Was browsing this blog that I really like, and saw this report;
Most falsely believe chemo is curative
According to a study in the New England Journal of Medicine although
chemotherapy is the primary treatment for patients with lung and
colorectal cancer, it is not curative.
In an American
national survey of 1193 advanced-stage patients, 69% of patients with
lung cancer and 81% of those with colorectal cancer misunderstood the
intent of chemotherapy, mistakenly believed that chemotherapy might cure
This seemed a little crazy to me, so of
course I looked up the original New England Journal of Medicine
article. If you are feeling geeky, you can read it here: NEJM Article. (It should download as a PDF.)
you might expect, the rate of misunderstanding was greater within
non-white ethnic groups. I'd guess perhaps there were some language
barriers (doctors often throw around the term "palliative," and for a
long time, I wasn't sure what "palliative" really meant). Also, the way
serious illness is treated varies by culture. BUT the rate for white
(and I assume English as a first language) patients who thought chemo
might cure their Stage 4 colorectal cancer was still 74%, which is
high. Consider: For every demographic, more than half of patients with a
terminal illness mistakenly believed chemo treatments might cure them.
as you might also expect, the rate of misunderstanding among patients
who had lower levels of education was slightly greater...but here again,
even among patients who had a college degree or higher 75% still
thought chemo might cure their Stage 4 colorectal cancer.
article brings up several issues to consider and the researchers offer
up ideas why this might be. I was interested in the idea that while the
oncologists do communicate the truth of the situation to the patients,
there tends to be a very quick transition from discussion of the
prognosis to discussion of treatment. I have experienced this myself,
where a doctor--I think with all good intent-- quickly steers away from
the emotionality of a diagnosis, and toward the logistics of treatment.
As soon as we can start talking about the pros and cons of various
options and setting up a schedule etc., it starts to feel like we are
"doing something." This can be comforting and work as a coping mechanism
to get you through that first appointment, but the authors here (based
on yet another study ) propose that this focus on treatment can lead to
false optimism--and I have a tendency to agree.
I can imagine
there is a great temptation to bolster a patient's morale. And I even
believe that good morale can help extend someone's life...but this kind
of misunderstanding ultimately takes control from the patient.
a chemo is going to extend your life by a few months, but you're going
to feel terrible for much of that time, do you want to it? It seems
like people should get to make that choice. People should also have
time to come to terms with the end of life, to do what things they can
to put their affairs in order. Finally, for those who are truly
committed to trying to beat the odds-- given the information that
conventional means are not likely to cure they might want to try
alternative means to prolong life--be it diet, meditation or whatever.
And regardless of outcome, it could be argued that a by-product of these
alternative practices could be a better life--or a more peaceful end of