Re: Cancer and the way some Doctors view same.
- From: "Peter Moran" <pmoran@xxxxxxxxxxxxxxxx>
- Date: Tue, 11 Mar 2008 06:45:45 +1000
"Rod" <deniecerod1@xxxxxxxxxxx> wrote in message news:Yg9Bj.24171$421.11452@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Hi,
I wrote many months ago about my brother in law that was found to have Bowel cancer.
The cancer was removed surgically in January 2007 and all went well except for spots on the liver.
Bob went through Chemo for this which seemed successful except by August the next diagnosis was for spots on the lung.
Initially the diagnosis after spots on the liver were found was for a shortened life span but some hope of chemo being useful. The next phase was for spots on the lung which the patient was told that lifespan had been shortened.
After Chemo the prognosis for the liver had changed to perhaps an operable situation for cure with the liver problem but enhanced problems with the lungs.
Come December the patient was admitted to hospital with a suspected virus caused by the Chemo, then all hell broke loose in February with the diagnosis being a spread of cancer to the brain.
At this stage whilst in hospital Bob was informed by three Doctors that he had around two weeks to live and that he should go home and sort out his affairs. The basis of this prognosis seemed to be reliant on that Chemo was ineffective with brain cancer. Then after a visit to the treating Oncologist he was informed that maybe he has two months with nothing else available. Chemo not being an option for brain cancer patients. The Oncologist shook his head at the request for perhaps a year or two.
Bob and his wife insisted that he be assessed for radio therapy as a means of prolonging life. They went to their Doctor who said that he would recommend radio therapy if the Oncologist did not. Today after the visit for radio therapy he is told that chemo is available after radio therapy and with both treatments he may have another year or two. When confronted with what was said by other Doctors and the Oncologist, the specialist stated that he would like to know their names but then decided that there was little that could be achieved.
So it goes on with Doctors insisting on death along with nursing staff and then finally some hope with radio therapy from the specialist.
Can you imagine how all this uncertainty dispensed by the medical industry is affecting a family and those around them?
Can you imagine the mood swings that these people are experiencing whilst one or more Doctors says that you will die within two weeks and then the specialist says that you have two years with good treatment?
Today after that visit to the main hospital Bob was told that they could and would do radio therapy which should give them the time that they so desperately need.
More to the point is that if you were to receive this diagnosis whilst your hand and feet were uncontrollable due to brain cancer would you accept the initial diagnosis from two Doctors and an Oncologist and if you felt strongly enough to stop the pain to loved ones, would you consider suicide or would you ignore the consensus of opinion and seek further treatment.
Luckily they have elected for further treatment and have not succumbed to the Doctors expressed opinions.
Rod
A sad but common scenario. Without even looking at any studies that have been performed on patients in this situation we can say that "may have another year or two" is not necessarily false, but it is almost certainly an extremely optimistic outlook for a program of treatment that may merely make his life less tolerable than it already is. We can predict that by far the majority of patients who undertake this treatment will derive little or no benefit, and that if survival is, on average, prolonged it will be more likely to be of a couple of months than years.
But then 1 in 10,000 patients may even be cured by it! Odd things sometimes happen in cancer treatment. There is no "correct" medical approach because we cannot predict the outcome in the individual case. We have weigh the possibilities against the probabilities.
In an ideal world the patient's decision after fully informed consent (better than m ay be applying here) would determine what is done. In the real world cost-benefit considerations and the availability of resources and the personal opinions of doctors will have an influence on what is offered patients.
PM
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