Before I meet him, one of my fren told me that she did meet Dr Ho at UMMC for her father's disease. My fren says he is a very soft spoken doctor (till my fren hardly to catch his words each time) that makes her dont have much confidence in him. I also feel hesitate to see him after I heard my friend's comment about Dr Ho. But luckily, I met him, and I got some useful information from him. He is a nice doctor and willing to spare me information.
He is scrupulous and smart. He gives me a very good impression for the start!
I passed him the pathology report, he read through. While he is reading, I start brief him about my journey, how I detected the lump and end up surgery in Prince Court. He noticed from the report that I have another lump in right ovary! This is what other doctor didnt noticed, may be except Dr Azrif, since he is Prince Court and can access my CT Scan report easily.
Dr Ho requested the scan report from me if I have. I passed him the CD (soft copy) of the CT Scan, I myself also never open it. I thought it is definitely something I will only get ??????? in my brain when I open it. It is an interesting CD
.
It contains a software which can open a series of images saved in the
CD. These images are the images took by the machine during the scan. I
can see all my body organs, lumps etc clearly! Dr Ho also shows me where
my ovary and breast lump is.I only discussed radiotherapy and hormone therapy with him, as I told him that whether will or will not he recommend chemo to me, I will insist NO to chemo.
He started with me discussing the ovary lump, which is something not in his scope
.
By using the images in the CD, he shows me that my lump is "light"
color inside. He says this tumor is undecidable on the type as it is not
something "dark" color like the edge of the tumor which can classified
as a cyst. He recommended me to see Dr BK Lim from UMSC. He says he is a
nice doctor.About radiotherapy
- 3D CRT
- Commonly 5 weeks shooting for whole breast, and 1 1/2 weeks for boost. But studies shows that 3 weeks whole breast shooting is also efficient enough for the cure. Therefore he recommended 3 weeks and follow by 1 1/2 weeks boost for me. This treatment will be conducted in SJMC.
- Lung damage, about 1cm depth, starts from the edge closest to breast. But this damage is not significant to us, but yes to a marathon runner.
- Without radiotherapy, it is about 25% to 30% local recurrent. With radiotherapy, it reduces to < 5%.
- Use marks but not tattoo. There is option for me to choose. Mark is fine and good enough for breast.
- Treated breast is firmer, tends to be long term. But degree is patient dependent.
- Treated breast will be swollen.
- Treatment course will take 4 weeks in SJMC, and will meet Dr Ho once a week or once every 2 weeks.
- Treatment must starts within 6 weeks after surgery. Therefore I must decide before end of February.
- Cost is a little bit cheaper than other hospital.
About hormone therapy
- When consuming Tamoxifen, cannot get pregnant as it is harmful to baby.
- < 50 yo women get more benefits from chemotherapy.
- >= 50 yo women get more benefits from hormone therapy.
- http://www.adjuvantonline.com, a website that shows me some statistics about the relapse and alive rate. This is the tool Dr Harjit is using that day!
- ovary ablation will stop ER production, but not Tamoxifen.
- Tamoxifen is to stop cancer from attaching to ER.
- AI, another name (?) of Armidex that was told by Dr Manivanan, is more effective for women in post menopause. AI can be prescribed following by ovary ablation. But the result is not significant for women > 30 yo. The result of Tamoxifen as compare to ovary ablation and follow by AI is the same.
- AI will cause osteoporosis.
- Something new to me, Tamoxifen will pause menses, uterus lining get thicker after some times, could then cause uterine cancer, especially to post menopause women. But reported case is only about 1%.
Before I leave his room, Dr Ho told me Dr Azrif is his best friend.
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