Thursday 25 October 2012

Cancer Debates


Yesterday, I read an atricle on daily telegraph about Albert Espinosa ( check also http://www.albertespinosa.com/books/el-mundo-amarillo) and although the article itself was quite encouraging, some of the comments below were really bold and some of them messed my mind.



Debate 1:
Does attitude affect the prognosis?



A lot of research and fuzz on this question as some scientists say it does, some say it doesn't. However, there is no light at the end of the tunnel because cancer remains a multifactoral disease and I am beginning to notice that doctors are frequently deceived by the test results and give prognosis that turn to be far from the outcome.  

Generally, by talking to countless doctors for the past two years and repeating the same questions I can plainly put it this way:
Oncologists' attitude is most reserved but they tend to overstress the negative outcome, perhaps in an effort to lower the patients' expectations. If things go well, the patients kiss their hand. In case things go bad, they had already informed the patients, so they keep their hands clean.
Surgeons are more optimistic. The leaps of advance in the medical/surgical field give them a slightly more positive mind and a belief that they can control the cancer but cutting of the naughty bits of tumors from here and there.
Everyone else,including patients and relatives have as many opinions as their number.
Then, in my hospital at least, the volunteers and nurses of the oncology ward share the belief that miracles do happen and those that "give up" are usually the ones to go while for those that have decided to fight , cancer means at the worst case a bad quality of life.

Some researches suggest that there are three categories of patients that generally outlive the prognosis:
a.those in denial
b.the agressive and angry ones
c. the positive and optimistic ones
(if I have the time, I should track them down and post the links...)



Debate 2:
Use of the words "fighting", "beating"  etc. as in "fighting cancer", "beating cancer"....


Some comments of relatives (of patients that passed away) on the article about Espinosa were pretty bold and stated that this phraseology is damaging and ignorant. They said that the use of this words imply that everyone that decides to stay home and not "fight" to live is thus considered a quitter and possibly coward, while in fact, accepting death is an act of courage.

My thesis in this, as a cancer patient, is a bit unrelated but I believe it to be a keen observation. I realised that relatives and loved ones are having a more difficult time to accept the situation and they tend to mature in a "slower" pace than the patients themselves. 
I have not encountered yet a fellow patient that was concerned about this phraseology. They simply don't bother and usually put such debates in the potato-potahto section. 
In the end, if we have to resort to philosophy, life means fighting. From the moment we are born and we fight to expand our lungs and breath through crying to the moment we close our eyes, surrendering to death in any form, we do fight. 
In the case of cancer, whether it is a 28 year old like me that fights to live a life yet unlived or it is a 86 year old lady that is filled with memories of gains and losses and fights to maintain her decency in her final days, it is still fighting. Both have to converse with death and learn to live with the prospect of it. But on the other hand, who doesn't? Our mortality is as certain as the rising sun. 

Finally, concerning "beating" cancer:
 who cares if the attitude served the outcome or if the chances where just good. You get a second opportunity to live and that's what matters. I say ,only God knows and decides how and when our life shall end so we should fold our sleeves and get down to do some serious living before our time comes. Right?