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Clinical Cases

Anxiety and Fatigue after Cancer Surgery

Homeopath Carla Marcelis shares a case of anxiety and fatigue after cancer surgery.  Repertories of Phatak, Murphy and Loutan were consulted as well as Scholten’s periodic table.


The patient is a 67-year-old woman who comes for the initial consultation on June 28, 2021. She has recently undergone mastectomy with lymph node removal after diagnosis of adenocarcinoma of the right breast. Post-operative scans confirmed complete removal of cancer.

Advice was chemotherapy and radiotherapy, but she declined. Pathology of tumor: HER: neg; estrogen: pos 95; progesterone: pos 40. Hormonal treatment with Letrozole was started after the 6-month visit with the surgeon (to alleviate fear).

Chief complaints:

Extreme fatigue, sleep difficulties. It takes an hour to fall asleep and she wakes up around 3 or 4 am and can’t fall back asleep. Anxiety, fear that the cancer will come back.


Retirement from work as a psychologist. Volunteer involvement in a committee. Unappreciated (I worked for 6 months at half-time), I gave everything.

“I sacrificed myself” – Loss of identity as the helper.

Patient’s words:

“I do everything with intensity. I put it at 100%. Even cooking dinner. You have to get it done. There is nothing easy in life. I clean. I’m on adrenaline. I never relax.

You need a goal. Relaxation is not a goal. Walking in the forest is to get in shape. I’m task-oriented.”

She is a retired psychologist, says that she is sensitive, perceptive. “I can feel pulsations, take in information.”

She decided to refuse chemotherapy:

“The chemo is poison, the pharmaceutical industry’s goals. You’re just a container in which they will pour a toxic product.”

Thinking about the chemotherapy and the MD who proposed it, she felt: Weak, destitute, vulnerable, defeated. Oppression. Wiped out. Destroyed. Not respected, not received.

“It’s a force of the sea, you’re out of luck, it’s swallowing you up, it’s crushing you, you have no chance. I feel choked, not able to breathe. Smashed, shattered. No chance to get out. It’s stronger than you. You can do what you want, but you won’t get out of it.

What characterizes me: I’m disciplined, determined, I’m good at listening, I’m receptive, perceptive.

I have a strong will. I protect the receptive side. I recoil, become aloof, sit back (HG). I smother my potential (HG). I withhold, it’s a denial of me.

I lack confidence: not being up to it. How I will be received. I play safe. I study the group, I analyze and now, the subject has gone further, my idea is no longer relevant. I feel the energy, the vibration of my environment. It can destabilize me, or I will look for a person who is similar to me to get support.

With people in a position of power, I feel crushed. I try to find my place, but I suppress my potential. I lack confidence, I feel I’m not up to the challenge and play it safe. When I feel my value is recognized, I become provocative and stand up for others, who cannot defend themselves (lots of work and volunteer examples). I become a dog with a bone and don’t let go.

I feel that I have a lot to offer, but in the end, I didn’t do anything. I changed jobs every six months and my potential was never seen. I’m unhappy, with lots of bad luck, living in a small home. It is important for me to be correct, relevant, and not to be rejected.”

Conclusion: Her whole life she has been seeking to contribute something valuable (in her work and volunteer activities) and that has never been noticed and appreciated, but she continued to sacrifice her life for the underdog that she felt she was representing.

Recurrent themes:

strength, power (of herself and others)

I feel my power, my strength (when I feel valued)

I’m lightning that can destroy, scorched earth, bursting

Explosion, fire, extinguish, crush others or implosion

The other is an energetic vampire, they siphon my energies, swallow me, drain me

I will withdraw, observe, be extinguished.

Value and appreciation

I withhold, it’s a denial of me

I lack self-confidence

Am I relevant

I feel rejected, not appreciated

Core: unappreciated has lead to sacrifice

Carbon themes:

Disciplined, value, looking for appreciation from people in power (father figure)

Reaction to MD: Weak, destitute, vulnerable, defeated. Oppression. Wiped out. Destroyed. Not respected, not received.

Good vs Bad

Sense of disorientation and intoxication.


Vacancy, vacant feeling.

