New and Improved

We hear a lot about the need for new treatments for cancer, but not all new developments are about newer and better drugs.  Consider this: 

·         What if you could know ahead of time if the chemotherapy you are about to take will actually work?  Instead of going through weeks of useless treatment you could start on alternative therapies or different protocols.   And wouldn’t it be easier to handle the neuropathy or rash or thinning of hair if you knew, with a high degree of accuracy, that the treatment would work?  Very soon products will be readily available that will take a step toward exactly this kind of care. 

·         Another product is now going on the market that counts circulating tumor cells.  The idea is that the more circulating tumor cells you have, the tougher the fight against metastatic colorectal cancer will be.  This information can be used to shape therapy.  If nothing else, it is another tool in the arsenal of an informed patient that will help in making decisions about care.

·         If you are diagnosed with Stage IV colorectal cancer, you are certain to receive some kind of chemotherapy.  But what if you are Stage II?  Should you go through chemo or not?  In theory, since no cells were found in the lymph system, everything should be OK.  This is a tough decision, though.  What if you decide to forgo the chemo, and then have a recurrence?  Or what if you go through the chemo (maybe unnecessarily!) and have some weird reaction that causes long-term problems?  Which is it, the lady or the tiger?  Under which cup lies the magic ball that will keep you cancer free?  In the near future tests will be available that promise to be far more accurate than current approaches in determining if any tumor cells have broken out of the colon.   Armed with this information, patients can make better, more confident decisions about whether or not to undergo further treatment.

But wait, there’s more!  OK, maybe not, but I have to say that all of these developments begin to sound like ads for the newest and best product, As Seen on TV!!!.  Every company will tell you that their device, drug, treatment, whatever, will revolutionize care.  The good news is that some of them are right.  The bad news is that some of them won’t quite pass the Mythbusters test.  Even if they do work, a lot of questions remain.  Who gets the test?  Only people being treated at the top-notch cancer centers, or someone being treated in a community hospital?  Who pays for the test?  Will these new developments deepen the quality of care divide that already exists between those who can pay and those who cannot?  Who makes the decision?  We already know that some doctors don’t offer expensive therapies to patients who they don’t think can afford them.  This clearly seems wrong, but what is the alternative? 

Tough questions.  Difficult decisions.  Isn’t it fantastic, though, that new developments are available?  That we can even have these debates?  The road from where we are to where we should be is rocky and fraught with peril.  But, at least we have a path before us, and the path leads always to more hope.  That’s not bad.

Comments

[Rotorhead]

I recall my genetic counselor's initial session with me: "In ten years, we will have a cure for cancer". Being the eternal pessimist I shot back "in 100 years of medicine we still cannot cure the common cold". I fully support the research efforts, and look forward to breakthroughs...with a cautious eye. I don't see the "leap of faith" going away anytime soon.

I'm more concerned right now with patient care and quality of life: Are we getting the proper information to make our decisions? In my case, too much is left to the patient. I belive healthcare providers are responsible for giving us every last bit of information available, from many sources, regarding our treatment options and the "branches and sequels" that they may entail. In my case, I had to go from zero actual knowledge about cancer treatment to a decision on the course of things in a short period of time. Fortunately I was able to round up enough info and talk to the right people to make that decision - but I envision a system that would eliminate the need to do all the self-research. That is an improvement that is attainable, today, and would have measurable results impacting quality of treatment and quality of life.

That's my opinion, anyway...
Aloha,
RH

[Tim]

RH, you are exactly right on this. The decisions a person makes in the first few days after diagnosis can have a tremendous impact on the eventual outcomes. But those decisions must be made quickly, are made when the patient has little knowledge of the disease or options for treatment, and are made when the diagnosis of cancer has just dealt a psychological and emotional blow that can be paralyzing. I think a major key in addressing this is to encourage people who are newly diagnosed to contact a group like CCA and talk through the issues they will face. I hope to implement programs in the next few months that will help drive people to our toll-free help line immediately after diagnosis. By connecting the newly diagnosed with other patients who are further along in their treatment, I am convinced we can help patients living longer and better lives.