Physician assisted suicide (PAS) in cancer- 3 reason for PAS and 4 reasons against PAS

PAS has been in the news a lot lately. I blogged about Brittany Maynard, the 29-year-old California woman with terminal brain cancer who ended her life last November. I wrote about Ms. Maynard primarily because of the cancer diagnosis/prognosis issues involved.

Who told Brittany Maynard that she was “terminal?”

“First, let me state that I believe that all cancer patients who want to end their own lives have the right to do so. Second, let me say that a “terminal” diagnosis is almost unbearable for the patient and his/her caregivers…”

Physician-assisted suicide is a hotly-debated issue in our society today. My challenge is that I can only consider the PAS issue through the eyes of a long-term cancer survivor of an “incurable” cancer. My cancer experiences color my PAS thinking.

If your cancer experience also colors your PAS thinking, scroll to the bottom of this page, post a comment or question and I will reply ASAP.

First, let me go on record as follows:

1) Across all posting on PBC, my opinion is consistent. Cancer patients and survivors must be in charge of, in control of ALL of their cancer care decision-making.

2) I believe in a higher power yet I consider my thinking as secular when it comes to cancer.

3) Conventional oncology and by extension your oncologist, is a human being first and a medical doctor second. As the Medscape article linked below points out, religious beliefs may guide your onc’s beliefs on PAS.

4) Palliative cancer care is NOT effective in all end-stage cancer situations.

5) For many cancer survivors, PAS is more about control that dying.

5) No prognosis is certain. I am not a 1 in 1000 fluke. There are thousands of examples of cancer patients living well beyond their terminal status.

Is Religion Why Docs Are Against Assisted Suicide/Dying?

This Medscape article raises some important PAS issues. The most important issues for all cancer patients, survivors and caregivers to understand is, odds are your oncologist is against PAS. This is important for you to remember.

The top reasons why physicians are against PAS are as follows:

“Why I’m Against Physician-Assisted Suicide”

1. God Is Against It (Religious Beliefs)

“The majority of physicians who were against PAS talked about God and religion.  “Life is sacred, I will not play God…”  While some respondents didn’t specifically mention God, they said, “my religious beliefs rule here.”

2. Support for Palliative Care

“Their assumption was that palliative care is available to all and effective in all or most situations. While that’s often true (or should be true), it may not always be the case.”

3. Maybe the Patient Has Treatable Depression

“One doctor commented that he supported PAS “pending a full assessment to rule out depression and other complicating conditions…

Studies showed that the fact that patients had access to the medication (suicide)  if they needed it gave them a sense of control that actually enabled them to not want to take the dose, and they died from the disease itself.”

4. No Prognosis Is Certain

“A number of physicians asked, “Who is to say what is terminal and when death will come? I’ve seen situations in which everyone expected the patient to die very soon, and for unexplained reasons, the patient lived and the symptoms—while they did not disappear, they definitely subsided.”

“Why I’m in Favor of Physician-Assisted Suicide”

1. Medication Barely Helps Intolerable Torment and Prolonged Misery

“Physicians who had more direct or more frequent exposure to patients suffering from not-always-controllable pain, inability to breathe or move, reliance on years of dialysis, loss of all control, etc, talked about the patient’s profound misery and the concomitant suffering of the helpless family members. “

2. We Shouldn’t Force Patients to Have to Figure Out How to Kill Themselves

“In one interesting subdebate, some doctors commented that if patients want to kill themselves, they are certainly capable of going out and doing so…Other physicians seemed outraged that innocent, decent people should be forced to resort to more pain and torment by stopping food and treatment and waiting to die or that others should be forced to create violent means of death for themselves or create situations in which family members or other unsuspecting people will be the ones to find them dead.”

3. Why Shouldn’t We Treat People as Well as We Treat Animals?

“When dogs and cats are suffering from terminal disease or intractable pain, and there’s no way to fully alleviate the suffering, euthanasia is the common “treatment…” Of course, animals are not people (although some folks disagree), and therefore the same standards should not be applied to them.”


Posted in Survivors

Myelodysplastic Syndromes-non-toxic therapies

Myelodysplastic Syndrome (MDS) is the most common bone marrow failure condition in the United States- it is referred to as pre-leukemia.

As a long term survivor a multiple myeloma, another blood cancer, I know that managing the toxicity of your therapy is critical. The average MDS patient is 70 years old. Not a group that handles toxicity very well.

The articles and studies linked below indicate that there are less toxic or non-toxic therapies for MDS.

For more information on managing your MDS or any other question or comment scroll down the page and leave me a comment or question. I’ll reply ASAP.

