The patient diagnosed with cancer today is confronted with an overwhelming amount of options and often confusing and contradictory information. As a physician who treats many patients who have cancer I am confronted daily with the dilemmas that these patients must come to terms with. I would like to offer some guidelines as to how to initially approach the diagnosis of cancer to help make the decision process a little more manageable.
The first and possibly the most difficult thing is not to panic. Any decision that is motivated by fear runs the risk of being seriously flawed. You cannot make a proper decision when you are in a panic state. It is not uncommon for the patient, once he is diagnosed, to feel that an immediate decision has to be made as to what course of treatment to ensue. The physicians involved in the patients care often reinforce this sense of dire emergency. The truth is that the cancer has been there for a very long time before it was discovered, often for years before it manifested clinically. Taking two weeks to adjust to the news and better understand what options are available in most cases will not alter the prognosis and is strongly advised in order to make a decision that you will ultimately feel comfortable with. (The exception to this is in instances when the patient is in imminent medical danger and a life saving emergency procedure must be performed.)
Most people who first learn they have cancer are diagnosed by a conventional doctor and are immediately sent to an oncologist or surgeon for treatment. While I strongly advocate that patients get oncological consults it is usually the case that patients do not leave the oncologist’s office with a clear understanding of all their options and realistic expectations as to what conventional medicine has to offer. It is rare that oncologists themselves have any understanding of treatments other than radiation, chemotherapy and surgery and will generally discredit other modalities without adequately investigating them. In addition the patient will often walk away with an overly
optimistic picture of the potential of conventional treatments. This is a very unfortunate situation as the patient is all too often disappointed with results of conventional treatments and regretful that they did not investigate alternatives earlier in the course.
It is essential for the patient to be very clear about the medical terms used in relation to the treatments. For instance patients are often told that their cancers have an excellent response rate to a certain chemotherapy. To the patient this sounds wonderful and they may not see much difference between terms like response rate, disease free survival and overall survival. However from a medical/scientific perspective each of these terms are very different. A response rate simply means significantly shrinking a tumor for a period of time. It tells us nothing of how the treatment will impact on survival. In fact studies do not necessarily show a positive correlation between shrinking tumors with chemotherapy and living longer. How can it be that chemotherapy can shrink tumors and people do not live longer because of it? It must be understood that chemotherapy is a double edge sword. It is a potent cytotoxin and will very efficiently kill cells that have a quick replication time. Cells that replicate quickly are not only cancer cells but also include the immune system. Therefore, chemotherapy is as effective as a killer of the immune system as it is of cancer cells. In addition chemotherapy causes increased genetic mutations in cells. It is well known that the more genetically mutated a cancer cell is, the more aggressive it will become. At the end of chemotherapy you may have much fewer cancer cells (chemotherapy except in a few rarer cancers never seems to kill all the cancer cells) but these are now more aggressive cells and you also have a much weakened immune system. Remember that the immune system is supposed to fight cancer in the first place and now that is even more compromised than it was before the chemotherapy. Now the cancer can come back with a vengeance even though there might have been an excellent early response with the tumor greatly shrinking.
What are the alternatives? Many patients are lead to believe that there are no other alternatives other than these toxic treatments and feel that doing something is better than just waiting for the cancer to run its course. The truth is that there are many other options that offer hope and do not have the high toxic profiles and side effects associated with most chemotherapy.
– From To Your Health
