Hi --

I read another paper -- just as an abstract-- that did a survey of cancer survivors and asked them to rank post-treatment quality of life vs. additional (survival) time and a slight majority wanted improved QOL over time. Now without the actual paper I do not know the details but the gist was that many patients had long-term disabilities that greatly reduced their enjoyment of life and they would have preferred a less-drastic treatment even if it somewhat reduced their chance of cure (or control).

This is not at all unusual -- there have been lits of similar observations and it's been discussed on this forum before.

I did ask our nurse today about her experience with cisplatin (which was standard where she was before, M.D. Anderson) and she said it was a very hard drug on the patients and they had lots of sick people. She said her (current) carbo and carbo/taxol patients are generally handling chemo better than her current cis patients. There are some on a trial that get cisplatin every day (a very low dose) and apparently do better -- one fellow we see every day said he was sick first week but now has adjusted.

She also said she felt that current treatment guidelines and usage have not kept up with some developments in the field -- e.g. the much reduced oral side-effects (mucositis and thick phelgm, in particular) that she and the other nurses are seeing in the tomo as compared to conventional IMRT patients. It will be a long time before this is out in the literature as lots more data, including long-term follow-up, is needed to change current guidelines.

Gail