Thank you,

David Emerson

Cleveland Clinic study shows promise for less toxic treatment for blood disorder

MDS is the most common bone marrow failure condition in the United States; each year, between 12,000 to 15,000 people are diagnosed with the condition. Robin Roberts, an anchor with ABC’s Good Morning America, developed MDS after undergoing treatment for breast cancer. Roberts had a successful bone marrow transplant in 2012…

The patients received doses of the drug that were 75 to 90 percent lower than what is typically given to people as part of treatment for MDS.

What the researchers found: In 44 percent of patients in the trial, the disease was well controlled. Of that group, 20 percent remained on the drug for more than three years.”

Clinical response of myelodysplastic syndromes patients to treatment with coenzyme Q10

“Naturally occurring compounds that are not toxic may provide a means to treat patients in the initial stages of disease. We conducted a pilot study to test the efficacy of coenzyme Q10 (coQ10) in MDS patients with low to intermediate-2 risk disease. A variety of responses were observed in 7 of 29 patients including two trilineage and two cytogenetic responses…”

Vitamin D treatment in myelodysplastic syndromes.

“Myelodysplastic syndromes (MDS) are a group of clonal disturbances with defective cellular differentiation. Vitamin D3 (VD) analogues can act on the differentiation and maturity of different cell lines…All the patients were in a low to intermediate risk group…

Treatment with vitamin D3 metabolites could induce a long-standing response of the haematological disturbance in some low-intermediate risk MDS patients without inducing hypercalcaemia.

Posted in Newly Diagnosed Tagged with: ,

Mesothelioma, expensive cancer research, death and taxes.

Nothing is certain in life but death and taxes. I want to add two more certainties to this proverb. First, nothing is certain in life but the high cost of cancer research and second, nothing is certain in life but the mortality of mesothelioma.

Sadly, my certainties are too awkward to add to the eloquent death and taxes proverb. But as the article linked below illustrates, the inevitability of how expensive cancer research is draws on the mortality of mesothelioma.

The one saving grace of mesothelioma is that unlike other incurable cancers (and let’s face it, most late stage cancers are incurable) mesothelioma is almost always caused by exposure to asbestos. And asbestos exposure can almost always be tied to corporations. Therefore as the law firm of Weitz & Luxenberg will tell you, corporations are responsible for mesothelioma and should compensate victims accordingly.

Please don’t misunderstand me. Research into incurable cancers is needed in order to try to figure out how to manage these horrible diseases. And the cancer survivor in me is glad that mesothelioma patients and their caregivers might find some solace in the surety of financial compensation.

My life has been dominated by cancer for so long (since ’93) that I’ve come to see the world almost exclusively through cancer-colored glasses .

I see the Silver Case, written about in the New York Times article linked below as first, an oncologist who specializes in an incurable, rare cancer who works hard to raise money for his cancer center. It can be argued that Dr. Taub blurred a few ethical lines to research mesothelioma but his research may have helped the lives of thousands.

Second, I see a law firm, Weitz & Luxenberg, who paid a lot of money for mesothelioma referrals- some of this money to Dr. Taub and his mesothelioma research center. Weitz & Luxenberg is good at what they do. Mesothelioma patients are worth a lot of money to plaintiffs lawyers.

I’m no lawyer but so far I only see two things through my cancer-colored glasses. First, I see cancer research being carried out by doctors and second, I see a law firm paying money for referrals.

I’m no lawyer but I don’t see anyone breaking any laws here.

The only real crime, as I see it, is the fact that Dr. Taub’s mesothelioma research center is being closed because of all this-

On Friday, Columbia announced that it would dissolve his mesothelioma center.”

In Silver Case, U.S. Cites Link to Litigation Tied to Asbestos

Dr. Robert N. Taub

  • “With a reputation as a devoted clinician intent on trying out innovative therapies, Dr. Taub is something of a hero in the world of mesothelioma, a devastating cancer that is nearly always fatal…
  • Dr. Taub, however, was obsessive about raising money for mesothelioma research, according to current and former colleagues…
  • Funding is extremely hard to come by in Dr. Taub’s field…

Weitz & Luxenberg

  • which says it handles about 500 new mesothelioma and other asbestos-related cancer cases a year…
  • Mr. Silver inappropriately pocketed about $4 million from two different law firms — Weitz & Luxenberg and a real estate law firm, according to prosecutors. Most of the illicit funds, the complaint indicates, came from the Weitz firm, which paid him more than $5 million in all.
  • Mr. Weitz said that Mr. Silver, who kept an office in the firm’s headquarters, sent just four or five cases a year to the firm, but each one had the potential to be hugely valuable. “Shelly always would bring in an occasional personal injury case,” said Mr. Weitz, whose firm is not accused of wrongdoing.



