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As a medical oncologist[1], your paragraph and that paternalistic and annoying article you cited makes me mad. The outrage with 'our language around cancer' is
by Gatsky 8y ago
As a medical oncologist[1], your paragraph and that paternalistic and annoying article you cited makes me mad. The outrage with 'our language around cancer' is a recent phenomenon, and I think it is actually not that important and even harmful. What you are proposing is to homogenise how patients cope with cancer, assuming that one way of dealing with it is qualitatively better than another. This 'one way' is a kind of stoic acceptance, an appreciation for the simple things in life, a focus on quality of life and meaningful experiences, good supportive care outcomes, ending finally with a peaceful departure surrounded by loving friends and family.
This sounds great, but it is a grave error to assume that all patients should think this way. First of all, many don't get the chance. Some patients are too alone, too poor or have too much chaos in their lives to be able to get anywhere near the 'one way'. For some patients, their cancer arrives suddenly and kills them before they have time to accept or deal with anything.
But the main point is that you can't a priori decide what is the right way for someone to deal with their illness. For some people, they need to fight it like a battle, before they can ever accept the fact they will lose. For others, they 'fight' because they know it is important to the people they love, even though they know it is probably a lost cause. Who are we to tell them that they aren't thinking about things the right way?
The final thing to say is that a cancer is incurable until it isn't. The worst thing is when a new treatment comes out (like immune checkpoint blockade), and a patient whom you know would have benefited immensely from that treatment dies just before they could have received it. There are patients I see today who decided to fight, sought out any avenue they could and are alive and going on holidays with their kids today because of it. That is a dreadfully uncomfortable notion, and something that a health system can't possibly deal with, but try telling those people that their 'language around cancer' is unhelpful. By the same token of course, there are many who never accept their illness, and waste precious time pursuing expensive, futile therapies.
In medicine, avoid generalisation and homogenisation at ALL cost. As colourful and varied as people are in their healthful lives, they are only more so when ill.
[1] In other words I give drug therapies to people with cancer. About 70% of the people I see have advanced, incurable cancer, with life spans ranging from a few years to a few months.
- hycaria 8y agoIsn't an oncologist always medical ... ?
- lazyasciiart 8y agoNo - as they explained, medical oncologists treat with drugs. Surgical oncologists operate on cancer patients, and radiation oncologists treat with radiation. https://www.cancer.net/navigating-cancer-care/cancer-basics/cancer-care-team/types-oncologists https://www.cancer.net/navigating-cancer-care/cancer-basics/...
- trhway 8y ago>Who are we to tell them that they aren't thinking about things the right way? you're an oncologist. Would it be an unreasonable expectation that you have observed/learned a correlation, if any, between patient outcomes and the various ways of thinking the patients practiced, and thus that you may have an idea what is the "right way" and what isn't?
- sbarre 8y agoThe right way for a patient to think? I don't think they teach that in medical school.
- sgt101 8y agoThis is a familiar and successful way of thinking that we are taught in school and even as scientists. The challenge is that some decisions and domains are simply not amenable to statistics and concepts like correlation break down in the face of infinite payoffs (like patients getting to go to a grandchilds wedding) and infinite penalties (like the death of a child). How does one account for a situation in which 10,000 good decisions are for nothing in the face of one mistake?
- apatters 8y agoIf I was ever diagnosed with cancer, I would fully expect to fight a hard battle which I might win or I might lose. Obviously the odds will be different depending on the type and stage of the cancer, but I don't believe for one second that individual choices will always have zero impact on the outcome. I wouldn't want anyone preparing me to die. If I die so be it but I agree that paternalistic is the appropriate word here. (As a side note, why don't we talk about things like a person's battle with heart disease? Poor cardiovascular health can be improved. It is hard but it can be done. Sounds like a battle to me.)