Cancer read very informative - Advanced Prostate...
Cancer read very informative
Are We Losing the War on Cancer?
For half a century, we have thrown everything we have at the disease, but we are no closer to curing it
Sep. 18, 2023
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Thanks for posting P2BH:
healthunlocked.com/redirect...
This a pretty good article - I read the whole thing - it's the kind of article that you'd want to read when you were just diagnosed (for non-Canadians and especially Americans, the reputation, and quality of articles in the Walrus is comparable to something you might find in the Atlantic).
"Booth’s research has shown that, for patients in the last year of life, whatever extension is gained may be completely offset by the time used up getting treatment."
I liked that comment by the researcher that was included in the article. It highlights the work of being a cancer patient. So often nobody wants to talk about this, but we ignore it at our peril. There's always a trade-off. And what's being highlighted here is that in the final stages it's so easy to make a decision that sadly robs one of what is probably much more valuable.
My comment here though mostly concerns palliative care, which shows up in the article. The researcher and clinician, who is the main focus of the article, expresses interesting ideas that there's a gap between palliative care and the clinical work of cancer treatment and quality of life. I would like to see more focus on this gap. I call this gap the "coaching gap".
One's personal physician doesn't know very much, the medical oncologist has so little time, and where do you learn that you should exercise a lot?! And where do you learn about some of the choices between therapies?
Palliative care is "great" - when you get there, and it seems there's a lot of funding and enthusiasm for palliative care. But I'm sure a lot of us would prefer more support before we get "there". Instead of "have a nice death", let's "work on your life now" 🙂. Working on one's life now is where coaching fits in. And right now there's a coaching gap.
OK. The article made me sad too. So - what am I going to do? 🏋️❤️👨👩👧👦🏋️❤️📖
Cures are never lucrative. Bridge the gap with integrative oncology and functional medicine.
Even naturopathy. The samplings out there are vast, and can be expensive but you only live once.
Chris Wark outlines some very guiding principles for working through this journey.
Let food be thy medicine to a degree. It helps. A lot.
great article, and great response JohnInTheMiddle!! " One's personal physician doesn't know very much, the medical oncologist has so little time, and where do you learn that you should exercise a lot? And where do you learn about some of the choices between therapies? "
That so many men come to HU for help with questions, and not to their physicians, says it all!!! It seems as though there is so much cancer that many Docs become desensitized to the despair that many feel when diagnosed..... I could go on and on in how I have been disappointed by the well-meaning but time-limited Docs I've visited....they don't seem to have the time to express empathy and discuss pros/cons of different options.
Maley you're comment is great. Nevertheless I want to highlight the question of empathy.1. Any person with cancer needs a lot of love and support. And we can call that empathy. So someone with cancer is very vulnerable. Where will they get this love and support?
2. And there's a huge literature about quality of life, which is often mostly about feelings. And the literature about feelings is overwhelming. And sometimes cancer is reduced to feelings.
3. This is an ideological sickness in our society. If any reader is familiar with the work of Christopher Lasch, most famously in the 1970s in the book "The Culture of Narcissism", this would be an analysis of this situation.
4. So it's kind of heartbreaking that on this forum that we spend a lot of time on feelings. This is not a criticism - just a little bit of a reflection of the atomization in our society.
5. And so we want our doctors to be empathetic and kind. And every second that the doctor spends being empathetic is less time being spent on being a good clinician.
6. Maybe some readers here might be familiar with Nassim Talib, the famous writer of "The Black Swan: The Impact Of The Highly Improbable", and other it's been difficult books on life and statistics. Talib claims that an understanding of the statistics of life leads him to conclude that on the whole grumpy doctors are likely better doctors than doctors with good bedside manners!
en.m.wikipedia.org/wiki/The...
There is also some evidence that people with good attitudes have no better outcomes with their cancer than people with bad attitudes. (And so far as people with bad attitudes are cruel to with their families, obviously a bad attitude is a very bad idea.)
7. It's probably more intellectually challenging and more hard work for any given doctor or clinician to be very good in their field. It's much easier to be empathetic.
8. So what do we want from our physicians and doctors? We want domain competence. The doctor is very good at diagnosing, and very good at knowing the latest research, and very good at knowing the latest therapies, and humble regarding the injunction "do no harm". I will say - "stay in your lane". I do want my doctor or clinician to have enough empathy to make the right diagnosis and recommendation for me as a human being, and not like some rat where they really don't care about the outcome.
9. Now we come to the profit motive. And consider financial rewards - or even for the psychosocial rewards of grateful patients. The motive of clinician or doctor can be distorted by incentives for profit and even for the display of empathy. And consider that it's a lot easier to deliver empathy to the "consumers of medical care" that it is to deliver the actual best medical care".
10. What do we want from our medical system and our doctors and physicians and clinicians? I think overall we want competence and humanity. Want them all to be really good clinicians.
11. All this is in the context of an article that says we really haven't made much progress in solving cancer!
12. So instead of solving cancer we will take your money and give you empathy. And coaching? What's that?
Great thoughts. I tend to be more cynical, but you said things that need to be said.
Unfortunately.......... we will never win............those teeny-weeny bastards are part of us... and are just like two business partners who own one establishment (they steal from one another),,,,,,
note: We Die (we win), They Die (they win)...........those fucking teeny-weeny bastards....
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 09/22/2023 2:55 PM DST
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