apr-09		Ruta Graviola
14-May-09	3.5 x 3.4 x 4.5
13-Aug-09	4 x 3.5
3-Nov-09	5 x 3.5 x 4
25-Nov-09		Surgery with 5 ALA
Year 2010
3-Jan-10		Stem Cells at Beijing
25-Feb-10	5.5 x 4.1 x 4.1 (New growth - 3mm)
10-Mar-10		Cytotron, Ruta Graviola
21-May-10	4.7 x 6.7 x 5.4 (New Growth - 2cm, 2 new growth <>
27-Jun-10		Stem Tech (AFA)

MRI after cytotron

2010-05-23T15:41:00.000-07:00

We had an MRI done on Friday, 21st May, about 6 weeks after cytotron treatment. Its bad news again. Sob! The damn tumor is now 6.7 x 4.7 x 5.4 cm. Its progressing! And thats not the only bad news! There is 2 small new enhancing tumor deeper in the brain! I am totally lost now. We dare not tell Norman about the new growth. We just told him that the tumor had increase very slightly. But I think he knows better as he is feeling weaker the past 1 to 2 weeks. The cancer is slowly consuming him, day by day. Oh God, why are you so cruel to him? Isn't there anymore good news for us? I wanted him to be one of the few who can "beat" this cancer but now our hope is now dwindling. I miss him so much. He is here but he is disappearing! Where is my husband who climb moutains, trek hills, who fixes eveything in the house, where is he who shares all my hope and dreams, his quick wit, his humor, his tender loving care. We were suppose to sit in our rocking chair, counting the stars from our balcony with our grand children! Now everyday is bittersweet and tinge with some underlying sadness. He is always angry, frustrated and miserable. But he is still here and he is my hero. We all love him with all our heart. My family and myself will give everything for him. We are still praying for a miracle.

Chemotherapy again?

2010-04-27T07:16:00.000-07:00

Thank you to CW, Laureh and Zulkifli for your comments and suggestions.
We did talked to our oncologist about avastin and he told us that it is only about 20% effective at this stage. On top of that, it will cost about RM10,000 per treatment per month. Avastin or Bevacizumab works by interfering with the process of angiogenesis. It cuts off the supply of blood vessels to the tumor causing it to shrink.

Dr Ibrahim did suggest the chemo call Nimotuzumab.It is quite new and clinical trials are still on going. Its given by IV infusion and results shows significant benefits for high grade gliomas. I do not know the cost yet.

The other alternative treatment is a combination of DCA and Laetrile. I am still researching on it. DCA or Dichloroacetate is a toxic chemical that can cause imbalance, finger numbness and nerve damage. It did shrink tumor in rats but is not tested on humans yet. Thus it is not approve in US but some Canadian Drs are prescribing it to their patients.

We are still in the wait and see attitude as we just finished our cytotron not long ago. We certainly do not wish to jump into the chemo wagon as it is so toxic and damaging. Moreover Norman have had 6 cycles of Temodar in 2008. We are praying that the cytotron is effective in controlling the tumor growth. Will be repeating a MRI in June.

Dorothy

Completed cytotron treatment

2010-04-20T06:49:00.000-07:00

We completed our cytotron therapy on the 8th April. It was a relief! To me, it was a renew hope. A hope that this will be the break through for Norman, that this will be the tretment that will cure him. BUT 2 days after he finished his treatment, he had a grand mal seizure! It happen early in the morning at 6.30am. He was lying in bed doing leg lifts when he felt twitching on his face. I sense something wrong and as i put my hand over his face, I started to pray. His hands and legs started jerking followed by his whole body jerking violently. His head was contorted to the side, his eyeball was rolled up, he was hissing saliva and gasping for air at the same time! I cried out to God for mercy. As a nurse I have seen patients having fits but nothing is more heart wrenching than seeing Norman suffering from such a severe fit. It lasted about 2 to 3 mins. He was daze for a few hours after that and he got weaker on the right side. I increased his fits medication and commenced steroids again. The cytotron Dr said that most probably its the edema causing the fits. It could be the tumor too.
We are still praying for god's miracle and we will continue to uphold our life to God. God is good, all the time.
May God bless you.

Cytotron treatment- 18th day

2010-03-28T20:06:00.000-07:00

We completed 18 days of the cytotron treatment today. So far there have been no improvement noticed. Norman's speech remain poor. He still could not speak a full sentence clearly. It is so frustrating sometimes. His right hand and leg is still weak and uncoordinated.

We have seen Dr Ibrahim at wijaya medical center and he suggested chemotherapy. However the MGMT report is not favourable for him to go back on Temodar and he might need other newer chemo drugs. I dread these awful drugs and its side effects! We feel that it is too toxic and too damaging and is hesitating to start on it. Dr Ibrahim does not agree on the cytotron treatment and suggest we stop it. Sob! What can we do now? Any suggestions? I am at my wit end!

Dorothy.

RFQMR

2010-03-08T06:20:00.000-08:00

This morning we went to this clinic in Subang Perdana(Bodi Harmony) to check out their treatment protocol for cancer. Earlier I read about their treatment using RFQMR to treat brain tumor and arthritis at www.care-nexus.com. It sound promising and on further research this is what I found out.

RFQMR (Rotational Field Quantum Magnetic Resonance) could provide new hope for cancer patients.

Cytotron therapy with RFQMR technology is a non-invasive, safe and effective option to treat tumours by arresting cancer cell division leading to degeneration of the tumor.

Cytotron therapy is patented treatment for tissue regeneration and degeneration. For cancer it utilizes a totally different approach compared to conventional cancer treatment. Instead of the very high frequency ionising radiation used in radiotherapy, RFQMR uses radio or sub-radio frequency, low power, non-ionising, non thermal electromagnetic waves.

The main concern of the therapy is not the immediate destruction of the cancer cells, but rather with the help of the small amount of energy provided to the cell to stop the DNA’s uncontrolled mitosis, put the cell in a vegetative state and in time through apoptosis mechanism let the body get rid of the cancerous cells in a controlled fashion as all cells are programmed by nature for self destruction over time.

RFQMR can be an option for tumor treatment for patients who are unwilling or unable to have surgery, chemotherapy and radiotherapy or where these treatments have failed. RFQMR beams are precisely controlled and focused onto tissues to alter the proton spin inside and outside the cells therein generating streaming voltage potentials. This alters cell membrane potential to control cell mitosis.

Cytotron treatment is easy for the patient. Patient lies on the Cytotron bed that moves into the focus area and the treating rays are focused onto the affected point with the aid of laser guides and the patient’s MRI.

The computer calculates the dose based on the MRI report, gender, height and weight etc. Usually the treatment is given for 60 minutes daily for a period of 28 days. Most tumors should require a single treatment cycle but more may be required depending on the extent and aggressiveness of the tumor.

The treatment is non-invasive and patient feels no pain or discomfort due to the treatment. Patients can even listen to music or read during the treatment. For patients diagnosed with a tumor with or without previous surgery, chemo, or radiation, the RFQMR alters the Cell Membrane Potential to selectively arrest the cancer cell division and growth of tumor.

Each cell has a limited life span and is programmed by nature to die after completing that life span – hence the tumor cells whose growth has been arrested with RFQMR will die in due course of time. Death of cancer cells whose growth has been arrested by RFQMR leads to cancer free body. The same principle applies for patients with a recurrence/metastasis earlier untreated or previously treated by surgery, chemo, or radiation.

Even in advanced and terminally ill patients, the response leads to improvement in quality of life. For patients with a brain tumor (primary, recurrence, or metastasis) the response is often dramatic as the tumor shrinks leading to pressure relief. This is especially important as RFQMR is unaffected by the blood brain barrier and many available chemo drugs to treat brain tumors are not as effective as they cannot cross this blood brain barrierThe procedure is purely external with RFQMR rays requiring no Anesthesia, Blood transfusion, Hospital stay and is possible even in most patients who are unfit for anaesthesia, surgery, chemotherapy and radiotherapy. Cytotron therapy can be used to decrease the chance of metastasis.

We need to repeat another MRI on wednesday and will most probably start treatment on saturday. Norman will need 28 sessions of treatment over 28 days, special supplements and some form of electro magnectic waves stimulation on his right side. Total cost is about RM32,000.

We are very thankful that God has open this new door of renewed hope for us. Our spirit are lifted up again and we will not cease to pray for God's divine healing to be upon us. Father God, lay your hands us, keep us from harm and sufferings. Amen

Dorothy

Recurrent tumor

2010-03-03T17:27:00.000-08:00

We had a brain scan done on the 25th February at sunway hospital. The report was not good. The tumor had grown bigger, 5.5 x 4.1 x 4.1 cm. We were devastated! The neurosurgeon could not offer anymore treatment now.
We saw Dr Ibrahim at Wijaya medical center and he suggest proton radiation therapy. This therapy is something like the normal radiotherapy. It directs highly precise beams of protons to kill the cancerous tumor. However, I went on to seek a second opinion from Dr Foo (oncologist from Subang Medical center) and she is not for it. It may not be effective at all since Norman already had 30 fractions of radiation therapy. Btw, the proton therapy is only available in Shan Don, Wanjie hospital in China. It takes 6 to 7 weeks to complete the therapy and cost about RM180,000! The other place that offers proton therapy is in Boston and the cost is double!
The other alternative is to start chemotherapy which could only temporary control the tumor growth. However we need to check the MGMT level of the tumor before we can start on chemo. This MGMT test can only be done in India!! The good Dr had make arrangment to courier the tumor specimen to India today and we need 1 week to get the results. This MGMT level will tell us wheather Norman is resistent to the chemo drugs.
I am so lost now. I need to make decisions fast and I feel so weary and burden.
If you all have any suggestions please write to me. Will blog again soon.
Dorothy

Stem Cell therapy at TTPH hospital. 3rd Jan 2010- 28th Jan 2010

2010-02-18T08:38:00.000-08:00

Hi everybody,
Its been a long time since I last blog. I was not able to blog in Beijing as blogspot.com was restricted. Since we returned on the 28th, Jan I was busy, busy and busy! Here is a brief summary of the treatment done at TTPH, Beijing.