Posted in Newly Diagnosed Tagged with:

Ask the Cancer Coach-“are there therapies that work to reverse small liver mass?”

Hi Cancer Coach:
“I Would like to know if there are therapies that work to reverse small liver mass (1.5 cm) by use of broccoli extract or other substances?”


Hi Liver Cancer Patient-
Yes, there are several therapies that may reverse small masses on the liver. I will list and link your info below. I will include and look beyond broccoli extract.

1) I couldn’t find specific studies showing that broccoli extract was a therapy for liver cancer. While broccoli may prevent many cancers such as bladder cancer and I would certainly recommend it to a liver cancer patient, I can’t find anything about broccoli extract as a LC therapy.

2) Please read the info about a supplement called AHCC and its use as a therapy for liver cancer-

AHCC and cancer

There have been reports of tumor reduction and even cures of cancer using Reishi mushrooms and Chinese herbs. It has been observed that these traditional remedies may work by up-regulation of the immune system.[14]

A study published in the Journal of Hepatology compared the outcomes of 113 post-operative liver cancer patients taking AHCC with 156 patients in the control group. The results showed the rate of recurrence of malignant tumors was significantly lower (34% versus 66%) and patient survival was significantly higher in the AHCC group (80% vs. 52%). The level of speculation was low because actual survival figures were recorded and the patients had all been carefully observed internally at the time of surgery with photographs of tumors and lesions.[4]

3) Consider Cryotherapy for liver cancer. Cryosurgery may offer options/benefits to you in your situation-

4) Consider Thymoquinone

Scroll to the bottom of the page an post any questions or comments that you may have. Hang in there.


David Emerson

Posted in Newly Diagnosed Tagged with: ,

Would you give cannabis oil to your daughter with stage 4 brain cancer if it were her only hope?

Try to imagine that your 2 year old child has been diagnosed with a brain tumor. And then more bad news. The brain cancer is stage 4. The worst stage.

Through Internet research you learn that even if your child’s cancer can be put into remission, the side effects from whatever therapies that are given, chemotherapy or radiation, will cause short and long-term and late stage side effects. 

Now try to imagine that you have read that cannabidiol (CBD) has proven ability to both kill brain cancer cells while it may protect your child’s body from the ravages of conventional toxic therapies. But CBD is illegal where you live.

What do you do?

Neuroblastoma, a specific type of brain cancer, when diagnosed as “high-risk” if most often incurable.  Pediatric neuroblastoma is every more difficult to deal with- especially if the pediatric patient is your child.


“…whereas high-risk disease is difficult to treat successfully even with the most intensive multi-modal therapies available.[5]

Australian father arrested for giving cannabis oil to daughter with advanced cancer

“When Adam Koessler’s daughter, Rumer Rose, was diagnosed with stage 4 neuroblastoma, he was told that she had about a 50 percent chance of living. Out of desperation to help Rumer, he started augmenting her chemotherapy treatments with the drug by putting cannabis mixed with coconut in her food. (This form of medical-grade cannabis doesn’t contain any of the elements that lead recreational users to get high.)

If I were told by a conventional oncologist that my 2-year old had about a 50% chance of living, my first question would be “living for how long?” I don’t mean to sound cynical but stage 4 brain cancer patients do not have a very good prognosis.

Koessler told the Australian Herald that Rumer’s condition worsened since he was barred from treating her with the cannabis oil. The little girl is now in intensive care and on morphine.”

Posted in Newly Diagnosed Tagged with: ,

Cannabidiol (CBD) kills multiple myeloma and enhances Velcade against MM-

One of the first things that newly diagnosed multiple myeloma patients learn about their cancer is that “it is incurable but very treatable.”

Most of us newly diagnosed mmers find this statement to be confusing, bewildering and downright annoying.

It has taken me every bit of the more than 20 years since my original myeloma diagnosis to understand what it means for a cancer to be incurable but treatable.

What have I learned about mm over the past 20+ years? Myeloma is about two things 1) metastases (bone damage) and 2) side effects. MMers don’t die from their cancer. They die from bone damage and/or from the toxicity caused by chemotherapy and radiation.

The solution? Take an integrative approach to managing your multiple myeloma. Enhance the efficacy of chemotherapy and while you reduce the toxicity.

The article below cites the ability cannabidiol (CBD) to  increase the activity of Velcade (bortezomib).

