09.26.11
More whoopie cushion Big C news
David Muir delivered a bog standard news media whoopie cushion last night for ABC. A new imaging technique was said to be a potential “game changer” in cancer treatment.
I flinched again, wondering about the people with cancer who’d see it and get all the implications wrong.
It concerned studies in which scientists at Purdue had come up with a fluorescent technique for dyeing cancer in living tissue, increasing resolution “thirty times.” It’s an order of magnitude but not the breakthrough it was billed as.
The problem is a simple one as lots of people who go through cancer treatment know.
If you’re slated for surgery, the doctors already assume the cancer is more widespread than they can see with whatever imaging they have used. And they take everything they think prudent.
Increasing the resolution only makes the target bigger. And while it may result in some early diagnosed cancers being eradicated, it does not alter the basic outlook for a disease in which one mostly assumes the worst — that somewhere imaging may have missed a microscopic clump of metastatic cells, or even a single one.
This is what happened to my father. Suffering from bladder cancer, he went to Sloan-Kettering in Manhattan. They took just about everything they could out of him. It left him with a hole in his abdominal wall, to be used for the next five years as an outlet.
And at the five year mark, although he’d been scanned and rescanned many times in the intervening period, the cancer returned with a vengeance.
It had been in him, somewhere. Invisible to various techniques, immune to chemotherapy, slow growing until it reached some point at which it began turning over very swiftly. Faced with a terminal diagnosis he went to the Bahamas for a quack cure that had been publicized on 60 Minutes and died there.
As for those who suffer widespread metastatic disease, the kind of diagnosis that all too often presents very late because of lack of symptoms, the method described on ABC does nothing at all. It may give some satisfaction in knowing where more foci of disease are located.
But in widespread disease surgery is no longer a cure.
And such is the case with something like stage IV esophageal cancer.
There is no surgery because the disease is widespread.
Imaging has determined where it is. In the brain, a regimen of radiation therapy — and all that entails — is undertaken.
This is followed by chemotherapy to attack the disease in the rest of the system.
The statistics are grim.
From the wire, a more accurately presented truth:
An explosion of new technologies and treatments for cancer coupled with a rapid rise in cases of the disease worldwide mean cancer care is rapidly becoming unaffordable in many developed countries, oncology experts said on Monday.
With costs ballooning, a radical shift in thinking is needed to ensure fairer access to medicines and address tricky questions like balancing extra months of life for patients against costs of a new drug, technology or care plan, they said.
“The cancer community needs to take responsibility and not accept a sub-standard evidence base and an ethos of very small benefit at whatever cost,” said a report commissioned by the Lancet Oncology medical journal …
The new cancer imaging dye described by David Muir on ABC News Sunday night falls into the category of treatment described in the Reuters piece.
Off for the waiting room of the radiation ward, hoping my friend gets the best from it.
Posting will continue upon return.