When Tony underwent radical nephrectomy for the removal of kidney cancer in 2004, he was already in the advanced stage of the disease. And even after one of his kidneys was removed by surgery, test results showed the malignancy had metastasized to his lungs and liver. Most doctors he consulted gave him only a five-percent chance to live, up to December of that year. There seemed nothing left but submit to fate, until a former high school classmate told him about her daughter undergoing a successful treatment for lymphoma. With little else to lose, he decided to pay the doctor a visit. After six months of treatment, the cancer cells in his lungs and other parts were in full remission. Four years after the date, Tony and his classmate’s daughter are both alive and living normal lives.
Dr. Carlos Ang Herrera used a combination treatment called Interferon and Interleukin 2 to treat Tony. Unlike chemotherapy, which has a shotgun effect that destroys the bad cancer cells as well as the good cells, immunotherapy through Interferon and Interleukin 2 treats the body more naturally by boosting the immune system that lets it fight the cancer cells. At that time, Interleukin 2 (IL2) had a high success rate in treating renal cancer in US clinical trials. Newer treatments, however, are now available and have as much success in treating renal cancer.
The truth is, today’s cancer patients have a number of options from among several treatment methods now available in the Philippines. Like surgery, radiation therapy, medical oncology, chemotherapy, immunotherapy, molecular targeted therapy, and hormonal therapy.
The best treatment, says Dr. Herrera, is the one that brings out the best response in a particular patient, and causes the least side effects. The most modern and most expensive treatment is not necessarily the best for all. Methods that work for some patients may not work for others. There are several factors to consider, such as the type of cancer, how advanced it is, the organs involved, and the condition of the patient — young or old, strong or weak, and if he or she is suffering from other ailments.
“Effective treatment is not so much on the type of treatment or medicine per se, but whether the condition is discovered and treated earlier, and whether the patient is responding positively to the treatment,” says Dr. Herrera. He stresses the importance of monitoring the patient’s condition closely during treatment. It is critical for the success of the treatment to see right away if the treatment is working or not, so that changes can be made the soonest time possible.
Dr. Herrera’s personalized and individualized treatment helps a lot in monitoring his patients and contributes greatly to the success of his cases.
“I don’t only give medical treatment,” he says. Giving medicine and performing medical procedures are, to him, only one part of treating cancer patients. “The main concern is to educate the patient, build his morale, and help him to fight. A strong fighting spirit helps a lot in the success of the treatment.”
The good doctor adds that doctors should be able to explain to the patients their condition and their options, let them make a decision, and strengthen their resolve to get well.
“I want my patients to take charge and take an active part in the treatment because only they can understand how they feel and what they want. I want them to talk to me, tell me what they think, what worries them. Hiding their worries can cause stress, and this can affect the success of the treatment. If at any time, they have any concerns, they can always call or text me. It is important for me to know so that I can explain and help them understand and, if necessary, make changes in their treatment.”
Simple and unassuming, Dr. Herrera can easily put a patient at ease. Tony recalls that at the time he was being treated by the doctor, he would tell him whatever concerns he had in mind, and ask so many questions. And Dr. Herrera would answer each of them thoroughly, patiently, competently. “I felt very confident and trusting. I knew I was in very good hands.”
“Making the patients feel comfortable is very important. Because when they are comfortable, they communicate more, so the doctor can monitor better, and see at the earliest time if an alternative treatment should be introduced,” Dr. Herrera explains.
This is one reason why Dr. Herrera prefers to see his patients in his private clinic in Banawe, QC, and treat them as outpatients, rather than confine them in a hospital — unless, of course, certain procedures require it.
After he finished his postgraduate training in medical oncology and hematology at the Montefiore Medical Center-Albert Einstein Cancer Center in New York, he practiced for one year in Texas. There he saw the advantages of outpatient treatment and, immediately upon coming home in 1997, set up the CAH Medical Center in Quezon City.
“Many patients do not want to be in a hospital and see other sick people. In a non-hospital setting, the atmosphere is more relaxing, patients are more comfortable, they have less fear.”
One other concern is the cost of treatment. Medicines for cancer are very expensive, Dr. Herrera acknowledges, but patients can cut on unnecessary expenses. A patient does not have to go to the most expensive hospitals and most expensive doctors to get the needed treatment. “That’s why I advise patients to seek the opinion of several physicians so they will have more options as to who they are most comfortable with and what kind of treatment and facility suit them most.”
Outpatient treatment naturally costs less. Even cancer medicines, says Dr. Herrera, may cost less than those found in hospital pharmacies.
Dr. Herrera also practices supportive care even for patients who do not want medical treatment. “As an oncologist, my role is not only to treat cancer, but to take care of the patients and help improve their quality of life. Sometimes we have to help them face the consequences of their illness. Many of them are afraid.”
He usually advises patients to go back to work, if they are working, after a specific period of treatment. “It makes them busy and helps them focus on other things instead of thinking only of their sickness. The more they socialize, the easier it will be for them to cope with their situation.”
Getting the support of relatives, friends, and other people close to the patient is also important. Their support helps both the patient and the doctor during treatment.
But before any of these become necessary, prevention and early detection are still the most effective weapon against cancer. Dr. Herrera recommends the following:
• Have regular health checkups. Many people do not give much attention to their personal health. They would rather buy new cell phones and other expensive items than go for a checkup.
• Go into a cancer screening program. Ask your doctor about it. Sometimes, cancer in its early stage does not show symptoms, so screening is very important.
• Look into your family history, if there is a history of cancer and other health conditions.
• Moderate your social life — avoid excessive vices and risky behaviors.
• Practice healthy living — improve your diet, physical activities, and your environment. Modify your lifestyle and living conditions if needed.