Cancer

[John F]

Today's CBS Sunday Morning was entirely devoted to aspects of cancer. It's a fearful disease, of course, and according to the American Medical Association, 1/2 of all males and 1/3 of all females either have it or will get it. But that doesn't mean they - we - must suffer a long and painful dying, or a long and painful treatment, or both. this program, titled "Beyond Cancer," told me lots that I didn't know about cancer, its treatment, research into new treatments, and that in many cases treatment of any kind is not necessary and may do more harm than good.

For this week, the program is here:

http://www.cbsnews.com/sunday-morning/

After next Sunday, the segments will remain on that web site but will make way on the home page for next week's program.

[Belle]

That looks like an interesting program. We all need to be up to speed on this disease and treatment options so we can be vigilant when a surgeon or physician becomes a little over enthusiastic with the scalpel. My late father-in-law was 85 and had dementia when the doctor discovered he had Prostate Cancer. He wanted to operate as soon as possible and I shooed him away very angrily, correctly suggesting George would likely die of Alzheimer's Disease before cancer got him. An avaricious doctor from whom our beloved relative narrowly dodged a bullet; dying naturally one year later from heart failure.

In short, one of the things to discuss in these types of programs is the one about over-treatment and the degree to which doctors are likely to make decisions based solely on the best interests of the patient and not their own hip pockets.

Same thing is unfolding right now with a friend whose husband has Alzheimer's Disease in the early-middle stages. His doctor was performing shoulder surgery last week and I emailed my friend (a cancer patient herself) and asked her whether she understood that surgery and a general anaesthetic very often added to a patient's confused state. She did not.

[John F]

Whether and how to treat cancer isn't necessarily about the doctor's bank balance. As the program explains, it has long been conventional medical wisdom, even doctrine, that cancer cells are inherently a mortal danger and need to be removed ASAP before they metastasize. What may change that, according to the program, is research and increasing knowledge about cancer, and its acceptance by rank and file doctors whose decisions often determine life and death. Not to treat cancer according to current medical doctrine, if that turns out to be the wrong decision, can damage a doctor's reputation and possibly make him vulnerable to a costly lawsuit.

All that said, the story of your father-in-law is an obvious example of when one needs to take charge from doctors who may adhere the old doctrine even when it makes no sense in the individual case. As for your friend's husband, it depends on whether his shoulder's condition was painful or otherwise harmful to his quality of life, and how long he had to live. (You don't mention his age.) If he was demented, it was up to his wife to decide, and if her decision was not fully informed - I'd say most people's decisions aren't, not always anyway - nonetheless it was hers.

Every time we undergo surgery or even take medicine, no matter how young and healthy we are, we may risk our lives. It's up to us to decide whether on balance the potential benefit weighs heavier than the potential risk. The decision isn't always fully informed or even rational. The movie star Angelina Jolie had a voluntary double mastectomy though she didn't have cancer but from fear that she had a genetic predisposition to the disease. On the other hand, denying medical treatment on principle, for example because of one's religious beliefs, can be tantamount to suicide.

Watching the Sunday Morning program may not make us fully informed about cancer, but I guarantee it will make us better informed than we are now. And perhaps more hopeful.

[jserraglio]

Tales about the overeager surgeon lie thick on the ground, but my experience differs. My daughter, working for Timken Corp in western NH at the time, now enjoys full health and her beautiful 3-year-old son thanks to Dartmouth-Hitchcock Medical Center's treatment for her rare form of cancer. When I visited the center, I was blown away by their warmth and expertise. As you enter Dartmouth's oncology section, a huge concert grand piano sitting in its lobby greets you with its implicit statement about living. By comparison, the Cleveland Clinic has plenty of expertise but lacks the human touch. I had always regarded Dartmouth generally as a place blessed by the gods, but their curing my daughter sealed the deal.

[Belle]

How hugely stressful and upsetting for you all having to go through that experience with your daughter! Thank goodness it turned out well and that hospital sounds excellent.

The vast majority of doctors do the right thing but we must be vigilant about those who do not! When my own mother was dying of Pancreatic Cancer in 1984 she was under the care of a well known surgeon who performed a gastric by-pass. When my father pressed him after the operation on the fate of my 58y/o mother the surgeon was walking quickly and seemed uninterested in answering his questions. Incredibly, he then turned to my father and said, "it won't make any difference; it's a palliative measure because she's going to die anyway".

[jserraglio]

The vast majority of doctors do the right thing but we must be vigilant about those who do not!

I completely agree. A hospital physician and I once had a set-to after he made a hallway wisecrack about how my mother-in-law, like all Catholic lefties, had been switched to right-handed by parochial schools!

On the other hand, whatever health I retain I owe to the medical profession.

[Chalkperson]

My dearest friend, the closest I have to brother, has cancer. He's stuck in Hong Kong and I think it very unlikely we can get him back to Paris, I Skyped with him on Sunday, he was in a Chinese Hospital where they don't wear masks or gloves. Luckily he got out today.

Its beyond heartbreaking, but he's stayed alive for more than two years using 'unconventional' medicine, he's be long gone without it.

My friend Charlie Chan (yup) is a Cancer Doctor so he tells me what he can, i'm lucky to know him. He sent Wilko Johnson to see his surgeon friends and they removed a tumor the size of a soccer ball that weighed 3 Kilos from a British National Treasure, and very old friend of mine....

http://www.bbc.com/news/entertainment-arts-27225857

This is very moving, and funny, Wilko's awards speech...

https://www.youtube.com/watch?v=GH3ntW_T3IE

[jbuck919]

As you implied, the site you gave no longer has this, and it appears the video itself has been deleted from other sites. However, this seems to be the substance of the text you are talking about:

http://www.cbsnews.com/news/when-is-it- ... at-cancer/

[John F]

Yes, that's part of it. I guess the rest is gone, unless somebody uploads it to YouTube.