Being diagnosed with a life changing illness opens up a Pandora’s box of emotions. It is a time of great confusion and vulnerability.
It is not only difficult to the patient and family but to the doctor as well. Having these patients in front of us stirs up our emotions as well. It brings to the forefront questions about life that perhaps we wouldn’t even consider during good times.
But most difficult of all is to be able to balance the need to bring hope and at the same time being in touch with reality.
Unlike in the past, a cancer diagnosis is no longer a death sentence all the time. There are patients who have survived more than the usual 5 years of monitoring after treatment. We have patients who have survived 10 years and still counting while there are also those who have succumbed to conditions entirely unrelated to the cancer. There are cancers where 60 to 80% of patients will be cured.
There are patients who have beaten all odds and have lived decades of productive and meaningful lives after treatment. There are patients who seemed to have lost all hope but are now a manifestation and evidence of what was once thought to be impossible.
The Not So Good
However, there are also patients who are not as fortunate. What is difficult on the part of the doctor is that there are few instances when our treatments are very specific and targeted. More often, we are like blind agents applying treatment to patients. Among 100 patients that we treat, there is the possibility that only 10 to 20 of these patients will respond yet we need to apply the treatment to these 100 patients to get that much response. There are still few cancers where we are more definite that we have already filtered those patients who have a very high likelihood of responding or not to treatment.
Moreover, even when we are able to pinpoint specifically those who are likely to respond, we have yet to deal with the potential side-effects and complications of treatment. There are milder forms of drugs available now. There are even oral forms of treatment that can eliminate the necessity of repeated hospital treatments but they are fewer than the conventional treatment. Sometimes, patients think that because their treatment is oral, it is just like taking any other drug.
Chemotherapy is chemotherapy whether intravenous (given through the veins) or oral (in tablet form). Although some are mild, they are not completely free of inconveniences and the same precautions, as in those taking the conventional drugs, must be taken.
Whether one sees cancer treatment as hype or hope, I must be careful not to push the line too much towards either side. I must as often as possible walk the tightrope as delicately and painstakingly as I can