4 ms·

Without scientific evidence the young doctors would be guessing and that would not be responsible of them. Without scientific evidence, you are guessing too.

jcims 7y ago
Philosophically there's nothing wrong with what you're saying, but it's not particularly applicable. None of the 'standard of care' therapies for, in our case, ovarian cancer are guaranteed to be effective...they simply have hazard ratios that are more favorable than the rest. So, quite literally, doctors are already guessing as to what to do next once you are in a recurrent cancer setting (even before, really). On top of that there is a mountain of clinical evidence that high dose intravenous vitamin C (IVC) has an incredibly low risk of adverse events in healthy patients and there have been clinical trials and case studies indicating that it improves quality of life in cancer patients undergoing chemotherapy. Evidence that IVC actually has a therapeutic benefit in killing cancer is starting to emerge, but definitely needs work to meet the standard of testing that is generally mandated for something to become standard of care. So now we're in this weird local minima of scientific interest in a potential therapy. Nobody that I've seen is seriously suggesting that IVC is an effective monotherapy against any kind of cancer. But there is growing evidence that it is a safe and effective adjunct therapy to increase quality of life and potential outcomes for many patients. Unfortunately, clinical trials are expensive and most oncology teams are not interested in results that haven't specifically tested the cancer that they specialize in. So you are left with waiting for someone to explore the enormous graph of specific cancer treatment settings and apply this trial. In other words, it's not coming to a theater near you any time soon. Meanwhile people are dying because the current treatments are not working, and finding a doctor with the guts to explore these options with a willing and educated patient is, in my personal experience, next to impossible.
- Retric 7y ago
  Cancer patients in chemo are the opposite of healthy. They are at vastly higher risk for a huge range of things because the ideal chemo treatment takes someone to literally the edge of death while killing off as many cancer cells as possible. Cancer meanwhile is doing it’s best to evolve past this setback to continue growing as fast as possible. This quite reasonably makes most doctors very cautious during the process. To the point where significant studies on exercise have been done to verify it’s still safe.
  - jcims 7y ago
    I understand this perspective, but I wholeheartedly feel that a patient should have agency in any decision where risk is involved. They certainly have the agency to deny treatment when it clearly is going to result in their accelerated demise, but they have no ability to access treatment that, at worst, could result in the same but at best give them a bit more quality or quantity of life.
    - asdff 7y ago
      It seems like a fair request, that you should be able to do what you want, but that isn't what you are asking of the doctor in this situation. You are asking them to do something outside the bounds of their profession to do what you want. An extreme example would be if a suicidal patient asked their therapist to put a bullet in their head rather than give them an antidepressant, should the patient be free to ask for this and should the therapist be obligated to fulfill this request? It's a question of what is ethical and that goes beyond your own agency. You are free to put a bullet in your own head, or find your own source of vitamin C, but you can't put that ethical dilemma on the doctor and expect a result.
  - ohmanthatsnotso 7y ago
    Cancer is not an entity, or creature. The whole concept of “fighting the cancer” or “cancer is doing it’s best” is completely misguided. Cancer are damaged cells in a highly acidic body. Chemo is adding even more acid to the body. Cancer appears to spread and grow since all conventional treatments do not understand the very basic concepts of cancer. There is no catalog of hundreds types of cancers. This is a man made industry. Eye cancer is lung cancer is prostate cancer. It’s just the location in which your body was unable to eliminate waste through the lymphatic system. Create a base chemistry and your lymphatic system and kidneys will be able to eliminate. Every person who suspects having “cancer” or really any sort of tumor or cyst should be consuming only fruits high in astringents such as organic grapes and aronia. And absolutely never get a biopsy. The body knows to keep the damaged cell inside a tumor and medical doctors decided the best thing to do was poke holes in it, which then makes it far easier to spread. Insanity...
- jcranmer 7y ago
  Regulators here generally have a mandate to screen for both safety and efficacy. I think the mandate for efficacy is quite important--if you loosen standards there, you get warped incentives, and you'll end up spending lots of money on things that the producers know don't work. We already have an example of such an industry in the health supplement industry.
- refurb 7y ago
  So, quite literally, doctors are already guessing as to what to do next once you are in a recurrent cancer setting (even before, really). If they have data on different therapies, they are not guessing. The data might not be perfect, but it's all we have, so it guides clinical decisions. On top of that there is a mountain of clinical evidence that high dose intravenous vitamin C (IVC) has an incredibly low risk of adverse events in healthy patients and there have been clinical trials and case studies indicating that it improves quality of life in cancer patients undergoing chemotherapy. I think we have different definitions of "mountain of clinical evidence". There is more data to back up the standard of care than the use of vitamin C.
  - jcims 7y ago
    >If they have data on different therapies, they are not guessing. The data might not be perfect, but it's all we have, so it guides clinical decisions. I'm sorry but there are cases where they are definitely guessing and will sometimes admit as much. It's an educated guess but if you ask a doc to, for example, strongly justify why they selected one of the three approved PARP inhibitors for an ovarian cancer therapy, you're going to see a little of that uncertainty in living color.
    - ksaun 7y ago
      My personal experience is consistent with what jcims describes. My situation is sufficiently atypical that it's been challenging to find consensus among multiple oncologists and oncological surgeons. The burden is on the patient to be their own advocate and parse through the various opinions (and their own research) to decide on the best treatment choices, with the assistance and guidance of the experts. Because despite them being experts, they have insufficient time to research and understand all of factors that are applicable to an individual's situation. (For example, in at least one matter, I proposed a significant change to the treatment plan and my oncologist agreed with the underlying logic and we made the change. Had I not mentioned it, it wouldn't have happened.) It seems like there are a few bounds within which a doctor, and the healthcare system (including insurance companies), are prepared/allowed to vary treatment. I imagine some patients, especially those with potentially terminal conditions, are interested in treatment options that fall outside of those bounds. (Perhaps if one's cancer follows one of the most normal/common paths, then blindly following standard of care is sufficiently wise. I'm not sure how often this is the case, but my impression is that there is great variation even within cancers of the same general type.)
- appleiigs 7y ago
  I would like to apologize for my terse comment earlier. I was a mode where I was reading and writing fast. I'm sorry that you and your wife are going through this. After reading your reply and re-reading your orignal comment, I see your point of view and it has more weight on me given your situation.
  - jcims 7y ago
    It's all good, it's the healthiest starting point to take!
hetman 7y ago
I don't think the issue here is about guessing. It's about how reluctant many doctors can be about exploring scientific paths which are newer and as yet less traveled. To be sure, it would take a non-trivial time investment on their part. However, many doctors (though not all) seem entirely blind to anything they are not familiar with already, even if there would be reasonable scientific basis. There can be a level of pride there.