1. Daily IV herbal infusion. This is given to strengthen his immunity and it has anti cancer properties too.
2. Daily speech and physio therapy
3. Daily accupunture, monday to Friday. A few doses of nerve growth factor was given during the first week to stimulate nerve growth.
4. IV stem cells. 3 doses was given over 3 weeks
5. Stem cells via lumbar punture.
6. Herbal soup and oral herbal capsules (to regress brain tumor)

We are home for 3 weeks now. Norman is still weak on the right side. I am worried but try to console myself as it is only 3 weeks after treatment. We need more time to allow the neurons to heal. I need to push Norman harder on the physio part. He gets so frustrated when he could not use his right hand. Our next MRI is due next week on the 25th Feb. I dread all these scans because I dread bad news! I pray for inner strength from God to see me thru this hurdle again. Please pray for us.

Tian Tan Pu Hua Hospital

2009-12-25T19:12:00.000-08:00

We are flying to Beijing, Tian Tan puhua hospital on th 3rd January. Norman is able to walk now but will still need the wheelchair as the airport is big and we need to walk quite a distance. I heard the Beijing airport is also one of the biggest airport too! Its freezing cold in Beijing and we need at least 4 layers of thick clothing to combat the -10 degree there. I think I might have icesicles dripping down my nose! The air is so dry, we will need to put an icing layer of moisturiser to protect our delicate skin!

Norman 's main treatment protocol is stem cell transplantation. High doses of stem cells will be administered via IV injection for the first 1-2 weeks, the dose gradually reduced later. It seems the stem cell can cross the blood brain barrier and kill the cancer cells directly. I will blog when I have more info in Beijing.

I would like to thank all friends for their well wishes, prayers and support this past weeks. Thank you, thank you and thank you. You all have been great!

In god's glory,
Dorothy

Photos pre op and removal of clips

2009-12-05T19:59:00.000-08:00

Clips removed by Dr Lee

Photos taken on the 24th Nov 2009, on the eve of the 3rd surgery

Physiotherapy and speech therapy

2009-11-30T19:03:00.000-08:00

Today is the 6th day after Norman's surgery. He is recovering remarkably well. I started rehabilitation 2 days ago because the earlier rehab is started the faster he will recover. Rehab is critical as it will help his brain to reorganize and recover functions that is lost. Most of the improvement will take place within the first 2 to 3 weeks, so during this time frame I will need total dedication and perseverance on my part as I will be his main physiotherapist cum speech therapist.At the moment, I have arrange a physio to come in 3 times a week for half hour each time($40 per half hour).We have started some tongue exercise. Today Norman was able to count 1 to 50 and recide A to Z with some minor difficulties. It is indeed a mark improvement compared to 2 days ago when he could not talk at all!

For his coordination exercise, I mixed chick peas and black beans together on a tray and get him to pick up the black beans and drop it into a container. He is still very slow but I believe he will improve. He still cannot hold a spoon yet. Sometimes when he tries too hard to tell me something I get him to write it with his left hand.Its difficult and I need all the patience in the world!

Strength and coordination is two different thing altogether. The strength of his right hand is grade4, (grade 5 being the best) but his right leg is rated grade 3. (The tumor is on his left frontal lobe). That means I need to work more on his right leg. I manage to walk him with a walking stick for a few minutes this morning. Hallelujah! He get tire easily, so I cannot push too much. His wounds is still raw and I cannot risk any increase in ICP(intra cranial pressure).

Norman's medication.
Dexametazone 2mg 4x a day. It is an anti inflammatory drug to reduce edema in the brain.
Keppra 250mg 2x a day, Epilim 200mg 2x a day. These are anti fits drugs.
Nootrophil(Piracetam) 2x a day. This drug is credited with improving cognitive functions and memory.
Neuroaid 4 capsules 3x a day. This is a mixture of herbs from China. Extensive clinical trails have been done with it and the results are promising. It improve recovery of speech and other neuro functions by regenerating healthy neurons pathways.

Besides all these medication, I give him a careful selections of natural vitamins and collagen to help boost his immunity and general health.

Thank you all for your uplifting emails, for your comforting word of encouragement and your fervent prayers. I will continue to write when time permits.

God bless,
Dorothy

Home after brain surgery

2009-11-29T01:48:00.000-08:00

Dear friends,

We are home. Yes, we made it! We are happy to be home yet we are weary and burden! The surgeon was a tat too adventurous and might have cut too much. But he wanted to remove every one of those damn mutated cells. He too, like us wanted Norman to have a full recovery. Now we are to pay a heavy price for this surgery. Norman is now with right hemiparesis and dysphasia.

Hemiparesis is weakness on one side of the body. The surgical knife have cause deep laceration in the brain and a lot of nerve are cut and damaged. Norman was unable to walk at all yesterday. His right hands and right leg have lost all power. He could could grip your hand but could barely hold a spoon! With 2 person holding him, he could barely drag his right leg forward! That was yesterday. Today he could just about lift his right leg forward to begin his long journey to recovery. With God's grace and mercy, he is going to recover fast and good. Praise God!

Dysphasia is a partial or complete impairment of the ability to communicate. Norman is able to understand what is said but have great difficulties pronouncing words. He was unable to say his own name or any of our children's name! He manage to count one, two, three with great dificulties. He tried so hard to say just one word, it bring tears to my eyes. There is slight improvement today and any improvement is a victory to us! We clap our hands and shout with joy when he manage to take his first step today! Hallelujah!

I want to express my deepest gratitute to all you kind friends who have help ease my pain thru this very painful times. God have indeed blessed me richly with good and sincere friends. Thank you.

In God's glory,
Dorothy

3rd surgery with 5-ALA

2009-11-16T19:07:00.000-08:00

5-aminolevulinic acid

We had a brain scan done on the 3rd Nov and the report shows a enhancing tumor 5cm in size. It was devastatiing for us. No words can describe how we felt at that point of time.
The Dr suggest another surgery, which will be his 3rd. The second surgery was on the 16th Feb this year. This time round, the surgeon will use a new technique using 5-ALA.
Malignant glioma exhibit characteristic infiltrative proliferation and even under a powerful surgical microscope the tumour perimeters are hard to differentiate from healthy tissue. In brain surgery we can’t remove a bit of extra tissue to be on the safe side because that tissue is always functional, A new fluorescence technique that shows up tumour cells extremely clear and enables the surgeon to achieve much higher accuracy with tumour resection is 5-ALA. Well-tolerated 5-ALA labels tumour cells
Brain tumours like glioma are able to accumulate a substance called 5-aminolevulinic acid (5-ALA) and transform it into the strongly fluorescing protoporphyrinIX (PPIX). Three hours before the operation, Norman will drink a solution containing 20 mg of 5-ALAper kilogram bodyweight. The solution tastes rather sour, but is well tolerated and causes practically no side effects, because 5-ALA occurs naturally in the body. The PPIX is made to fluoresce under blue-violet light, enabling Dr Lee to clearly identify and safely remove the otherwise hard to spot tumour perimeters and any tumour residue remaining after resection of necrotic tissue and the solid tumour.
There is the danger of over cutting, so the Dr will wake up Norman half way thru the surgery to test his neuro functions like speech,memory and movement functions. We are assure that they will be no pain.
Dear friends, we need your fervent prayers to uphold us thru these trying times. We have not confirm the surgery date yet. Will be seeing the surgeon today and will update you all then.
May God bless you.
Dorothy

Brain tumors may not always be fatal.

2009-09-11T09:15:00.000-07:00

Dear friends, I read this good news about brain cancer and felt uplifted! There is hope!

Brain Cancer May Not Always Be Fatal
September 3, 2009
The recent death of Senator Edward Kennedy made many people more aware of brain cancer, in particular malignant gliomas, the aggressive form of brain cancer that ended Senator Kennedy's life. Malignant gliomas are the most common type of brain cancer. Few patients survive more than a year and a half after diagnosis.
At Duke University, Dr. John Sampson says the poor outcome is partly due to the many different types of cells in brain cancers. "While one cell may be susceptible to chemotherapy and another susceptible to radiation, there may be a third cell that is susceptible to neither of those standard therapies," Dr. Sampson said. Some doctors hold out hope, if not for a cure, for a longer life. VOA reported earlier that Dr. Marcus Bredel at Northwestern University has identified certain genes that may help some patients survive longer, and other genes within the tumor that resist treatment and continue growing. "We were able to predict the survival of glioblastoma (brain cancer) patients in a couple of populations across the United States," he said. Twenty-four-year old P. J. Lukac is one of the researchers. He has glioblastoma, the deadliest form of brain cancer. "When I started in the lab it was a very surreal experience because they talk about uniform fatality, they talk about inevitable recurrences of the cancer, and that kind of just hits you," Lukac said. But he is also hopeful. "I think in my lifetime we will see glioblastoma become a chronic and manageable disease," he added. Surgery is still the preferred option to remove as much of the tumor as possible. But a new treatment involves using fiber-optic laser probes placed inside the brain tumor. With a burning hot laser, doctors can destroy cancerous tissue they may not be able to reach during conventional surgery. Doctors Gene Barnett and Steven Jones use fiber optic lasers at the Cleveland Clinic.
"This [the procedure] allows us to steer the laser in different directions, to treat larger areas of tumor and protect normal brain," Dr. Barnett said.

Norman is holding on bravely. In spite of such adversity, we are trying to lead a normal and peaceful existence. We believe in miracles!

