Wednesday, August 8, 2007

Alternative Medicine

Wanted to make a comment about this, as several things came up in regards to this. The term - alternative medicine - is basically in addition to surgery, radiation, and chemo - i.e., standard medical treatments - what other things like acupunturist, massage, etc. can help in cancer treatment. A research grant was given to some doctors at the cancer center I go to to understand this better and develop guidelines that doctors can use. The first step in the study is get a better idea of what patients think about these things. I was interviewed for this. No results yet.

At yoga class I was talking about the study and a patient who goes to another clinic said this approach was integrated into her chemo sessions. An acupunturist and naturopath come in while she having her infusion. This is covered by her insurance. Then someone comes by for imagery work, which is provided by the center. Massage is an additional cost. Exercise and spirituality are not offered in any way. I thought, though, this was a good approach.

Ultrasound Result

The CT scan I had in July (routine 1 year post-chemo CT scan) indicated a nodule on my thyroid. I went to an endocrinologist and had an ultrasound last week. The endocrinologist called today with the results. Turns out there were two nodules - one about just under 1 cm that looks cystic and is probably benign. (Cystic means the nodule is filled with fluid.) To be sure, they are going to do a biopsy of it. There is always something. My mind goes to thinking it might be cancer. I know if it is, it's treatability is high. They take out your thyroid and you take medication everyday, but it's not life threatening. Still, I just don't like dealing with all this. As a fellow cancer survivor said: "Life for us will always be one more doctor appointment and every little extra test will always set are head in motion with the what ifs".

Saturday, August 4, 2007

NY Times on Cancer

The New York Times, on July 29, 2007, did a series of articles on cancer. A couple of excerpts from Denise Grady follow:

Push Hard for the Answers You Require
In a report by the Institute of Medicine, in 2002, “Uninsured cancer patients generally have poorer outcomes and are more likely to die prematurely than persons with insurance, largely because of delayed diagnosis.”


Cancer Patients, Lost in a Maze of Uneven Care
“In cancer, there is frequently no one best doctor and no one best treatment,” said Dr. John H. Glick of the Abramson Cancer Center at the University of Pennsylvania.

When patients consult him for second opinions or to transfer their care to his center, Dr. Glick estimated that he and his colleagues concur completely with the original doctor in about 30 percent of cases. But in another 30 to 40 percent of cases, they recommend major changes in the treatment plan, like a totally different chemotherapy regimen or the addition of radiation. Sometimes his team makes a completely different diagnosis.

In about another 30 percent of cases, his team recommends minor changes in chemotherapy, or additional tests. “We interpret things differently, maybe because we have more experience,” Dr. Glick said.

Warning Signs Overlooked

Karen Pasqualetto had just given birth to her first child last July when doctors discovered she had colon cancer. She was only 35, and the disease had already spread to her liver. ... Looking back, Karen Pasqualetto thinks she had cancer symptoms that were dismissed by doctors in 2003 or 2004 — at least two years before the disease became horribly obvious. She noticed blood in her stool, a classic warning sign of colon cancer. But it lasted only a few days, and such bleeding can also be caused by minor ailments like hemorrhoids. Many doctors do not even think of colon cancer in a young person with no family history of the disease, and her doctor said anal fissures had probably caused the bleeding. There is no way now to know whether that was correct. No sigmoidoscopy or colonoscopy was done to examine the inside of her colon or rectum. Other warning signs were also missed or ignored: anemia and blood in her stools during pregnancy and in the hospital after giving birth.

Ninety percent of colorectal cancers occur in people 50 and older — the reason screening generally starts at 50 — but that still leaves more than 15,000 new cases a year in younger people, some of whom have no symptoms.

The sad paradox of colon cancer is that it is often preventable — but not prevented. It is one of only two cancers (the other is cervical) for which screening tests can find cancers or precancerous growths early enough to cure the disease or even prevent it with surgery alone.
Only 39 percent of colon cancers are detected early. The disease is still the second leading cause of cancer death in the United States (lung cancer is first), with about 154,000 new cases and 52,000 deaths expected this year.