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Tuesday, 7 May 2013

Stage 4 Cancer

Stage 4 Cancer Biography


It seems to be a general thought that chemotherapy will rid the body of cancer. Even when a cancer is in the later stages - stage 4 - there seems to be a hope that perhaps in some people, chemotherapy will be curative. Kind of like the lottery.
But that's not the case. And sadly, too few stage 4 lung cancer patients (and stage 4 colon cancer patients) understand that.
I have to admit, it's not just patients. Just recently I held on to a feeling that chemotherapy would cure a friend with stage 4 lung cancer. Somehow I thought that she would beat the odds, and a treatment that was only designed to lengthen life, would save hers. But that's, unfortunately, not how chemotherapy usually works for stage 4 cancer.

When chemotherapy is given for stage 4 lung cancer it can extend survival. People may live a few weeks longer. Maybe months longer. (An exception may be people treated with some of the targeted therapies such as Tarceva (erlotinib) in people with EGFR mutations or Xalkori (crizotinib) in people with ALK mutations.) Chemotherapy can also be palliative. In other words, it may kill off a part of a tumor resulting in an improvement in symptoms such as shortness of breath or coughing. But, it doesn't cure cancer. In other words, with rare but wonderful exceptions, it doesn't work like a miracle and completely clear a tumor for some fortunate people.
Researchers decided to see if patients understood this concept. In other words, what percent of patients were carrying a false hope that chemotherapy may cure their disease? The results brought tears to my eyes. 69% of stage 4 lung cancer patients (and 81% of stage 4 colorectal cancer patients) didn't understand that chemotherapy was not at all likely to cure their cancer.
It was interesting that patients who said they had good communication with their physicians were more likely to carry false hope that chemotherapy could be curative. Why? One possibility is that sharing the bad news results in patients being less happy with their physicians. Yet that's only speculation. It is, however, a thought that oncologists may wish to consider. Are they allowing their patients to feel this false hope in order to be "liked" better by their patients? On the other hand, are oncologists afraid that sharing the truth will remove hope?

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