jcims 7y ago

Philosophically there's nothing wrong with what you're saying, but it's not particularly applicable. None of the 'standard of care' therapies for, in our case, ovarian cancer are guaranteed to be effective...they simply have hazard ratios that are more favorable than the rest. So, quite literally, doctors are already guessing as to what to do next once you are in a recurrent cancer setting (even before, really). On top of that there is a mountain of clinical evidence that high dose intravenous vitamin C (IVC) has an incredibly low risk of adverse events in healthy patients and there have been clinical trials and case studies indicating that it improves quality of life in cancer patients undergoing chemotherapy. Evidence that IVC actually has a therapeutic benefit in killing cancer is starting to emerge, but definitely needs work to meet the standard of testing that is generally mandated for something to become standard of care. So now we're in this weird local minima of scientific interest in a potential therapy. Nobody that I've seen is seriously suggesting that IVC is an effective monotherapy against any kind of cancer. But there is growing evidence that it is a safe and effective adjunct therapy to increase quality of life and potential outcomes for many patients. Unfortunately, clinical trials are expensive and most oncology teams are not interested in results that haven't specifically tested the cancer that they specialize in. So you are left with waiting for someone to explore the enormous graph of specific cancer treatment settings and apply this trial. In other words, it's not coming to a theater near you any time soon. Meanwhile people are dying because the current treatments are not working, and finding a doctor with the guts to explore these options with a willing and educated patient is, in my personal experience, next to impossible.