Still fighting

2009-08-27T19:17:00.000-07:00

Dear friends,
I have been taking care of Norman for the past 21 months, since Nov 2007 and while part of me is very grateful that he has made it so well thus far,another part of me is screaming why, oh why doesn't it end soon! Since his second surgery in Feb 2009,he has poor control over his emotion. He gets angry over minor things especially with the children and no one can do enough to make him happy. Sometime I feel like pulling out my hair or something like that. Then I step back and try to see things from his side. Norman has always been a very independent person and now he is not able to work or drive. His sleep is always disrupted. His social life is non existent. He complains about being bored and there is nothing to do and he feels like craps most of the time! Sob! I can feel all his frustration and anxiety. As a result, I too don't sleep well, I don't want to exercise and feel like craps too! Well, no one says life is ever easy living with cancer!Let me learn to go through the bad times and enjoy the good times. Let me be thankful even for all these trails and tribulations from God. I am blessed to know that God will never forsake me and Norman. With strength and courage from God, we will overcome. Thank you for all your care and support.

Dorothy

Steroid withdrawal syndrome

2009-08-24T08:06:00.000-07:00

On Friday,21st August, we saw a neurosurgeon at Sunway and Norman was diagnosed with Steroid withdrawal syndrome. What is that? Precisely what it mean, his body is suffering because we taper off the dexamethazone a week ago! And what were the syptoms?
On Thursday evening(20th August), he could not speak at all, his right side was weak,his right face was droopy and he was not steady when he walks! He couldn't even swallow well as water and food leaks out from the right corner of his mouth.He had 2 fits on thursday night.It was all so exhausting! On Friday morning we were like zhombies! And all these happens because of the devastating effects of steroid withdrawal!

What are steroids?

Steroids are hormones produced by the adrenal glands that are used to reduce brain swelling. Steroids belong to a class of drugs called corticosteroids. The steroids used to treat brain tumors are not the same as those used by athletes. The most common steroid is Dexamethasone. Norman was given steroid to treat his brain edema.
Usually he will take it for about 2 weeks and I will taper it off very gradually, about 1 mg daily by the third week. Since his second surgery in Februay, he has been on this steroid cycle several times because the MRI scan keeps showing massive edema and now the fits keep coming back. So when will all these steroid madness ends? I dont know. The Drs are trigger happy with the steroid and we are drowning with fear from this withdrawal symptoms not to listen to them. Isn't there any other treatment? I wish I know!
For the time being, Norman's condition have improved after taking the steroid. He still could not talk in proper sentences but at least he can say something! We are praying fervently for a complete and speedy recovery.
May God bless you all.

MRI, fits, brain edema

2009-08-20T07:17:00.000-07:00

On 13th August,2009 Norman had MRI of the brain at Sunway medical center. He have been having difficulty with his speech lately but can still manage to carry on a conversation slowly. The scan still shows a tumor about 4cm by 3.5cm with massive edema and lots of necrotic tissue. The Dr was not so worried and send us home with more fits medication.
2 days ago, Norman finds that his speech was not only slow but slurred as well. The symptoms of the disease is progressing- anger, aggression, weakness on one side( he was not able to hold a spoon) and extreme difficulty to say anything! It is all so terrifying. I am trying to keep my hope up but the fears keep creeping in. Again and again my faith have been tested! My wonderful children have been very supportive and we pray constantly for a miracle from God.
At this point, I want to thank all our friends who have upkeep us with your fervent prayers. Knowing you all are there for us have been a great help. Thank you.

Dorothy

Yoka Ha and family

2009-07-10T21:48:00.000-07:00

Hi guys and gals,
This pic is taken in Hanoi in Oct, 2008. My 3 boys, daughter-in-law, daughter, Khoon Hock and myself.

Reunion of class73 sjc

2009-06-24T20:17:00.000-07:00

To all my dear friends, we have indeed mellowed after 36 years (since we left school in 1973) But we look good,don't we? Here is the proof. Take a look at these gorgeous photos! Lets keep it up!

Hard on the brain

2009-05-14T15:40:00.000-07:00

Hard on the brain and brain scan report

There was an article on the star newspaper (6th May 2009) entitled “ Hard on the brain. After chemotherapy, patients can experience huge cognitive problems”. This couldn’t be more true for Norman! It is indeed a widespread problem for cancer patient, especially brain tumor patient who have undergone brain radiation therapy as well.

After 30 fractions of radiotherapy and 6 cycles of Temozolomide chemo treatment, welcome to chemo brain! Nowadays, Norman struggled to find the right word for an object or is unable to type out a letter smoothly (he could not spell words correctly). He could no longer multitask as he easily lost concentration and the ability to focus. On top of that he suffers short term memory loss too! All these occurrences shake his confidence and upset him tremendously. Friends said he looks good but they don’t really know what he is still going through. All these problems could be the results of chemotherapy and radiation therapy damaging the brain’s ability to grow new cells.

Lately, Norman gets tire easily. On Tuesday ( 13th may), he had a mild facial fit after playing 18 hole of golf. We were worried sick! Yesterday (14th may) we had a brain scan done. The report shows the tumor now measure 3.5 x 3.4 x 4.5 cm in size and still massive edema present. It is this edema that is causing him the fits. Again the Dr put him on high doses of steroids. So now he not only have a chemo brain but also a steroid brain! God bless him! Sob! I don’t know how much more of this medication abuse we can take! I am so tire from so much fear. I might just freak out but the Dr said I have to be strong for him. So, the battle continues……

Prayer of bereavment

2009-04-14T20:30:00.000-07:00

Dear Shirley and Josephine,

ALMIGHTY GOD, we rejoice to know
that your reign extends far beyond the limits of this life.
In the mystery of what lies beyond our sight
we pray that your love may complete its work
in those whose days on earth are done;
and grant that we who serve you now in this world
may at last share with them
the glories of your heavenly kingdom

HEAR US, O merciful Father,
as we remember in love, our brother Heng Li and TL Yeap
whom we have placed in your hands.
Enfold them in the arms of your mercy,
in the blessed rest of everlasting peace

Heng Li and TL, go forth upon your journey from this world,
in the name of God the Father almighty who created you;
in the name of Jesus Christ who suffered death for you:
in the name of the Holy Spirit who strengthens you;
in communion with the blessed Saints,
and all the armies of the heavenly host.
may you be in peace,

Give rest, O Christ, to your servant Heng Li and TL
Where sorrow and pain are no more,
neither sighing, but life everlasting.

Father of all mercies and God of all consolation,.
give courage to Shirley and Josephine in their loss and sorrow.
Be their refuge and strength, O Lord,
reassure them of your continuing love
and lift them from the depths of grief
into the peace and light of your presence.
Your Son, our Lord Jesus Christ,
by dying has destroyed our death,
and by rising, restored our life.
Your Holy Spirit, our comforter,
speaks for us in groans too deep for words.
Come alongside Shirley and Josephine. Remind them of your eternal
presence and give them your comfort and strength.
Amen.

Dear shirley and Josephine,

I wish you enough sun to keep your attitude bright no matter how gray
the day may appear.
I wish you enough rain to appreciate the sun even more.
I wish you enough happiness to keep your spirit alive and everlasting.
I wish you enough pain so that even the smallest of joys in life may
appear bigger.
I wish you enough gain to satisfy your wanting.
I wish you enough loss to appreciate all that you possess.
I wish you enough hellos to get you through the final good-bye

May the good lord continue to bless you and your family.

Heng Li(liver cancer) and TL Yeap(prostate cancer) are members of our Elpizo cancer support group lead by Shery Lim. May God bless their souls.

Ruta Graviola and Calcarea phosphate

2009-04-09T00:05:00.000-07:00

Dear friends,

Its been a while since I last blog. Life hasn't been easy since Norman's craniotomy on 16th Feb. The recovery was good but there are some slight neurological deficit we have to put up with,mainly speech issues and short term memory loss.

We did a MRI on the 30th march and the report was not favorable.There is a big cyst about 3-4.8cm, lots of necrotic tissues and massive edema. The Dr put him on steriod and epilim for fits again. Sob! This is a real monster we are dealing with! There is no need for chemo untill the next MRI due on the 28th May. The oncologist will review him then.

Norman started the CAAT diet on the 1st April. So far he is keeping closely to the diet plan. In fact the people reviewed his food chart(which I chart everyday and send over to them) and they are very pleased with him. Will be commencing the supplements next week.

We received the ruta graviola and calcarea only yesterday. The herbs cost only USD25but the shipping charges cost USD35.50!! ohmigosh!! Its only 2 very tiny bottles and its not heavy at all! How come it cost so much for shipping? For friends who is not familiar with this herb, graviola is an extract from the sour sop plant. It has been extensively research by Dr Banerji of India and he claim that the success rate for brain tumour is very high.We are willing and desperate to try anything at this junture as we are not keen on chemo anymore.

May God bless and keep you in good health.

Controlled Amino Acid Treatment

2009-03-02T22:36:00.000-08:00

Dear friends,
I was recommended this special diet by Mr Looi of Medi food. CAAT stands for controlled amino acid treatment.

THE SCIENTIFICALLY FORMULATED AMINO ACID THERAPY
CAAT is much more than just a “diet”; it is an amino acid, carbohydrate, & glucose REDUCTION protocol which strategically uses the chemical reactions of amino acids, foods, and nutritional supplements to impair the development of cancer cells, thus starving them to death.) Clinical trials have already been done with humans using amino acid depravation formulas, and with much success.

CAAT is a course of therapy to control a patient’s amino acid intake. This is achieved by taking certain foods out of a persons’ daily food plan for a short time and by replacing them with a scientifically supported formula of amino acids. It is also important to emphasize that the food plan that accompanies the amino acid formula needs to be followed so as not to offset any of the benefits that are created by depriving the cancer cells the nutrients they need to grow. Controlled Amino Acid Therapy inhibit phosphofructokinase which shuts down the energy supply to cancer cells, simultaneously enhancing the benefits of chemotherapy while lessening their toxic side effects. CAAT has also proven to work successfully alone.

Phase 1: CAAT Formulation

The most important component of CAAT is the scientifically formulated amino acids. Based on the specific formula for each cancer, it consists of separate amino acids, citric acid, and small amounts of sodium benzoate. Each formula replaces most of the regular daily proteins found in meats, dairy, fish, beans and nuts, which cancer cells can derive their energy from. The CAAT formula taken two times per day will nourish the healthy cells while causing the cancer cells to starve to death.