To learn more about therapies that further enhance myeloma chemotherapies while they manage their toxicity, scroll down the page and post a question or comment. I will reply ASAP.

Thank you,

David Emerson- mmer since 2/94

Bortezomib (Velcade) was approved by the FDA for use as initial or as induction therapy for multile myeloma in 2008.

Food and Drug Administration (FDA) has approved VELCADE® (bortezomib) for the retreatment of adult patients with multiple myeloma (MM) who had previously responded to VELCADE therapy and relapsed at least six months following completion of prior VELCADE treatment.

The effects of cannabidiol and its synergism with bortezomib in multiple myeloma cell lines. A role for transient receptor potential vanilloid type-2.

“Because bortezomib (BORT) (Velcade) is commonly used in MM treatment, we investigated the effects of CBD and BORT in CD138+TRPV2- MM cells and in MM cell lines transfected with TRPV2 (CD138+TRPV2+). These results showed that CBD by itself or in synergy with BORT strongly inhibited growth, arrested cell cycle progression and induced MM cells death by regulating the ERK, AKT and NF-κB pathways with major effects in TRPV2+ cells. These data provide a rationale for using CBD to increase the activity of proteasome inhibitors in MM.”

Posted in Newly Diagnosed Tagged with:

Ask the Cancer Coach-Aggressive Genital Cancer- supplements, nutrition, trials?

Hi Cancer Coach-

After four surgeries, 30 rounds of chemo and 2 rounds of 5 FU not in that order.  The pathology of my last surgery came back and indeed they were not able to clear out the Squamous cell carcinoma that has been aggressively growing in my genital region.

I have been referred to a Medical oncologist and am currently waiting that appointment.

Couple of questions that I am hoping you might be able to help me with.
1. Are there any supplements or foods that I can take that help the chemotherapy work?
2. I know that the chemo could potentially slow down growth (though the first rounds of chemo didn’t) but wont’ stop it per say.  Are there any specific questions that I should be asking that are not maybe as obvious?
3. Are you aware of any drugs, trial etc. that can slow the cancer down from metastasizing? Or recommendation of changes or things I might do to slow that down?

Thanks in advance

Hi GC patient-
I am sorry to learn of your genital cancer. I have little experience with your condition but I will answer your questions below to the best of my ability.

1. Are there any supplements or foods that I can take that help the chemotherapy work?

Yes. i will link studies below. While my search of curcumin and 5FU did not turn up any studied on genital cancer, my guess is that this cancer has not been studied where the other cancers had been studied. You can decide.

Curcumin and 5FU-

Green tea extract and 5FU-

Vitamin D3 and 5FU

Fish oil and 5FU-

2) …”Are there any specific questions that I should be asking that are not maybe as obvious?”

Only ask about those therapies that are curative rather than “standard of care.”

3) Are you aware of any drugs, trial etc. that can slow the cancer down from metastasizing? Or recommendation of changes or things I might do to slow that down?
It is currently common for oncs to prescribe bisphosphonates (bone strengthening drugs) to patients AFTER their cancer has metastasizing.

I recently found two studies advocating bisphosphonates upon diagnosis (sooner).


The key will be to get your onc to prescribe the bisphosphonate therapy in order to get your insurance to pay for it.

4) Are you aware of any treatments being used to ease the pain of skin cancer lesions?

I am sorry for not being able to offer any info here- no I don’t.
Let me know if you have any other questions. Let me know how your therapy progresses.

David Emerson

Posted in Newly Diagnosed Tagged with:

Reduce Cyclophosphamide (CTX, Cytoxan) toxicity while you enhance its efficacy

I underwent Cyclophosphamide (CTX, Cytoxan) chemotherapy during my induction therapy for multiple myeloma in preparation of an autologus bone marrow transplant.

Over the years I have read numerous accounts of cancer patients undergoing cytoxan therapy. It is clear that cytoxan is a commonly prescribed chemotherapy.

The challenge is that cytoxan has severe long term and late-stage side effects.

The second article below documents the ability of “C orchioides methanolic extract” to both enhance the efficacy as well as reduce the toxicity of cytoxan.

Further, the first article linked below documents the dose limiting nature of cytoxan side effects. In other words, if you can get your onc to agree to reduce the dosage of your cytoxan dose you may avoid the documented side effects.

To learn more about enhancing chemotherapy’s anti-cancer action while limiting toxicity scroll down to the bottom of the page and post a question or comment. I will reply ASAP.


