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Colon cancer patient turned away from NHS – found success treatment in Japan

melony 4y ago
I am surprised that the NHS let him leave the country. They have a poor track record of using the courts to assert their medical authority.
- DanBC 4y ago
  Over a million patient contacts per day. How many court cases?
- pmyteh 4y ago
  The courts' jurisdiction for deciding what is in the 'best interest of the patient' extends only to people not competent to make their own decisions. It's a substitute for imposing the judgement of treating doctors or families, not an override of a patient's own autonomy. It absolutely wouldn't apply here: while a competent patient can't insist on treatment doctors aren't willing to give, they're absolutely free to find one who is, in the UK or abroad, whether the treatment is effective or placebo, painless or excruciating. That does not necessarily extend to a next-of-kin; the court may rule there that the patient is better served by a relatively peaceful death rather than further treatment if it's likely to be futile and painful. Even so, that's really quite rare - a handful of very public cases about dying children notwithstanding. The hearings are in the Family Division of the High Court, or sometimes in the Court of Protection, and the judgments are public. This[0] is a fairly typical one selected at random. A very sick child at the end of life with a progressive and incurable disease, with disagreement between the parents and medical staff about the best course of treatment. It's easy to understand and well worth a read if you're interested. I don't think the court is in any way infallible, but it's a world away from some of the more tabloid criticism that's thrown at it. [0]: https://www.bailii.org/ew/cases/EWHC/Fam/2021/2927.html https://www.bailii.org/ew/cases/EWHC/Fam/2021/2927.html
- tim333 4y ago
  I think you may be thinking of Archie Battersbee who was on life support and hence couldn't just go somewhere else easily. In general if you can walk there's no problem leaving the NHS and going wherever.
ilrwbwrkhv 4y ago
Seems about right. Japan > UK > ... > Canada in innovation.
scyzoryk_xyz 4y ago
I frequent surgical and medical conferences as a PM on a product for training surgeons. I also visit hospitals etc. I’m not from the medical background but I think I’ve developed a unique perspective over this time on hospitals and surgery. I always find these kinds of headlines very irritating. It always follows something along the line of: healthcare system of country A is so bad but healthcare system of country B is so good. Or: new innovative treatment for xyz is offered here, but not over there. And then there is the worst kind: I had a <MildSymptom> and my <HealthcareProfessional> turned me away, what am I even paying for! These are invariably by residents of first world countries. People who expect that their relatively low monthly insurance payments should give them space age medical tech. Or that when they have some extremely rare disease, that they should get multi-million dollar niché treatment immediately. Thing is - more often than you would think they really do. The closer you are to a big western metropolis, the more likely it is that you will receive state of the art care from a super-specialist with space-age tech. It’s just a matter of probability. But there are also situations where you won’t. The system can’t afford to throw Dr. House and his team at every patient walking in off the street. You also just might not come across someone who understands your specific case and all the latest in medical treatments. It might be that the thing that can save you is so unique that only several people in the world know enough about it to be able to help. Spewing hate at the system or at practitioners is just fucking awful. They’re essentially sitting there all day making trolley-track-payoff decisions. Don’t get me wrong. It’s fantastic that this guy found a way, found the funding, got the treatment for his kids and all. And it’s awesome that he’s representing others seeking help. But our healthcare systems work incredibly damn well, it’s just that there is an infinity of ways in which we get sick…
- omreaderhn 4y ago
  > Spewing hate at the system or at practitioners is just fucking awful. It's as awful as it is unwarranted. > The system can’t afford to throw Dr. House and his team at every patient walking in off the street. Telling a patient they're inoperable or not a candidate for immunotherapy or are going to die in 6 months from their disease is immoral and yet very common. It's really not difficult to just say to someone "based on my experience and the protocols we have at this institution, this is what I believe to be the case for your situation but you may find others with a different perspective". There's a seriously depraved amount of egoism and elitism in the medical world, in particular among younger medical professionals. > They’re essentially sitting there all day making trolley-track-payoff decisions. Yes but that's precisely not their job in a non-emergency context. They're not philosophers, they're not Maimonides. Their job is to provide medical expertise, not make value judgements on behalf of patients or arrogate themselves to a level of expertise or knowledge they don't have.
sniperjoe360 4y ago
To put on my best British accent "complete rubbish". The UK runs world-class trials in adoptive cell transfer and other cell based therapies for cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442586/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442586/ I surmise it was the radiation, chemotherapy, and surgery that contributed most to a 5+ year survival and no evidence of disease. This is available worldwide. Adoptive cell transfer has a complete response rate of 10-30% in unselected patients. By far the most important recent advance in metastatic colon cancer is PDL1 directed immunotherapy for microsattelite instable colon cancer. This is also readily available in the UK Source: I am a cancer doctor in the US and I treat colorectal cancer

I am surprised that the NHS let him leave the country. They have a poor track record of using the courts to assert their medical authority.