Daily Food Intake

The following food program SHOULD NOT be consumed without the amino acid formula and without consent from your doctor and our Institute.

Breakfast:
*1/2 Grapefruit or 1-orange or 6-ounces of fresh orange juice.
Whey Enhanced Protein (Vanilla Flavor – Vitamin Shoppe Brand) approximately
10 – 12 grams of protein – read label carefully, based on 150 lb. person ].
A serving of Grits (Butter, cinnamon and other spices are okay).
1 cup of green or black tea (Fructose is sweetener of choice).
* Do Not have ½ grapefruit if taking Chemotherapy

Lunch:

Amino acid formula (4 level plastic scoops) mixed with any of the following: Water & Fructose; Sugar free Kool-Aid; Diet ginger ale; Fresh lemonade & Fructose; Chicken or Beef broth; V8 juice.
Generous amounts of One cooked vegetable or a combination of the following: asparagus, broccoli, cabbage, brussell sprouts, spinach, squash, string beans.
One serving (1/2 cup)of fresh fruit. Choice of: pear, orange, blueberries, raspberries, strawberries.
1 serving (moderate) of grits or corn or rice or pasta (Add tomato sauce or butter)
1 tablespoon of coconut oil
8 to 10 black or green olives
2 tablespoons of vinegar (minimum of 5% acidity) add to vegetables or food
1 cup of green or black tea (Fructose as desired)

Dinner

Amino acid formula (4 plastic level scoops) mixed with any of the following: Water & fructose; Sugar free Kool–Ade; Diet Ginger Ale; Fresh lemonade & Fructose; Chicken or Beef broth; V8 Juice.
Generous amounts of One cooked vegetable or a combination of the following: asparagus, broccoli, cabbage, brussel sprouts, spinach, squash, string beans.
One serving (1/2 cup) of stewed plums with fresh cream & fructose; use 4-ounces of orange juice if plums are not in season.
Avacado salad with lettuce, tomatoes, celery, onions, with lemon juice and coconut oil or olive oil.
2 tablespoons of vinegar (minimum of 5% acidity) add to vegetables or food.
1 serving of grits or corn or pasta or rice (Add garlic and butter or tomato sauce)
1 cup of green or black tea (Fructose as desired)

Phew! I think it will take alot of discipline to keep to this diet. Very western lah!
Will be seeing a nutritionist Dr tomorrow to review if this diet is acceptable. In the mean time Norman is resting well. We dare not see any oncologist untill the next brain scan is due, most probably end of march. Dont want anymore poisonous toxic chemotherapy! We are trying to keep up the good spirit. My sisters said, when fear knocks on the door, send faith to open it.Praise God

2nd surgery

2009-02-24T23:30:00.000-08:00

Dear friends,
On 4th feb, norman's brain scan showed a malingnant tumor measuring 3 x 3.5cm. I was devastated! I feel like I have fallen through a trap door into total darkness and i felt numb to the bones! Nothing felt the same after that bad news. Nothing is the same and nothing will ever be the same. I see the despair in Norman's eyes and I feel so helpless! I do not know, honestly, how I will weather all the grief, the emotional stress and the deep agony in my soul. God have mercy on me! I will breath deeply through every bout of anxiety and fears and pain!
After several visit to several hospital and several doctors, we decided on surgery.
On 16th feb, surgery was done at sunway medical center.5 glaidel wafers was implanted. Norman recovery was excellent. Praise God. The price?? Its too traumatic to tell. Leave it alone ok! We are discharged on the 19th feb.
Below are some pre and post op photos.

Family Support Is Of Utmost Importance

ECG before operation

Tumour mapping on the night before op

In ICU - 6 Hours After operation

Waiting To Remove clips - 8 days post op

Glialdel wafer for glioblastoma

2009-02-07T22:29:00.000-08:00

Treatment Options for Glioblastoma Multiforme
The Role of GLIADEL Wafers in Glioblastoma Multiforme
GLIADEL Wafer (polifeprosan 20 with carmustine implant) is a small wafer containing the cytotoxic agent BCNU (carmustine) in a biodegradable polyanhydride copolymer. GLIADEL Wafer is a localized drug delivery system that allows high concentrations of BCNU to be delivered to the tumor cavity, thereby, overcoming the adverse side-effects associated with conventional systemic administration of BCNU.

GLIADEL Wafer is biodegradable, meaning that it dissolves slowly over time and releases high concentrations of BCNU in a sustained fashion over an extended time interval.

The GLIADEL wafers are implanted into the tumor bed following surgical removal of the brain tumor. Up to 8 GLIADEL wafers are implanted into the surgical cavity after the tumor has been removed and, as the wafers dissolve, they release high concentrations of BCNU at the tumor site to destroy residual tumor cells that have not been removed by the surgery. More than 70% of the polyanhydride copolymer degrades by three weeks after implantation although "wafer remnants" can be detected even several months after implantation.

In February 2003, the United States Food and Drug Administration (FDA) approved GLIADEL Wafer for use in newly diagnosed patients with high-grade malignant gliomas as an adjunct to surgery and radiation therapy. Prior to the FDA approval for use in newly diagnosed patients, GLIADEL Wafer was used only for those patients who suffered recurrence of glioblastoma multiforme and required a second surgery to remove the tumor.

The results of clinical trials have shown that GLIADEL Wafer significantly prolonged survival in both newly diagnosed patients and patients with recurrent glioblastoma multiforme when used as adjunctive therapy to surgery and/or radiation therapy.

The most common side-effects of GLIADEL Wafer that were observed during clinical trials included:

seizures
brain edema
wound healing problems
intracranial infections

2009-02-05T23:02:00.000-08:00

Medical History

14th nov 2007
-Had a seizure of the right face lasting 1-2 mins
-had numbness of the right side
-unable to spell words
-very slow in speech

!6th nov 2007
MRI done. reports show a tumor on the left frontal lobe measuring 4 x 4.5 cm
Diagnosis- glioblastoma multiforme

21st nov2007
craniotomy and excision of tumor done at sunway medical center by Dr Lee Foo Chiang
Biosy report:
The tumor is compose of high grade glial cells exhibitig marked pleormorphism, many tumor giant cells and endocapillary vascular proliferation. Necrosis is seen.
The cells are strongly positive for GFAP and EGFR. MIB-1 activity is seen in about 35% of cells; P-53 mutant protein is seen in more than75% of cells.

17 dec2007-1st feb 2008
30 fractions of radiation therapy completed

march-july 2008
6 cycles of temodar chemo therapy completed

Brain Scan (MRI and MRS)
3rd may 2008- small lesion about 1 x 1.5 cm seen. suggestive of radiation nercrosis
13th sept 2008-lesion now 1.4 x 1.5 x 2.1 cm. still suggestive of necrosis
30th dec 2008- lesion now 2.2 x 2.1 x 3.4 cm. still suggestive of necrosis

3rd feb 2009
Had 2 facial seizure lasting 1-2 min. No loss of consiousness. Admitted to hospital
Put on epillim 200mg 3x/day for fits
Put on steriod 2mg 3x/day for brain edema

4th feb 2009
Brain scan shows enhancing mass of 3 x 3.3cm with cerebal edema. Its a recurrent glioma.It is malignant.

The neurosurgeon suggest craniotomy with insertion of gliadel wafer.

Dear friends, we thank you for your support and prayers at this very trying times. I will update you all on the surgery date. Norman needs to rest more now. Even though depress and worn out, he is putting up a brave front. We will fight this bitter war till the end. God will be with us.

Brain edema

2009-01-31T15:28:00.000-08:00

On the 3oth Dec 2007 Norman had a brain scan done at HUKM. The report was bad. The previously seen enhancing lesion in the left parietal lobe measure 2.2cm x 2.1cm x 3.4cm(previously 1.4 x 1.5 x 2.1) showing significant increase in size. The edema has also worsen compare to the previous scan on 13th sept 2007.However the report says that there is no evidence of tumor recurrence. This could represent just an enlarging area of radiation necrosis. We consulted both doctors, Dr Lee Foo Chieng(neuro surgeon) and Dr Foo Yoke Ching(oncologist). We were told to repeat another scan after cny. Then only we will decide on the next step of treatment. However the brain edema was causing speech problems and norman need to take steriods.

Brain Edema
Brain edema (swelling) is a common occurrence in brain tumor patients. The swelling is caused by the accumulation of fluids in the tissue around the tumor. This exerts pressure on the brain that can lead to additional symptoms including headaches, seizures, and focal neurological deficits. Brain edema may initially be due to the tumor itself or it may occur as a result of treatment (craniotomy or radiation therapy).

The first-line treatment for brain edema is the administration of steroids. The most commonly used steroids for brain edema are prednisone and dexamethasone (Decadron). Patients who are given steroids must be carefully monitored for side-effects which may include:

weight gain
upset stomach
muscle weakness
increased susceptibility to infections
mood swings
insomnia
increased blood sugar levels - particularly dangerous in diabetics

So far, Norman did put on some weight(from gorging on new year goodies!), feels bloated all the time and worse of all,gets irritated easily(mood swings). Sob!

10 foods you don't have to buy organic

2008-12-02T18:00:00.000-08:00

10 Foods You Don't Have to Buy Organic
These Fruits and Vegetables Don't Hold on to So Many Pesticides, So You Can Save Your Organic Dollars for the Ones That Do.

Asparagus
Asparagus face fewer threats from pests such as insects or disease, so fewer pesticides need to be used.

Choose: Look for firm spears with bright green or purplish compact tips. Plan on a 1/2 pound per person, and for more uniform cooking, select spears of a similar thickness. Store in the refrigerator vegetable crisper and give them a good rinse before using (even if you're going to boil them).

Avocados

Avocados have thick skins that protect the fruit from pesticide build-up.

Choose: Look for avocados that are still somewhat unripe and firm to the squeeze; they'll ripen nicely on your kitchen counter in a couple of days. Store at room temperature. Although you'll be using only the meat of the avocado, it's always a good idea to rinse them before you slice them open.

