Wednesday, 29 July 2009


Dad went for follow-up at NCC on Tue. His CT scan done a week ago showed the following:

lung - tumour size remained the same, but water retention is seen on one side of left lung (that's what caused his fever last week and persistent cough and panting)

neck & shoulder - the tumours in the original lymph nodes have resurfaced and new ones have been found at the back of the neck too. Probably the lymph node embedded under the left armpit is growing too, thus causing the water retention and numbness in his left arm and also the pain in his shoulder and chest.

After the doctors discussed, they decided to try a new drug on him. Tarceva is a new chemo drug, already approved for use on patients. This is an oral medication which he'll take 1 tablet a day. Doc has prescribed him a 6-week course and then to do a CT scan and review the effect.

Sometimes I hate doctors for being so frank and direct. He said, "This is not to cure. I think you understood there is no cure. But since he has these symptoms of water retention in his lungs and limbs that's causing him pain and discomfort, we will try this on him. This medication has been proven to work on non-smoker lung cancer patients. But with ex-smokers, it is hard to say. It may, or may not work to reduce the symptoms. We hope it will work on him and make him more comfortable." Ok, first fact ascertained. It is not meant to cure, but just to relieve him of his discomfort.

Next comes the cost of the drug. After subsidy, it costs S$103.00 per tablet. Which translates to S$3,193.00 per month. As this drug is considered oral chemotherapy, we will be able to cover part of the costs with medishield and pay part with medisave. The balance will have to be paid in cash.

Dad was very sharp. The moment we left the doc's room, he asked me. "what was the $100+ that the doctor mentioned? is it the price of the new medication?" I quickly said "yes yes" without going further into the actual costs. I'm not sure what will his reaction be if he knows it actually costs that much.

At the pharmacy, the pharmacist brought some 'good' news. As the drug is new in the market, the company is giving the first month's supply free to patients. That means we'll save S$3k+. Only catch is they'll only dispense 10 tablets at a time, meaning I'll have to make 2 more trips to NCC to collect the other 20 tablets. Their rationale is in case patient has too much side effect and cant carry on taking the medicine, then the balance will be wasted. NCC's pharmacy is very cautious, any medication dispensed are not returnable nor exchangeable. Anyway, this is definitely nothing compared to the costs saved.

This drug's common side effects are skin rash, vomitting and diarrhea. And like any other chemo treatments/drugs, patients' immunity will be lowered and more susceptible to infections. So will have to be extra careful when Dad's on this.

To my nieces and nephews: Please do read up on the drug from the website, especially that section under Caregiver Support. Even though you may not be caring for him physically now, but it's useful for you to know and understand so as not to flood him with too many questions. And please, if you want to visit him, ask yrself if you're well enough. Any light cold or cough can be dangerous to him. So please be more careful. Thanks.

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