DanBC 4y ago
Over a million patient contacts per day. How many court cases?
pmyteh 4y ago
The courts' jurisdiction for deciding what is in the 'best interest of the patient' extends only to people not competent to make their own decisions. It's a substitute for imposing the judgement of treating doctors or families, not an override of a patient's own autonomy. It absolutely wouldn't apply here: while a competent patient can't insist on treatment doctors aren't willing to give, they're absolutely free to find one who is, in the UK or abroad, whether the treatment is effective or placebo, painless or excruciating. That does not necessarily extend to a next-of-kin; the court may rule there that the patient is better served by a relatively peaceful death rather than further treatment if it's likely to be futile and painful. Even so, that's really quite rare - a handful of very public cases about dying children notwithstanding. The hearings are in the Family Division of the High Court, or sometimes in the Court of Protection, and the judgments are public. This[0] is a fairly typical one selected at random. A very sick child at the end of life with a progressive and incurable disease, with disagreement between the parents and medical staff about the best course of treatment. It's easy to understand and well worth a read if you're interested. I don't think the court is in any way infallible, but it's a world away from some of the more tabloid criticism that's thrown at it. [0]: https://www.bailii.org/ew/cases/EWHC/Fam/2021/2927.html https://www.bailii.org/ew/cases/EWHC/Fam/2021/2927.html
tim333 4y ago
I think you may be thinking of Archie Battersbee who was on life support and hence couldn't just go somewhere else easily. In general if you can walk there's no problem leaving the NHS and going wherever.

ilrwbwrkhv 4y ago

Seems about right. Japan > UK > ... > Canada in innovation.

scyzoryk_xyz 4y ago

I frequent surgical and medical conferences as a PM on a product for training surgeons. I also visit hospitals etc. I’m not from the medical background but I think I’ve developed a unique perspective over this time on hospitals and surgery. I always find these kinds of headlines very irritating. It always follows something along the line of: healthcare system of country A is so bad but healthcare system of country B is so good. Or: new innovative treatment for xyz is offered here, but not over there. And then there is the worst kind: I had a <MildSymptom> and my <HealthcareProfessional> turned me away, what am I even paying for! These are invariably by residents of first world countries. People who expect that their relatively low monthly insurance payments should give them space age medical tech. Or that when they have some extremely rare disease, that they should get multi-million dollar niché treatment immediately. Thing is - more often than you would think they really do. The closer you are to a big western metropolis, the more likely it is that you will receive state of the art care from a super-specialist with space-age tech. It’s just a matter of probability. But there are also situations where you won’t. The system can’t afford to throw Dr. House and his team at every patient walking in off the street. You also just might not come across someone who understands your specific case and all the latest in medical treatments. It might be that the thing that can save you is so unique that only several people in the world know enough about it to be able to help. Spewing hate at the system or at practitioners is just fucking awful. They’re essentially sitting there all day making trolley-track-payoff decisions. Don’t get me wrong. It’s fantastic that this guy found a way, found the funding, got the treatment for his kids and all. And it’s awesome that he’s representing others seeking help. But our healthcare systems work incredibly damn well, it’s just that there is an infinity of ways in which we get sick…

omreaderhn 4y ago
> Spewing hate at the system or at practitioners is just fucking awful. It's as awful as it is unwarranted. > The system can’t afford to throw Dr. House and his team at every patient walking in off the street. Telling a patient they're inoperable or not a candidate for immunotherapy or are going to die in 6 months from their disease is immoral and yet very common. It's really not difficult to just say to someone "based on my experience and the protocols we have at this institution, this is what I believe to be the case for your situation but you may find others with a different perspective". There's a seriously depraved amount of egoism and elitism in the medical world, in particular among younger medical professionals. > They’re essentially sitting there all day making trolley-track-payoff decisions. Yes but that's precisely not their job in a non-emergency context. They're not philosophers, they're not Maimonides. Their job is to provide medical expertise, not make value judgements on behalf of patients or arrogate themselves to a level of expertise or knowledge they don't have.

sniperjoe360 4y ago

To put on my best British accent "complete rubbish". The UK runs world-class trials in adoptive cell transfer and other cell based therapies for cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442586/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442586/ I surmise it was the radiation, chemotherapy, and surgery that contributed most to a 5+ year survival and no evidence of disease. This is available worldwide. Adoptive cell transfer has a complete response rate of 10-30% in unselected patients. By far the most important recent advance in metastatic colon cancer is PDL1 directed immunotherapy for microsattelite instable colon cancer. This is also readily available in the UK Source: I am a cancer doctor in the US and I treat colorectal cancer