David Emerson


Cyclophosphamide (INN, trade names Endoxan, Cytoxan, Neosar, Procytox, Revimmune), also known as cytophosphane,[1] is a nitrogen mustard alkylating agent[2] from the oxazaphosphorine group…

Cyclophosphamide has severe and life-threatening adverse effects, including acute myeloid leukemia, bladder cancer, hemorrhagic cystitis, and permanent infertility, especially at higher doses”

Enhancement of Cancer Chemotherapeutic Efficacy of Cyclophosphamide by Curculigo orchioides Gaertn and Its Ameliorative Effects on Cyclophosphamide-Induced Oxidative Stress

“Cyclophosphamide (CTX) is a synthetic antineoplastic drug with severe and life-threatening side effects…

In this study, the tumor reduction capacity of CTX in combination with C orchioides methanolic extract was studied using Dalton’s lymphoma ascites-induced solid tumor models. Effect of C orchioides on the reversal of the damage induced by CTX administration (intraperitoneally) was also determined in this study…

The alcoholic extract enhanced the tumor reduction capacity of CTX and reduced GPT and ALP levels in liver and serum, which were elevated by CTX administration.

In conclusion, the plant extract when administered in combination with CTX, can result in enhanced anticancer properties; it also ameliorates the toxic side effects of CTX.

Posted in Newly Diagnosed Tagged with: ,

Early chemotherapy does NOT help smoldering multiple myeloma

The diagnosis of an incurable cancer like multiple myeloma is awful. Patients feel as if they lose all control over their health.

So when an oncologist offers therapy to possible slow down pre-multiple myeloma from becoming full-blown multiple myeloma the newly diagnosed smm patient may jump at the idea.

Unfortunately, chemotherapy is toxic, even at low doses and brings with it “gastrointestinal toxicities, constipation and fatigue or asthenia” and possibly other side effects.

The study below is a meta-analysis meaning that the authors compared numerous studies to arrive at their conclusion.

Have you been diagnosed with smoldering multiple myeloma? If you are interested in learning about non-toxic therapies to delay full-blown multiple myeloma scroll down the page and post a comment or a question. I will reply ASAP.

Thank you,

David Emerson (mm survivor since 2/94)

Early versus Deferred Treatment for Smoldering Multiple Myeloma: A Meta-Analysis of Randomized, Controlled Trials

“Herein, we conducted a meta-analysis comparing the efficacy and safety of early treatment over deferred treatment for patients with SMM…

Early treatment delayed disease progression but increased the risk of gastrointestinal toxicities, constipation and fatigue or asthenia. The differences on vertebral compression, acute leukemia, hematological cancer and second primary tumors were not statistically significant. Based on the current evidence, early treatment didn’t significantly affect mortality and response rate.


Posted in Newly Diagnosed Tagged with:

Hyperbaric oxygen therapy (HBOT) to stimulate stem cell collection

Central to autologus peripheral blood stem cell transplant is collecting enough of one’s own stem cells to properly re-populate one’s immune system after you undergo high-dose chemotherapy.

These days in fact, it is common to have more than one auto bmt and therefore patients often need to collect enough stem cells for multiple stem cell transplants.

I’ve been logging on to myeloma listservs for years.  Peripheral blood stem cell transplants are frequently discussed.  The majority of the discussion is how well they work against multiple myeloma. There is also discussion of doing two transplants- a tandem transplant.

Occasionally posters will refer to their ability to collect their own stem cells.  Some have no problem collecting their stem cells and many do not collect enough stem cells.  When you have plenty of stem cells for collection it seems as if the collection process is a breeze.

As the two articles linked below illustrate, hyperbaric oxygen therapy can improve stem cell collection.

Are you about to undergo an autologus bone marrow transplant? Would you like to learn more about the risks and benefits of this procedure?

Scroll down the page and post your question or comment. I’ll reply to you ASAP.

Thank you,

David Emerson

Stem Cell Collection And Hyperbaric Oxygen Treatment

The actual treatments (HBOT treatments) were easy. He said that his ears would feel pressure, like while flying in an airplane. The chamber was clear, and he could watch TV during his 90 minute sessions…

Dave’s WBC count jumped from below 2.0 to over 13 during the night! They ran the ProCOUNT test, and Dave’s was at 50 million cells available for collection! The collection doctor said that in 20 years of doing this she had never seen anyone with his extensive radiation history with those numbers!”

Penn Study Finds Hyperbaric Oxygen Treatments Mobilize Stem Cells

“According to a study to be published in the American Journal of Physiology-Heart and Circulation Physiology, a typical course of hyperbaric oxygen treatments increases by eight-fold the number of stem cells circulating in a patient’s body…”

Posted in Newly Diagnosed Tagged with:

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