Retric 7y ago
Cancer patients in chemo are the opposite of healthy. They are at vastly higher risk for a huge range of things because the ideal chemo treatment takes someone to literally the edge of death while killing off as many cancer cells as possible. Cancer meanwhile is doing it’s best to evolve past this setback to continue growing as fast as possible. This quite reasonably makes most doctors very cautious during the process. To the point where significant studies on exercise have been done to verify it’s still safe.
- jcims 7y ago
  I understand this perspective, but I wholeheartedly feel that a patient should have agency in any decision where risk is involved. They certainly have the agency to deny treatment when it clearly is going to result in their accelerated demise, but they have no ability to access treatment that, at worst, could result in the same but at best give them a bit more quality or quantity of life.
  - asdff 7y ago
    It seems like a fair request, that you should be able to do what you want, but that isn't what you are asking of the doctor in this situation. You are asking them to do something outside the bounds of their profession to do what you want. An extreme example would be if a suicidal patient asked their therapist to put a bullet in their head rather than give them an antidepressant, should the patient be free to ask for this and should the therapist be obligated to fulfill this request? It's a question of what is ethical and that goes beyond your own agency. You are free to put a bullet in your own head, or find your own source of vitamin C, but you can't put that ethical dilemma on the doctor and expect a result.
- ohmanthatsnotso 7y ago
  Cancer is not an entity, or creature. The whole concept of “fighting the cancer” or “cancer is doing it’s best” is completely misguided. Cancer are damaged cells in a highly acidic body. Chemo is adding even more acid to the body. Cancer appears to spread and grow since all conventional treatments do not understand the very basic concepts of cancer. There is no catalog of hundreds types of cancers. This is a man made industry. Eye cancer is lung cancer is prostate cancer. It’s just the location in which your body was unable to eliminate waste through the lymphatic system. Create a base chemistry and your lymphatic system and kidneys will be able to eliminate. Every person who suspects having “cancer” or really any sort of tumor or cyst should be consuming only fruits high in astringents such as organic grapes and aronia. And absolutely never get a biopsy. The body knows to keep the damaged cell inside a tumor and medical doctors decided the best thing to do was poke holes in it, which then makes it far easier to spread. Insanity...
jcranmer 7y ago
Regulators here generally have a mandate to screen for both safety and efficacy. I think the mandate for efficacy is quite important--if you loosen standards there, you get warped incentives, and you'll end up spending lots of money on things that the producers know don't work. We already have an example of such an industry in the health supplement industry.
refurb 7y ago
So, quite literally, doctors are already guessing as to what to do next once you are in a recurrent cancer setting (even before, really). If they have data on different therapies, they are not guessing. The data might not be perfect, but it's all we have, so it guides clinical decisions. On top of that there is a mountain of clinical evidence that high dose intravenous vitamin C (IVC) has an incredibly low risk of adverse events in healthy patients and there have been clinical trials and case studies indicating that it improves quality of life in cancer patients undergoing chemotherapy. I think we have different definitions of "mountain of clinical evidence". There is more data to back up the standard of care than the use of vitamin C.
- jcims 7y ago
  >If they have data on different therapies, they are not guessing. The data might not be perfect, but it's all we have, so it guides clinical decisions. I'm sorry but there are cases where they are definitely guessing and will sometimes admit as much. It's an educated guess but if you ask a doc to, for example, strongly justify why they selected one of the three approved PARP inhibitors for an ovarian cancer therapy, you're going to see a little of that uncertainty in living color.
  - ksaun 7y ago
    My personal experience is consistent with what jcims describes. My situation is sufficiently atypical that it's been challenging to find consensus among multiple oncologists and oncological surgeons. The burden is on the patient to be their own advocate and parse through the various opinions (and their own research) to decide on the best treatment choices, with the assistance and guidance of the experts. Because despite them being experts, they have insufficient time to research and understand all of factors that are applicable to an individual's situation. (For example, in at least one matter, I proposed a significant change to the treatment plan and my oncologist agreed with the underlying logic and we made the change. Had I not mentioned it, it wouldn't have happened.) It seems like there are a few bounds within which a doctor, and the healthcare system (including insurance companies), are prepared/allowed to vary treatment. I imagine some patients, especially those with potentially terminal conditions, are interested in treatment options that fall outside of those bounds. (Perhaps if one's cancer follows one of the most normal/common paths, then blindly following standard of care is sufficiently wise. I'm not sure how often this is the case, but my impression is that there is great variation even within cancers of the same general type.)
appleiigs 7y ago
I would like to apologize for my terse comment earlier. I was a mode where I was reading and writing fast. I'm sorry that you and your wife are going through this. After reading your reply and re-reading your orignal comment, I see your point of view and it has more weight on me given your situation.
- jcims 7y ago
  It's all good, it's the healthiest starting point to take!

hetman 7y ago

I don't think the issue here is about guessing. It's about how reluctant many doctors can be about exploring scientific paths which are newer and as yet less traveled. To be sure, it would take a non-trivial time investment on their part. However, many doctors (though not all) seem entirely blind to anything they are not familiar with already, even if there would be reasonable scientific basis. There can be a level of pride there.