Bananas

Pesticide residue remains on the banana peel, which isn't eaten.

Choose: There are basically 3 stages to a ripening banana. You'll want to choose them according to how you're going to use them. Chosen green, where the peel is pale yellow and the tips are green, their taste will be somewhat tart. These work best for frying or baking in a pie. Chosen at their next stage of ripeness, where the peel is mostly all yellow, the pulp will still be firm but their starch content will have started to turn to sugar. These also work well in pies and tarts. In the last stage of ripeness, the skins will show signs of brown spots with the peel a deeper yellow color. This is when they're sweetest and work well mashed and added to baked goods like banana bread recipes. Store at room temperature. If they're unripe, you can place them in a brown paper bag to ripen. Give the bananas a quick rinse and dry before you peel them.

Broccoli

Conventional broccoli doesn't retain so many pesticides because the crop faces fewer pest threats, which means less spraying.

Choose: Look for tightly bunched flower buds on the broccoli stalks that are immature. In other words, try not to buy them if their little yellow flowers have opened. Color-wise, the broccoli should be deep green and the stalks should be firm and not rubbery. Before use, wash in a cool water bath and change the water a couple of times in the process. Store in the refrigerator crisper.

Cabbage

Cabbage doesn't hold on to so many pesticides because a ton of spraying isn't required to grow it.

Choose: Look for cabbage heads whose leaves are tight and be sure the head is heavy for its type, and firm. For most cabbage varieties, you'll want to make sure the outer leaves are shiny and crisp. Savoy is the exception to this rule, as it forms a looser head and the leaves grow crinkly naturally. You'll want to avoid any with leaves that show signs of yellowing. Bok choy should have deep green leaves with their stems a crisp-looking white. Discard the outer leaves of a cabbage before using. You can wash and spin most cabbage leaves just like you do salad greens. Store in the refrigerator crisper.

Kiwi Fruit

Kiwi peel provides a barrier from pesticides. Give them a rinse before cutting.

Choose: Here's where your nose plays an important part when choosing fresh fruit. Sniff out kiwis that smell good. They should be plump and yield to a squeeze like that of a ripe pear. Steer clear from those with moist areas on their surface or any skin bruising. If unripe kiwi are all that are available, simply take them home and place them in a paper bag at room temperature with other fruits that need more time, such as bananas or pears. Store in the refrigerator crisper.

Mango

Sweet mango flesh is protected by its thick skin from pesticides. Still, you'll want to rinse under water before cutting open.

Choose: Depending on the variety of melon, look for those that are bright in color such as red, yellow, or orange. It should have a distinctive "fruity" smell. If there's no ripe-fruit aroma, steer clear. Mangoes should be slightly firm but yield to your touch somewhat -- the softer the mango, usually the sweeter it is. If the mango is too soft, there's a good chance that it will be rotten inside. Store in the refrigerator crisper.

Onions

Onions don't see as many pest threats, which means less pesticide spraying.

Choose: Look for onions that are firm, have a distinctive "oniony" smell that's not overpowering, and show no visible signs of damage or soft spots. Store in a cool, dry place or in the refrigerator.

Papaya

Pesticide residue stays on papaya skin, but be sure to give them a wash before slicing open.

Choose: Papaya colors usually range between yellow and green. Look for those that are slightly soft and show no signs of bruising or appear shriveled. If they're not fully ripened, you can toss them in the brown bag along with your unripened kiwi fruit, peaches, and pears. Once they're ripened, store in the refrigerator crisper.

Pineapples

You won't be eating the tough pineapple skin, which protects the fruit from pesticide residue. As with all your produce, you should rinse the pineapple before cutting.

Choose: Although tempting, this is one fruit that you won't want to choose if it has a strong, sweet smell. This usually means that the pineapple is overripe and has even begun to ferment. Like all other fruits, avoid any that have soft spots, and in the case of pineapples, damage to the rind. Store in the refrigerator crisper.

excessive exercise produces free radicals

2008-11-20T18:19:00.000-08:00

Free radicals are reactive oxygen molecules that have lost an electron in interactions with other molecules. As a result, these molecules are extremely unstable and they race around stealing electrons from other molecules creating more free radicals in the process, damaging cell components. The body produces several free radical quenching enzymes as its first line of defense. They are superoxide dismutase (SOD), catalase, and glutathione peroxidase. Additionally the body uses antioxidant vitamins, minerals and substances found in food to counteract free radicals. Free radicals overtax the immune system and keep it so busy fighting the breakdown of the body's own cells that it cannot fight off viruses, microbes, and infections that attack it from without.
The brain is susceptible to free radical damage due to the high content of polyunsaturated fats and high mitochondrial content. Levels of vitamin C in the brain are 50 times higher than elsewhere in the body to protect brain tissue and neurotransmitters from oxidation. The free radical damage to proteins in neurons reduces their efficiency. Raising antioxidant levels not only allows damaged proteins to repair, but increases neurotransmitter levels as well. To protect the brain from free radical damage during the heightened nerve flow we need to take hydrophobic (water repelling) antioxidants like pine bark, vitamin C-Ester and alpha lipoic acid, as the blood brain barrier is impervious to hydrophilic (water loving) substances. We must aim to get more antioxidant protection into the cerebrospinal fluid.

One of the best ways we can counter and overcome the stress in our lives is through regular exercise. However not all exercise is good for fighting the free radical war. In fact excessive exercise for which the body is not prepared for can actually cause extensive oxidative damage. Free radical production goes up during exhausting, high intensity workouts and such free radical activity is associated with oxidative damage in the muscles, liver, blood and other tissues. Hence at the heaviest training levels there is increased susceptibility to cancer, heart attacks, cataracts, premature aging and decreased immunity. Some of the reasons why there is increased free radical damage during exercise are: the consumption of oxygen goes up 10-20 times, there is an increased output of Superoxide radicals by mitochondria, there is oxygen deprivation from the increased demand by tissues and the bodies antioxidant defenses are over burdened. There is an increase in free radical production in both excess oxygen and lack of oxygen conditions.

Regular lower intensity exercise minimizes the production of free radicals while strengthening the indigenous antioxidants and enzymes. Without regular exercise the body's internal defenses against free radicals (SOD, GSH, Catalase) may become too fragile for the antioxidants in our food and supplements to have their full affect. Sedentary people are twice as likely to get cancer and heart disease as active individuals. Trained muscles are resistant to oxidative damage because of the increased supply of the bodies own antioxidants. Regular training prepares the bodymind to better handle unexpected physical and emotional stresses and strains. That is exercise builds up our resistance to free radical damage from all stressors. Fast walking at the pace of 12-15 minutes per mile is ideal for returning optimum endurance benefits, without creating excess free radicals and damaging tissues. Fast walking can be as effective as jogging without the risk of injury. To strengthen our endogenous free radical defenses we need to do at least 30 continuous minutes of brisk walking three times a week. Besides this we also need to do some weight bearing strengthening exercise and some stretching as well. By maintaining strength and subtly we prevent the aches, pains and free radicals that come from physical stress to an unconditioned body.

Norman now exercise at a moderate level compares to his pre tumour days when he exercise 7 days a week! His brain scan on 13th september 2008 still shows a dead necrotic tumour which has increased slightly in size. It could still increase in size for the next 1 to 2 years due to radiation side effects. He is taking turmeric ginger juice every morning to help shrink the tumour.

2008-11-20T17:18:00.000-08:00

The Healing Power of a Wholesome Diet for Brain Tumor Patients
By Jeanne M. Wallace, PhD, CNC

What can a healthy diet accomplish?
Brain tumors are a formidable foe, and many of us view our fight against them as a war,harnessing powerful treatments like surgery, radiation and chemotherapy as the linchpin of our plan of attack. How then can “wimpy” fruits, vegetables, whole grains and other healthy foods have any effect against this dreaded enemy? While wholesome foods and nutrients are not a cure for brain cancer, they can provide an important complementary strategy to help bolster the body’s regulatory “controls” against cancer. A healthy diet is one of the best ways to boost your immune system and complement your radiation and/or chemotherapy treatments…and there are several other ways good nutrition can help.

Phytonutrients: Our Cancer “Phyters”
The anti-cancer benefits of diets rich in fruits and vegetables have long been attributed to their high vitamin, mineral and fiber content. More recently, however, researchers have discovered that fruits, vegetables, legumes, whole grains and kitchen spices contain thousands of other health-promoting compounds, collectively known as phytonutrients. Many phytonutrients appear to have significant cancer fighting properties.
Phytonutrients in many common foods have been shown to promote the death of brain tumor cells in cell culture studies. Among these are:
elemene (found in ginger)
tangeretin and limonene (in citrus peel),
catechins (in green tea)
anthocyanins (in blueberries and chokecherries).
Genistein (in soy)
Perhaps most compelling are new studies that demonstrate phytonutrients have the remarkable capacity to talk directly to and influence our genes. A growing
body of research on phytonutrients shows they can inhibit oncogenes (tumor-promoting genes) and increase the expression of tumor suppressor genes.
In addition, food-based phytonutrients are the richest source of antioxidants - far more potent than vitamin pills! The antioxidant capacity for vitamin E (one 400iu capsule) has been measured as 125 ORAC units, but it’s over 1,000 units per serving for blueberries, cinnamon, pomegranate juice, figs, prunes, raspberries, green tea, strawberries, spinach and kale. Food-based antioxidants are important for promoting gene stability and preventing mutations to the DNA of cancer cells that may lead to more aggressive behavior of tumors and/or resistance to Chemotherapy.