Fire and explosion

Animal themes:

People in position of power, I find my place

Become provocative

Dog with bone

Strength and power

Common physicals:





Remedy Choice

Carbo animalis 200K

The 200K was chosen because the patient’s expression was mostly on the emotional level. 200K addresses the emotional response to the concept of self and the deep physical symptoms she was experiencing.

The core dynamic of Carbo animalis is Sacrifice. See Loutan’s Repertory:

Loutan, G. Répertoire des Thèmes et de Matéria Médicale Dynamique. 19e édition, 2014.

“angoisse et la souffrance par le sacrifice. A tout donné et se trouve seul et abandonné. Tristesse infinie, déception de s’être donné sans reconnaissance de personne. Sensible à tout ceux qui se sacrifient et souffrent dans le monde. Aurait voulu pouvoir se donner à fonds perdus, inépuisable, non par sacrifice mais pas capacité infinie de donner de sa substance sans souffrier, sans rien perdre ni être entamé ou avoir à se restaurer et reprendre des forces. Ne pouvant être le bon Dieu qu’il voulait être, qui peut donner sans péril car inépuisable et impassible “ je me suis privé pour rien.”

MICH Translation: It is anguish and suffering through sacrifice. Has given everything and finds himself alone and abandoned. Infinite sadness, disappointment at having given oneself without receiving recognition from anyone.

Sensitive to all those who sacrifice and suffer in the world. Would have liked to be able to give of oneself completely, inexhaustible, not by sacrifice but by infinite capacity to give of her substance without suffering, without losing anything or being damaged or having to restore and regain strength. Not being able to be the good Lord he wanted to be, who can give without risk because he is inexhaustible and impassive. “I deprived myself for nothing.”

Carbo animalis is a tumor remedy and a remedy for exhaustion.

Phatak Materia Medica:

“It is suitable to old persons of feeble constitution or to those persons whose vitality becomes low on account of some serious, or deep seated diseased condition, or loss of fluids…Tendency to malignancy. ”

Rubrics (Murphy, Clinical Repertory, 3rd edition)

Clinical; chronic, fatigue syndrome; acute, diseases, after (50)

Weakness; general, fatigue, exhaustion, low vitality (313)

Breasts; cancer, breast (100)

Glands; cancer, glands, adenocarcinoma (38)


Calcarea sulph because of the feelings of rejection.

Sulph: identity, explosion, cast out. Calc: house, support

However, Calc-Sulph doesn’t cover the sacrifice she feels she has made her whole life.


She had a great improvement immediately after taking the remedy: In her words:

“When I woke up after the first week of taking Carbo-An, I felt like a veil was being torn, followed by a feeling that life would not be the same as before, that I was freeing myself from a heaviness that I dragged with me since a long time. A sort of fog had cleared (comment: this is a further confirmation of the Carbon theme). My vitality continues to be good. I can do a lot more activities during the day without getting exhausted. I feel more present and interested. On the other hand, I still have difficulty stabilizing my mind to meditate.

My sleep is also better than before. Often my dreams are positive. Otherwise, I react with equanimity to dreams with negative content like being robbed, having to go to the hospital with a sick nephew.  Although I believe that I am calmer, I still experience irritability and sometimes anger at certain insignificant irritants in life. However, it is less frequent than before.

I’m worried about the cancer coming back and I have started taking Letrozole.

Rx Carbo-an 200K weekly for 4 weeks since she had a good response to the remedy but not a complete resolution. She also still has a lot of anxiety and fear that the cancer would come back (emotional response, hence the choice of the 200K potency). The remedy was stopped after 4 doses. She did not repeat until the three month mark, where sleep started to be less satisfactory. Two more doses were given 2 weeks apart. Nothing else was required for the next three months.




About the author

Carla Marcelis

Carla Marcelis has been in practice for more than 20 years. The majority of people who come to consult with her have chronic and often serious diseases and she uses the full spectrum of homeopathic approaches together with nutrition and life-style adaptation to support this population. , Carla is also a teacher and Director of the Montreal Institute of Classical Homeopathy (MICH) and is the coordinator of the work by the non-profit HTSF-Canada (Homeopathes Thérapeutes Sans Frontières - homeopaths without borders) in Honduras. She has trained numerous community leaders and primary care workers in Honduras in homeopathy. The knowledge that homeopathy can do so much for people’s health while costing so little, makes it an important medicine for developing countries such as Honduras.

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