Radiation/Chemo Debate - 10-01-2002 09:01 AM
Hi Group,
I hope a lot of you will use this post to express your opinions about this topic. As someone who is going through their second loved one with cancer, I would like to think I've learned a thing or two about cancer treatments. Please understand, these are MY opinions, based on much reading and first-hand experience.
First, I think it is a shame that the patients and families have to have this debate. This is what we pay the doctors for - doctors who should be able to get together and come to a consensus on the most appropriate treatment for a patient. But that is not the case. In my two experiences with cancer, I have encountered more "in-fighting" between radiation oncologists, medical oncologists, and surgeons. To me, a multi-disciplinary approach to cancer which all NCI facilities advocate is nothing more than a way to "spread the wealth" amongst cancer specialists. And one hand doesn't know what the other is doing. So how are the patients and families supposed to know what are the best treatment options?
Something I learned with my husband's cancer was to trust the doctor that you feel most comfortable with - the one who seems to be most informed and concerned about the patient. This should be all of the doctors, but I have not found this not to be true. I have been amused of late that the doctor who I least liked when my mother started her journey (her medical oncologist) has actually been the one who is most responsive to her needs – and gets things done. Even though it was the radiation that left my mom unable to swallow and eat, it was the medical oncologist, not the radiation oncologist, who ordered the PEG placement. And it was the medical oncologist, not the radiation oncologist, who ordered home infusions for dehydration as a result of not taking in enough fluids. When my mother went to her first post-treatment radiation visit, her radiation oncologist was very dismissive of her because of her weakened condition. He dismissed any neck dissection surgery, even though it appears there is disagreement about the existence of remaining cancer in the lymph nodes. I learned this from a doctor at the tumor board who called to tell us of the disagreement, but said that she will be scheduled for the surgery. So where does that leave us in the decision?
We are left debating amongst ourselves- Surgery alone? Surgery & radiation? Surgery, radiation and chemo? Radiation and/or chemo? After reading and exchanging ideas with others, we also have to factor in our own personal feelings and convictions – how much can we tolerate-physically and emotionally? What are our feelings about life in general – quantity or quality? And some decisions are based on the attitudes of the type of cancer – even though lung cancer is the leading cause of death from cancer, it is woefully under funded compared to breast, colon, and prostate cancer. And since oral cancers comprise a small percent of all cancers, it too is under funded. So we are left with the same ole, same ole – doing things the way we've always done them – which may not be the best way for the patient.
Sorry for the length of this post – as you can tell, this is a sore subject with me. I hope I have not offended anyone. This has simply been my reality in recent years.
Cynthia
I hope a lot of you will use this post to express your opinions about this topic. As someone who is going through their second loved one with cancer, I would like to think I've learned a thing or two about cancer treatments. Please understand, these are MY opinions, based on much reading and first-hand experience.
First, I think it is a shame that the patients and families have to have this debate. This is what we pay the doctors for - doctors who should be able to get together and come to a consensus on the most appropriate treatment for a patient. But that is not the case. In my two experiences with cancer, I have encountered more "in-fighting" between radiation oncologists, medical oncologists, and surgeons. To me, a multi-disciplinary approach to cancer which all NCI facilities advocate is nothing more than a way to "spread the wealth" amongst cancer specialists. And one hand doesn't know what the other is doing. So how are the patients and families supposed to know what are the best treatment options?
Something I learned with my husband's cancer was to trust the doctor that you feel most comfortable with - the one who seems to be most informed and concerned about the patient. This should be all of the doctors, but I have not found this not to be true. I have been amused of late that the doctor who I least liked when my mother started her journey (her medical oncologist) has actually been the one who is most responsive to her needs – and gets things done. Even though it was the radiation that left my mom unable to swallow and eat, it was the medical oncologist, not the radiation oncologist, who ordered the PEG placement. And it was the medical oncologist, not the radiation oncologist, who ordered home infusions for dehydration as a result of not taking in enough fluids. When my mother went to her first post-treatment radiation visit, her radiation oncologist was very dismissive of her because of her weakened condition. He dismissed any neck dissection surgery, even though it appears there is disagreement about the existence of remaining cancer in the lymph nodes. I learned this from a doctor at the tumor board who called to tell us of the disagreement, but said that she will be scheduled for the surgery. So where does that leave us in the decision?
We are left debating amongst ourselves- Surgery alone? Surgery & radiation? Surgery, radiation and chemo? Radiation and/or chemo? After reading and exchanging ideas with others, we also have to factor in our own personal feelings and convictions – how much can we tolerate-physically and emotionally? What are our feelings about life in general – quantity or quality? And some decisions are based on the attitudes of the type of cancer – even though lung cancer is the leading cause of death from cancer, it is woefully under funded compared to breast, colon, and prostate cancer. And since oral cancers comprise a small percent of all cancers, it too is under funded. So we are left with the same ole, same ole – doing things the way we've always done them – which may not be the best way for the patient.
Sorry for the length of this post – as you can tell, this is a sore subject with me. I hope I have not offended anyone. This has simply been my reality in recent years.
Cynthia