Brain tumor vaccine

2008-07-15T18:16:00.000-07:00

Hope for new brain tumour vaccine

One in four brain tumours are glioblastoma multiformes
A vaccine has been developed which may be able to fight the most aggressive form of brain tumour, scientists say.
US researchers say their vaccine increased survival times for the 23 glioblastoma multiforme patients they tested it on by at least 18 months.
Only four patients went on to die from the cancer, the study to be presented at a meeting of experts in the US said.
A larger trial of the jab, which works by targeting a protein thought to drive the tumour's spread, is now planned. It uses an artificial form of the protein, which is found on the outside of 30-50% of tumours, to alert the immune system to its presence and attack it.
The brain is tricked into thinking the protein, known as EGFRvIII, is foreign, and fighter cells in the immune system are sent in.
Amy Heimberger, assistant professor of neurosurgery at the MD Anderson Cancer Center in Texas, said the vaccine was an easy-to-use "off-the-shelf" treatment that could potentially help half of all patients with glioblastoma multiforme (GBM).
She said results from the trial showed the vaccine significantly delays the progression of tumours until the cancer finds a new way to grow.
Survival times
But when tumours did grow again they did not display the EGFRvIII protein which led researchers to conclude that the vaccine had worked.
Professor Heimberger said: "This is a proof of concept, and optimal use of the vaccine may be with chemotherapy to further retard progression.
"Still, this is exciting because people have been trying to use immunotherapy against gliomas for a long time."
She also said that the median survival times were five months longer than those for GBM patients treated with the most up-to-date combination of chemotherapy and radiotherapy.
Patients with this type of tumour left untreated tend only to survive for four months.
GBMs affected adults between 40 and 60-years-old and represent about a quarter of brain tumours.

Miracle soup for cancer

2008-06-12T16:13:00.000-07:00

Dear friends,

Would like to share this super food formula with you.I have tried it for Norman and it taste ok. Hope u can try it too.

by Tateishi Kazu
When cancer strikes a family, what course of action should one take? Dr. Tateishi Kazu’s father and brother both died of cancer. And then he found himself suffering from cancer of the duodenum and spreading. His stomach was removed, but the cancer cells had spread to his lungs. He resolved to fight for his life. He researched, studied and tested over 1,500 types of herbs and plants. Eventually he discovered the right combination of ingredients and formulated a unique healing vegetable soup and brown rice tea with its own molecular powers. The vegetables are rich in green chlorophyll, amino acids, iron, phosphorous, calcium, all in a natural form.

He based his soup on the principles of Five Elements theory, the harmonizing balance of the forces of yin and yang, acid and alkaline, that engenders health as opposed to the imbalance, which leads to disease. The five elements in our environment are wood, fire, earth, metal and water. Because of the balance of the five elements, the earth is able to produce life. Dr. Tataishi Kazu used the essence of the five elements. Each essence possesses its own color: green, red, yellow, white and black. These relate to the corresponding internal organs: heart, liver, spleen, lung and kidneys. He used the concept of the five different colors as matched to specific vegetables:

Green=Daikon Radish Leaves
Red=Carrot
Yellow=Burdock Root
White=Daikon Radish
Black=Shittake Mushrooms

This is a remedy for all age groups. When the soup is ingested, it produces thirty different elements for fighting disease. Within three days, it can stop the growth of cancer cells. Even for some last-stage cancer patients, it can lead to 100% remission. Patients who have subsisted on feeding tubes for nourishment, when given the soup, after two days regained their strength. Over 10,000 last-stage cancer patients have used this remedy. 99% are alive and were able to return to work.

What This Remedy May Do:

1. Heal Cancer
2 Restore injured joints and bone structure
3. Slow down the aging process
4. Rejuvenate the skin
5. Heal Cataracts
6. Heal liver disorders
7. Lower high blood pressure
8. Improve heart conditions
9. Reduce brain tumors and other head-injury problems
10 Reduce high white blood cell counts
11. Improve T-cell function

——————————————————————————–

Vegetable Soup Recipe
(2 day’s quantity)

16 ounces white daikon
8-10 ounces white daikon greens
8-10 ounces carrot
8 ounces burdock root
3-5 fresh shitake mushrooms (sundried)
If not sundried, expose dried mushrooms to sun again.

Directions:
Don’t peel anything! Don’t add any seasoning!
Fill a pot with 14 cups of water. When it comes to a boil, reduce the flame and simmer for two hours. Strain and drink.

Cherry Blossom in Japan

2008-05-27T09:28:00.000-07:00

9th April till 15th April 2008

Magnectic Resonance Spectroscopy

2008-05-27T09:21:00.000-07:00

What is magnetic resonance imaging (MRI) and MRS?

MRI, or magnetic resonance imaging, is a means of “seeing” inside of the body in order for doctors to find certain diseases or abnormal conditions. MRI does not rely on the type of radiation (i.e., ionizing radiation) used for an x-ray or computed tomography (CT) scan. The MRI examination requires specialized equipment that uses a powerful, constant magnetic field, rapidly changing local magnetic fields, radiofrequency energy, and dedicated equipment including a powerful computer to create very clear pictures of internal body structures.

During the MRI examination, Norman is placed within the MR system or “scanner”. The powerful, constant magnetic field aligns a tiny fraction of subatomic particles called protons that are present in most of the body's tissues. Radiofrequency energy is applied to cause these protons to produce signals that are picked up by a receiver within the scanner. The signals are specially characterized using the rapidly changing, local magnetic field and computer-processed to produce images of the body part of interest.
MR spectroscopy is used to characterize biochemical components of normal and abnormal brain tissue. MRS complements MRI as a non-invasive means for the characterization of tissue. The most widely used clinical application of MRS has been in the evaluation of central nervous system disorders. MRS has its limitations and is not always specific but, with good technique and in combination with clinical information and conventional MRI, can be very helpful in diagnosing certain entities. MRS may also be helpful in the differentiation of high grade from low grade brain tumors, and perhaps in separating recurrent brain neoplasm from radiation injury.

On the 3rd May 2008, Norman had his 2nd MRI and MRS done at Wijaya Medical center in PJ. The result shows necrotic brain tissues. It was indeed good news for us. There are 2 rounded heterogeneously enhancing lesions in the left frontal lobe measuring about 1.0x1.5cm and 0.6x0.5cm. There was still some edema seen.
Norman finished his 4th cycle of Temodar chemotherapy on the 22nd May. He experience the usual side effects of gastric bloatedness, loss of appetite and lethargy. However he still manage a full round of 18 hole at the golf course!! 3 cheers! Golf power wins!! Another 2 more cycles of temodar in June and July and that’s the end of chemotherapy(I pray he doesn’t need any more of this toxic poison anymore).

Baptism Day

2008-03-29T01:15:00.000-07:00

Easter is the festival commemorating the resurrection of christ. Christian celebrate this day in observance of their believe that Jesus rose from the dead on the third day after his crucifixion. This year easter falls on the 23rd of march. It is a very special day for the whole family as Norman was baptized on this meaningful day. Praise the Lord!

Quote:Revelation3:20 Look! I stand at the door and knock. If you hear my voice and open the door, I will come in and we will share a meal together as friends.

Brain Necrosis

2008-03-08T22:55:00.000-08:00

Brain Necrosis

Radiation is a powerful weapon against cancer cells, but sometimes it kills healthy brain tissue as well, resulting in a severe side effect called radiation necrosis. Necrosis can cause headaches, seizures, or even death.

Radiation necrosis is a focal structural lesion that usually occurs at the original tumor site. It is a potential long-term central nervous system complication of radiotherapy.

Regular follow-up treatment is extremely important after treatment for a brain tumor. Besides regular physical and neurological exams, Norman need periodic magnetic resonance (MRI)or computed tomography (CT)and regular blood test.

On March 1st, Norman had his 1st MRI check up. There was a lesion measuring 1.9cm by 1.2 cm seen on the x-ray. I was instantly petrified! It could be reoccurrence of the glioblastoma or brain necrotic cells! There was a moderately big patch of Oedema (Water) around the tumor site also.

On 6th march, we saw Dr Lee F.C. at Sunway Hospital. He said it was a residual tumor! As t is impossible to remove 100% of the tumor due to its infiltrative character, there is bound to be some tumor left in the brain. We breath a big sigh of relieve! The odema was also due to the Radiation. Norman now needs to go back on steroids, dexamethazone 2mg twice daily for 2 weeks.

For the past few weeks, Norman have been complaining that he feels cold most of the time esp in an air con room. His pulse rate is exceptionally low at about 50 beats per minute! Inactive thyroid? Well, to be on the safe side, he is put on thyroxine to activate his thyroid for 2 weeks. I really hate this chain of medication that he has to swallow daily.

Norman’s 2nd cycle of chemo starts on the 19th of march. The routine round of blood test will be done first to check his lymphocyte and platelets level. Poor Norman! Sob!
The next MRI will be about 3 months time. If the lesion increases in size, an MRS will need to be done. Will tell you all about MRS later.

Quote: Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me;your rod and staff, they comfort me. Psalm23:4

A Birthday Celebration

2008-02-02T22:05:00.000-08:00

To all our trekkers friends,
Thank you so much for celebrating Norman's birthday with us on the 20th january. This year is indeed special as it is his 51st birthday. The journey of life is now extra tough for us as we face the unknown future. But with good friends like you all, it will make our journey happier as we share time together. Knowing that we have such supportive friends empowers us to be stronger mentally and emotionally. Thank you.
Dorothy

Quote: It is not so much our friend's help that helps us as the knowledge that they will help us.

Completion of radiotherapy

2008-02-01T21:53:00.000-08:00

Yippy!! Finally norman’s radiation therapy is completed. All 30 fractions of this damn rays bombarding into his brain and making him look like an uneven kojak!! What’s next? Well, we will have an MRI on the 3rd March to check on the effects of the radiation. Adjuvant chemo (Temodar 250mg for 5 days per month) will begins on 26th February. A blood test need to be done to determine if his body is fit enough for chemo.

Glioblastoma Multiforme

2008-01-20T22:36:00.000-08:00

Playing golf after glioblastoma surgery

Dear friends,
Below is a write up of different types of brain tumors. I find it very educational and would like to share it with you all.

