TMI II

I saw a disturbing article in the NY Times yesterday. This is a good example of how too much information can be a bad thing. It’s long but worth reading. Here is an excerpt:

Cancer has always been an expensive priority. Since the war on cancer began, the National Cancer Institute, the federal government’s main cancer research entity, with 4,000 employees, has alone spent $105 billion. And other government agencies, universities, drug companies and philanthropies have chipped in uncounted billions more.

Yet the death rate for cancer, adjusted for the size and age of the population, dropped only 5 percent from 1950 to 2005. In contrast, the death rate for heart disease dropped 64 percent in that time, and for flu and pneumonia, it fell 58 percent.

Still, the perception, fed by the medical profession and its marketers, and by popular sentiment, is that cancer can almost always be prevented. If that fails, it can usually be treated, even beaten.

The good news is that many whose cancer has not spread do well, as they have in the past. In some cases, like early breast cancer, drugs introduced in the past decade have made an already good prognosis even better. And a few rare cancers, like chronic myeloid leukemia, can be controlled for years with new drugs. Cancer treatments today tend to be less harsh. Surgery is less disfiguring, chemotherapy less disabling.

But difficulties arise when cancer spreads, and, often, it has by the time of diagnosis. That is true for the most common cancers as well as rarer ones. With breast cancer, for example, only 20 percent with metastatic disease — cancer that has spread outside the breast, like to bones, brain, lungs or liver — live five years or more, barely changed since the war on cancer began.

What has happened? Is cancer just an impossibly hard problem? Or is the United States, the only country to invest so much in cancer research, making fundamental mistakes in the way it fights the cancer war?

Researchers say the answer is yes on both counts. Cancer is hard — it is not one disease or, if it is, no one has figured out the weak link in cancer cells that would lead to a cure. Instead, cancer investigators say, the more they study cancer, the more complex it seems. …The grim facts about cancer can be lost among the positive messages from the news media, advocacy groups and medical centers, and even labels on foods and supplements, hinting that they can fight or prevent cancer. The words tend to be carefully couched, but their impression is unmistakable and welcomed: cancer is preventable if you just eat right and exercise. If you are screened regularly, cancers can be caught early and almost certainly will be cured. If by some awful luck, your cancer is potentially deadly, miraculous new treatments and more in the pipeline could cure you or turn your cancer into a manageable disease.

Unfortunately, as many with cancer have learned, the picture is not always so glowing. It turns out that, with few exceptions, mostly childhood cancers and testicular cancer, there is no cure once a cancer has spread. The best that can be done is to keep it at bay for a while.

As a doctor who tries to be honest with patients, Dr. Saltz says he sees the allure of illusions. “It would be very hard and insensitive to say, ‘All I’ve got is a drug that will cost $10,000 a month and give you an average survival benefit of a month or two,’ ” he said. “The details are very, very tough to deal with.”

This information is upsetting. I’m fairly sure that all of it is “true” but I am so glad I didn’t read it at the time of my previous diagnosis and treatment! If I had, I might have been tempted to forego treatment in favor of a cruise or a beach retreat. Of course either would have been easier, but then I wouldn’t be here.

I have always known that I “beat the odds” but I never realized just how high those odds were. I know that cancer can be defeated with aggressive treatment and I know many breast cancer survivors. I’m very optimistic that I will join their ranks.

This is a good time to remind myself that I am not a statistic. If only one percent survive in a given set of circumstances, we should always remember that we can be that one. So fight the good fight and go to the beach later. That seems like a good plan.


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