Monday, April 13, 2009

Infection after chemotherapy led to death

HOW do you deal with a cancer that attacks blood?

Early diagnosis and treatment improve the odds of beating this fast-spreading blood cancer, or acute myelogenous leukaemia (AML).

But it was an infection, soon after his latest round of chemotherapy, that led to the sudden death of DBS chief Richard Stanley yesterday.

In fact, doctors had felt that Mr Stanley's AML was treatable when it was diagnosed in late January. Mr Stanley, 48, went to see a doctor when he had flu-like symptoms, including fever and a cough, over the Chinese New Year holidays.

Tests over the next three days confirmed he had AML.

The bad news came just nine months after he became chief executive of Singapore's biggest bank. He took leave, for up to six months, and began chemotherapy treatment at once.

In a staff memo then, DBS chairman Koh Boon Hwee said doctors felt Mr Stanley's condition was treatable and full remission was possible.

Haematologists who spoke to The Sunday Times yesterday explained that AML is a type of cancer in which the bone marrow makes abnormal white blood cells. These leukaemia cells build up in the bone marrow and blood, so there is less room for healthy cells. The causes of AML are mostly unknown.

It is a very serious illness and the cancer can worsen very quickly if not treated. Dr Benjamin Mow, consultant haematologist at Mount Elizabeth Hospital, said: 'If it is not treated, the person can die within three months.'

Patients have even died within two to three weeks of diagnosis due to complications from the disease or during treatment, said Dr Koh Liang Piu, senior consultant at the National University Cancer Institute.

Even with treatment, chances of recovering fully come with caveats. A normal, healthy person might have a 40 per cent to 50 per cent chance of recovery. But the elderly or sickly will have less than a 10 per cent chance, said DrKoh.

A relapse is common, occurring in three or four out of every 10 'cured' AML patients, he said.

In the less serious cases, the patient will have to go through four cycles of chemotherapy as treatment. The more serious and risky cases will need both chemotherapy and a bone marrow transplant, said doctors.

Because AML patients lack white blood cells needed to fight infection and disease, they have to be isolated during treatment to minimise the risk of infection.

Their single-bed isolation wards are specially cleaned. The few visitors who see them have to wash their hands and wear a face mask before entering the room. Such care is needed because, often, it is infections which lead to death among AML patients - especially after chemotherapy treatment.

Said Dr Koh: 'After chemotherapy, the patient's immunity is very low for the next two to three weeks. This is when the risk of infection is very high. Usually, death happens during this period.'

In a statement yesterday, DBS said Mr Stanley contracted an infection after chemotherapy, after which his condition 'deteriorated rapidly' in the last 48 hours.

Mr Stanley was treated at Mount Elizabeth Hospital. His doctor, consultant haematologist Dr Freddy Teo Cheng Peng, could not be contacted yesterday.

Infections can come from anywhere - from airborne bacteria to the pre-existing bacteria carried by the patients themselves. In very serious infections, such as blood or lung infection, the patient can die within hours, said Dr Koh.

Internal bleeding is also a common cause of death among AML patients, the worst being bleeding in the brain. This can happen suddenly and results from a lack of healthy platelets which help to form blood clots.

Said Dr Mow: 'Usually when the patient no longer responds to chemotherapy or becomes very sick, it might be too late to do anything else.'

FRIENDS and family on Saturday night flocked to the wake of DBS Group Holdings chief executive Richard Stanley, who died on Saturday morning after a short battle with leukaemia.

His body is resting at the Singapore Casket and his funeral will be held tomorrow at the Church of St Teresa in Kampong Bahru Road.

In a statement, the bank said Mr Stanley, 48, died at 8.36am.

His family 'kept vigil all night long and were by his side as he slipped away peacefully', added the statement. He is survived by his wife, Ms Koh Li Peng, and three children.

Mr Stanley was diagnosed with acute myelogenous leukaemia in late January and had been responding well to treatment.

After two rounds of chemotherapy, his doctors believed that his cancer was in remission. But his weakened immune system made him susceptible to infection, said the bank. His condition rapidly deteriorated over the last 48 hours and he succumbed to the infection.

When will the present oncologists ever learn there are many alternatives, safer and more effective treatments for any types of cancer beside the chemotherapy? Perhaps they will never want to depart from the status quo, yet. Or perhaps they will now.


Its ME said...

Saturday, January 31, 2009
Bone Marrow Cancer :
In November 1988, I was diagnosed with bone marrow cancer and was told that my condition was terminal. For twelve (12) years, I did not receive any type of chemotherapy.

Doctors do not understand how I can live so long with terminal cancer. Most patients with this type of cancer normally live three to six years, which was the life of expectancy they gave me. They cannot understand why I do not have holes in my bones by now.

On August 4, 2000, I was taken to parkway medical Center's ER in the following condition:
*Respiratory failure
*Fever, temperature 104.8
*Heartbeat was 222 beat per minute
*Blood pressure 200/130
*Bacterial meningitis (inflammation of the spinal cord and the lining of the brain)
*Blood was sludge
*Hemorrhaging from the nose
*Multiple melanomas (bone cancer)
*Zero immune system (due to bone cancer)

That same week it was reported on television that two healthy young men ages 17 and 21 died of meningitis. the doctors said that if i had arrived at the hospital two hours later I would have been dead upon arrival. bacterial meningitis is the worse kind of meningitis a person can contract.

I was in Intensive care Unit(ICU) for ten days, unconscious and on a ventilator. the doctors did not think I was going to live. The primary-care physician informed my family that I might need a tracheotomy, having a feeding tube placed in my intestines, and kept alive by machines. My family was informed that I might be a 'vegetable' if and when I did wake up. the doctors said that most patients that have be unconscious and on the ventilator for the length of time i was, usually wake up brain dead.

By the grace of God, on the 11th day I woke up breathing on my own with all my facilities and a sound mind. Today, none weeks later, I stand in God's amazing grace giving Him all the praise and all the glory. I am healed , walking in divine health. I am also still drinking a gallon and half of water with 1-teaspoon of salt every day. Thanks to your teaching.

Sincerely, M.J.

Its ME said...

Saturday, October 11, 2008
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Fully determined, I began the treatment, drinking only the juice. It wasn't easy, because in those days (year 1955) juice extractors had not yet been invented, so I had to grate the vegetables and squeeze out the juices with a towel and potato press.

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