Astrocytomas and oligodendrogliomas are the most common primary tumors of the adult brain. Both tumors are types of gliomas. Primary brain tumors arise from cells of the brain itself rather than traveling, or metastasizing, to the brain from another location in the body. Gliomas can be slowly growing (low-grade, grades 1 and 2), or rapidly growing (high-grade, grades 3 and 4). This material will give important facts about the diagnosis and treatment of high-grade gliomas.
High-grade gliomas are diagnosed by a biopsy

Once a brain tumor is detected on a CT or MRI scan, a neurosurgeon obtains tumor tissue for examination by a neuropathologist (a biopsy). The neuropathologist then gives the tumor a name and grade. The exact name and grade of the tumor determine treatment options, and also give important information about prognosis.

When neuropathologists analyze tumor tissue under a microscope, there are two main questions being asked:
-first, what type of brain cell did the tumor arise from? The answer to this question gives the tumor a name, for example, astrocytoma.
-second, do the tumor cells show signs of rapid growth? This involves assigning the tumor a grade, such as grade 3 or 4 (see below).
These two pieces of information are then combined, as in "grade 4 astrocytoma". Once a tumor has been given a name and a grade, brain tumor specialists can give advice about treatment choices, prognosis, and provide useful health-care information to brain tumor patients and their families.

Tumor name: from what type of brain cell did the tumor arise?
Astrocytomas arise from brain cells called astrocytes. Normal astrocytes are star-shaped cells that give the brain its shape. Astrocytes are the most common cell type to become tumors. Oligodendrocytes are brain cells that provide insulation around the electrically-active neurons. Tumors of oligodendrocytes are less common than astrocytomas. Many tumors contain a mixture of astrocytoma and oligodendroglioma cells. Tumors of other cell types in the brain are less common. For instance, tumors of neurons are very rare in adults.

Tumor grade: how aggressive does the tumor appear under the microscope?
Astrocytomas and oligodendrogliomas come in four grades, with grade 1 being the most benign and grade 4 being the most malignant. The neuropathologist looks at the brain tumor tissue under the microscope for signs that the tumor is growing rapidly. Examples of these features include cells undergoing division (mitosis), the presence of newly-formed blood vessels, and evidence that the tumor is outgrowing its blood supply (necrosis). The more features that are present, the higher the grade assigned to the tumor.

Gliomas have more than one name in everyday usage. The Table gives the common names of high-grade gliomas:
Synonyms for high-grade Gliomas
Anaplastic astrocytoma = grade 3 astrocytoma
Glioblastoma multiforme = grade 4 astrocytoma
Anaplastic oligodendroglioma = grade 3 oligodendroglioma (oligodendrocytoma)
Anaplastic oligoastrocytoma = grade 3 oligoastrocytoma = anaplastic mixed glioma

Why do brain tumors occur?
Tumors form because of the abnormal, unregulated growth of cells. After the human brain completes it development soon after birth, the vast majority of its cells enter a resting state in which they never divide again. One exception to this rule is when a brain tumor develops. The abnormal brain cells re-enter the "cell-cycle" because of alterations in any of a large number of genes that control cell division and growth. Although much is known about the alterations in these genes in brain tumors, the reason why the gene alterations arise in the first place is poorly understood. The MGH has a very active research program in this area.

Are brain tumors hereditary?
The use of the word ‘gene’ invariably brings up the important question of whether brain tumors are hereditary. The answer for almost all patients is no. Although there are conditions in which brain tumors can occur in families, these syndromes are very rare and usually known prior to the development of an individual family member’s tumor.

Types of therapy
There are three standard types of treatment for patients with high-grade gliomas: surgery, radiation therapy, and chemotherapy.
Because grade 3 and 4 tumors have a tendency to grow rapidly, treatment must be started as soon after surgery as is feasible, allowing time for the surgical incision to heal. Generally, this means that patients should be undergoing either radiation therapy or chemotherapy within 2 to 4 weeks after surgery.

While therapies for high-grade gliomas are helpful, at present these treatments cannot cure these tumors. The two major reasons for this are that tumor cells infiltrate into surrounding brain and thus cannot be completely removed by the surgeon, and that most glioma cells are at least partially resistant to radiation and chemotherapy.

The goals of treatment are to:
-remove as many tumor cells as possible (with surgery)
-kill as many as possible of the cells left behind (with radiation and chemotherapy)
-put remaining tumor cells into a nondividing, sleeping state for as long as possible (with radiation and chemotherapy)

High-grade glioma cells almost always start to grow again at some point in time. Patients receive aggressive treatment in order to delay this regrowth as long as possible. Regrowth does not necessarily imply loss of control of the tumor, but it does mean that a new series of treatments should be considered because the tumor is becoming more aggressive.

Norman have just finish his 22nd radiation today. He is feeling fine except for a bee sting on his left fore head. It is slightly swollen and painful to the touch. The Dr suggest to take an anti-histamine.

On another note, I would like to say a big thank you to all our trekkers friends who celebrated Norman's birthay on sunday 20th January. (His actual birthday is on the 22nd). All the ladies are fantastic cooks!! I always look forward to any of our pot luck gathering. Whose birthday is next? I will post the photos another day as it is still in Nicky's camera.

Quote: A merry heart is good medicine, but a crushed spirit dries up the bone. Proverbs17:20

The macrobiotic diet

2008-01-20T22:28:00.000-08:00

A macrobiotic diet is a strict whole-foods pesco-vegetarian (a diet that includes fish but no meat or poultry) diet. It is appealing to health-minded people who are practicing a holistic approach to physical and spiritual well-being. It focuses on balancing yin and yang foods, which are described below. There have been numerous anecdotal reports of the macrobiotic diet curing people of cancer or other serious diseases, but very little scientific evidence exists.
· 50 to 60% of your diet should be whole grains, 25 to 30% vegetables, 5 to 10% miso and bean soups, and 5 to 10% beans and sea vegetables.
· Avoid very yin or very yang foods
· The diet includes other principles like eating only when hungry, chewing food completely, and keeping the kitchen tidy.
Best bets: Brown rice, barley, whole wheat, fresh broccoli, cauliflower, chickpeas, tofu, sea vegetables like kombu and nori, and vegetable soups. A few servings of nuts and seafood per week are allowed.
More about this diet
The earliest recorded usage of the term “macrobiotics” is found in the writings of Hippocrates. Translated literally, macro is the Greek word for “great” and bios is the word for “life.” Macrobiotics is used by its practitioners as a tool that allows one to learn to live within the natural order of life. Throughout history, philosophers and physicians from many parts of the world have used this term to signify living in harmony with nature, eating a simple, balanced diet, and living to an active old age.
The modern practice of macrobiotics was started in the 1920s by a Japanese educator named George Ohsawa. Ohsawa is said to have cured himself of a serious illness by changing to a simple diet of brown rice, miso soup, and sea vegetables. At the core of Ohsawa’s writings on macrobiotics is the concept of yin and yang. In Chinese philosophy, the opposing forces of yin and yang govern all aspects of life. Yin—representative of an outward centrifugal movement—results in expansion. On the other hand, yang—representative of an inward centripetal movement—produces contraction. In addition, yin is said to be cold while yang is hot; yin is sweet, yang is salty; yin is passive, yang is aggressive. In the macrobiotic view, the forces of yin and yang must be kept in balance to achieve good health.
The macrobiotic diet, therefore, attempts to achieve harmony between yin and yang. To this end, foods are classified into yin and yang categories, according to their tastes, properties, and effects on the body. The two food groups—grains and vegetables—that have the least pronounced yin and yang qualities, are emphasized in the macrobiotic diet. Eating these foods is thought to make it easier to achieve a more balanced condition within the natural order of life. Foods considered either extremely yin or extremely yang are avoided. The standard macrobiotic diet recommendations are as follows:
· Whole grains—including brown rice, barley, millet, oats, corn, rye, whole wheat, and buckwheat—are believed to be the most balanced foods on the yin/yang continuum, and should comprise 50 to 60% of a person’s daily food intake. Although whole grains are preferred, small portions of pasta and bread from whole grain flour may be eaten.
· Fresh vegetables should comprise 25 to 30% of food intake. Daily consumption of any of the following vegetables is highly recommended: cabbage, broccoli, cauliflower, kale, bok choy, collards, mustard greens, turnips, turnip greens, onion, daikon radish and pumpkin. Vegetables to be eaten occasionally include celery, iceberg lettuce, mushrooms, snow peas, and string beans. Vegetables should be lightly steamed or sautéed with a small amount of unrefined cooking oil,preferably canola or olive oil.
· Beans and sea vegetables should comprise 5 to 10% of daily food intake. Especially recommended are adzuki beans, chickpeas (garbanzo beans), lentils, and tofu. Sea vegetables, including wakame, hijiki, kombu, and nori, are rich in many vitamins and minerals, and are easily added at each meal.
· Soups and broths comprise 5 to 10% of food intake. Soups containing miso (soy bean paste), vegetables, and beans are acceptable.
· A few servings each week of nuts, seeds, and fresh fish (halibut, flounder, cod, or sole) are permissible. Brown rice syrup, barley malt, and amasake (a sweet rice drink) may be used as sweeteners. Brown rice vinegar and umeboshi plum vinegar may be used occasionally. Naturally processed sea salt and tamari soy sauce may be used to flavor grains and soups.
· Fluid intake should be governed by thirst. Only teas made from roasted grains, dandelion greens, or the cooking water of soba noodles are generally considered acceptable. All teas with aromatic fragrances or caffeine are avoided. Drinking and cooking water must be purified.
· To maintain proper yin/yang balance, all extremely yang foods and all extremely yin foods are avoided. All animal foods, including eggs and dairy products, are believed to have a strong yang quality. Extremely yin foods and beverages include refined sugars, chocolate, tropical fruits, soda, fruit juice, coffee, and hot spices. In addition, all foods processed with artificial colors, flavors, or preservatives must be avoided.
· All foods should be organically grown. Produce should be fresh and locally grown.
Macrobiotic principles also govern food preparation and the manner in which food is eaten. Recommendations in this area include: avoid using a microwave oven to prepare food; cook rice in a pressure cooker; eat only when hungry; chew food completely; eat in an orderly, relaxed manner using good posture; and keep the home in good order, especially where food is prepared.

Nutritional Strategies Against brain Tumour

2008-01-07T00:37:00.000-08:00

Can cancer patients eat anything they like? Sure … eat anything you like, so say some experts. There is now enough evidence to say that food has got a lot to do whether you get cancer or not. When and after you have cancer – can you still eat anything your like? They say -- Sure, eat anything you like to build up your body! Is this not making the cancer worse? According to one expert, “cancer could not careless what we eat”. Of course cancer couldn’t careless what we eat …. the more we feed the cancer cells with what they like, the happier they are! Yes, the cancer couldn’t careless but our body ought to care … we need to feed our body right so that we can become healthier and DENY the nutrients that would make cancer cells grow and flourish in us. Is it not logical enough?

Fruits and vegetables have been shown to be among the best means to reduce risk of cancer and other diseases … deeply hued fruits and vegetables provide the wide range of vitamins, minerals, fiber and phytochemicals your body needs to maintain good health and energy levels, protect against the effects of aging, and reduce the risk of cancer and heart disease.

Evidence suggests that either a near vegetarian diet or a vegetarian diet is the best Reduction in cancer rates were observed in studies where participants reduced their animal-food consumption. A study showed that some fish added to a vegetarian diet provides benefits … diet containing a significant quantity of animal products cannot be healthy!

A well nourished cancer patient can better manage the disease, has fewer side effects from RT and chemo and increase chances for remission, Norman has completed about half of his 30 fractions of RT and Temodar treatment but he has yet to experience side effects like nausea, vomiting, hair loss and fatigue. At the moment he is still able to work and even treks up Gasing Hill like a breeze! Cool! He and Yam Koh are still racing each other! Oooiiiiiii, slow down abit, will ya?
We are seeing a Dr Pang at USJ9 for guidance on eating a proper diet and taking the correct supplements. She majors in preventive medicine. Her chief objective now is to boost up Norman’s immune system. Her diet plans plus my knowledge from hours of fervent reading online is as follows:

1 The super nutrients juicer
Juice 3 veggie -celery, cucumber, carrot twice a day
Juice 2 fruit- Guava, pineapple, grapes, pear, apple twice a day
Fruits to be taken whole-banana, papaya, red dragon fruit, kiwi, chestnuts
If possible, eat organic fruits. Sometimes I add enzyme powder to the juice too.
Avoid watermelon and durians, they contains too much toxins.

2 Eat organic food
Recommended diet portion of veggie is 1 cup cooked + 2 cups raw veggie for lunch or dinner. Only small portion of fish is permitted. We try to keep to this regime but I usually end up stir frying the veggie instead. I would like to add more variety and spices eg. Organic curry, mixed herbs, oregano, basil leaves, to enhance the flavor of food for Norman.

Norman likes salad. So I try to mix all the veggie, nuts, tomatoes, carrots, flaxseed oil, etc from the organic shop and I call it “Dorothy’s Salad”. So easy, No need cooking. Ha! Ha!

I welcome any vegetarian recipes from anyone. I am now learning to make lui cha fan. I got the recipe from Amy Beh website.

3 Food to avoid
a) Any sweet food. Sugar fuel and strengthen cancer cells. Elevated blood glucose lowers immune system.
b) Avoid all fizzy drinks (including 100 plus), white sugar (substitute with Stevia or molasses sugar), white rice (substitute with millet, cous-cous, brown rice, quinoa), and white bread (substitute with whole grain bread, rye bread).
c) Avoid all diary products and processed foods.
d) Avoid all meat to reduce acidosis in body. Meat like, beef, chicken, pork, lamb are completely out. Small portion of fish is permitted. Beans, nuts and millets will provide sufficient intake of protein.

While on radiation and chemotherapy, Norman drinks wheat grass juice, Millennium juice, coconut water, phyto-berry drink and lots of alkaline water. We just installed a Toyo alkaline water system recently.

Super food-We try to eat these food daily.

Garlic - Scientist find that garlic is deadly to invading pathogens or tumor cells, but is harmless to normal healthy body cells, thus offering the hope of the truly selective toxin against cancer that is being sought world wide.

Cruciferous vegetables – Broccoli, cabbage, spinach, all types of big leafy greens and cauliflowers are able to increase the body’s production of glutathione peroxides, which is one of the most protective enzyme systems in the body.

Mushrooms – Now there is an abundance of scientific evidence showing that Rei-shi, Shiitake, and Maitake mushrooms are potent anti cancer food. Oral extract of Maitake provided complete elimination of tumors in 40% of animals tested while the remaining 60% of animals had a 90% of elimination of tumors. It contains a beta-glucan which stimulates the immune system and even lowers blood pressure.

Legumes – Soya beans, pinto beans, black beans, garbanzo, red beans and green beans provide adequate proteins in the diet. Isoflavones and phytoestrogens in the soy beans have potent anti cancer properties. I boil these together with the millet for dinner. Organic fermented beans like black bean taucu and miso are the best. I use them to enhance food taste instead of salt.

Other food that we eat regularly- seaweed, ginger, snow fungus, black fungus, Inoki mushroom, sweet potatoes

Food Supplements Taken By Norman

Supplements recommended by Doctor

1 AHCC- Active Hexose Correlated compound. Please check online for this very interesting super food from Japan. It is extracted from the myecial threads of a mushroom.
2 Green Tea extract-
3 Prolactar- Friendly bacteria
4 Alpha Lipioc Acid- an antioxidant that increased production of glutathione which helps
dissolve toxic substances in the liver. It can cross the Blood Brain Barrier to go directly where it is needed.
5 Vitamin E
6 Zinc- essential for brain development and function.

Quote of the day!

"Let thy food be your medicine and your medicine be your food."

Hippocrates, father of modern medicine, 400 B.c

Together with good friends

2008-01-06T06:06:00.000-08:00

Nurses of University Hospital

Trekking at Bukit Gasing

Breakfast at Mrs Khor's House

Eternal Friendship

2008-01-04T00:43:00.000-08:00

The three beauties

The War Begins Now!

2007-12-31T21:22:00.000-08:00

At Mulu cave Resort at 5 July 2007

The Diagnosis.

On the 14th Nov. 2007 my husband Norman had a right sided facial fit followed by numbness of the right hand. It lasted 2 mins. and he went back to sleep. 2 days later I took him to Pantai hospital to see a neurologist. An MRI was done and the x-ray showed a massive brain tumor on the left temporal side. The neurologist said it was a malignant tumor!! Our whole world collapse before us!! We could not believe it, could not accept it and definitely not ready for this bombshell. How could it be? Norman was fit as a fiddle, He doesn’t drink or smoke, Has no hypertension or any kind of illness. He treks up Mount KK, Sabah like an arrow and even climb up the vertical Pinnacle, Mulu, in Kuching on the 7th of July 2007!! And all this while he had a tumor growing inside his head!. The learned Dr guess that the tumor could have been growing for at least 6 months! Maybe he got the wrong X-ray ya? No, unfortunately, it was Norman’s X-ray and the diagnosis….GLIOBLASTOMA MULTIFORME. It was like being pass the death sentence when you are innocent.
[ The prognosis of this deadly tumor is 3-6 months if untreated ] We cried and cried and we hug each other and we cried and cried…..

The Surgery – 21st November, 2007

The tumor is very aggressive and need to be removed as soon as possible. There was gross oedema in the brain causing him speech impairment, memory loss and fits! We need a very competent neurosurgeon to operate and we need it fast! After consulting 2 neurosurgeons, we decided on Dr Lee Foo Chiang at Sunway Medical Center. On the 21st November ‘07, the evil beast was excised after a two and a half hour (2 ½) surgery. Norman was wheeled into ICU for 24 hour monitoring and nursing care, Dr lee told me that the tumor is a grade 4 tumor! My world came crashing down again! Brain tumors are graded according to malignancy, grade 1 being the most benign and grade 4 the most malignant.

Norman recovers amazingly well. There was no surgical side effects like seizures, loss of memory, further speech impairment, infection and excessive bleeding. Praise god! We came home on the 3rd post op day. It was like the nightmare was over but in fact the battle has just begun!! The long road to recovery lies ahead and we are not ready… yet!

Radiotherapy and Chemotherapy-17th December, 2007

Getting ready for radiotheraphy

Complete surgical removal of GBM is not possible. Even after the most successful surgery, residual microscopic tumor remains. Dr Lee managed to remove more than 90% of Norman’s tumor. He is a brilliant Neuro surgeon. The prognosis of survival depends very much on maximal removal of the tumor. The aim now is to kill off the remaining cancer cells by conformal radiotherapy [RT] and chemotherapy. After seeing 3 oncologists we decided to choose Dr Foo Yoke Ching at SJMC for our RT. A total of 60 Gy of radiation [30 fractions] is given daily, Monday to Friday over 6-7 weeks. Saturdays, Sundays and public holidays are off days. Each fraction last about 1-2 minutes only as the brain is too delicate to receive too high doses of radiation. Daily Temozolomide [temodar] 120mg is taken orally before radiation. Temodar is a radiation sensitizer drug. Clinical studies have proven that the addiction of Temodar to RT improves long term survival benefits with minimal side effects.
Common side effects of RT are hair loss, nausea, vomiting, fatigue and loss of appetite. So far, Norman haven’t experience any of these effects yet. Praise God! Radiation necrosis [total destruction of nearby healthy brain tissue] occurs in 25% of patient treated with RT. Additional surgery might be needed to remove necrotic tissue if it causes severe reduction in mental functions. According to schedule, Norman will finish his treatment on the 31st january, 2008. Estimated cost of RT and chemo is a whooping $80,000.

Dear friends, your comments and suggestion will be a great encouragement to norman and myself. As this is the first time I am creating a blog, please excuse any mistakes in my blog. Please feel free to pen a few words as it will greatly encourage me.

Quote of the day:

A friend is one who sings loudly witn you on the mountain top but walk quietly with you in the deep valley