Questions to ask..........

[Steph]

Patients with cancer have to make very significant decisions about which, if
any, treatment to take. The aims of treatment are often rather "woolly", and
"success" is measured in things like reduced tumour markers or decreased
size of abnormalities on CT scans. These things MAY be associated with
improved outcome, but not necessarily so. The fact is that although
technically treatments are complex and require skilled supervision, the
decision to embark on a treatment should be, if not simple, at least
amenable to being assessed logically and objectively.

This is the way I get my patients to look at the cost-benefit analysis when
deciding on a course of treatment I have suggested would be right for them.
The "algorithm" isn't specific to cancer, or even orthodox medicine, but
most patients find it useful, and I hope some people on this NG may, too.

Question 1
Does the cancer I have pose a threat to my life or health?
If the answer to this is "No", then you probably shouldn't be taking
treatment.
If yes, consider treatment by going to the next question.

Question 2
Does the suggested treatment have any realistic chance of curing me, and if
so, are the side-effects and risks acceptable to me?
If the answer to either part of this is "No", then you probably shouldn't be
taking treatment.
Otherwise go to the next question.

Question 3
Although the treatment stands no real chance of curing me, does it stand a
realistic chance of extending my survival by some worthwhile amount, and are
the side-effects/risks acceptable?
If the answer to either part of this is "No", then you probably shouldn't be
taking treatment.
Otherwise go to the next question.

Question 4
Although the treatment stands no real chance of curing me, or of extending
my survival, does it stand a realistic chance of improving my quality of
life, after I have taken into account the side-effect/risks?
If "Yes", go for it.
If the answer is "No", then you probably shouldn't take the treatment.

A patient's quality of life is not measured by PSA levels, but by how they
feel and how well they are able to carry on with their life. Improvement in
a patient's quality of life is not measured by whether the oesophageal
cancer looks smaller on the CT scan, but whether the patient can swallow
better. A patient with bone pain is not better because the bone scan is
better, but because the pain is better.

Think about it.

[Robin Els]

This is fabulous Steph...where were you when we called Duke??

It's so sad..they're approach, was treat, no matter what. So it put us on guard
from the beginning, to try and guess whether they were thinking of Hannah, or
were they thinking of their records. They never acknowledged, until her tumors
grew, that this was going to kill her...almost like lying..just kept saying,
it's a bening tumor..never mentioned, the horror if it's/their location. And so
many thought I was nuts, for my views...even my pastor's wife, "chastised" me,
for not continuing treatment on her...said it was our responsibility as
Christians, to do anything to keep her here as long as possible?? Needless to
say, we're churchless right now..I just have always appreciated your
approach...I know, I'm kind of strange, but honesty is just life to me...good
on you!
Robin...mom to hannah,aka "wild thing".1/17/98 - 9/1/00 wife to E....the other
love of my life.

[Curly++]

On Wed, 1 Aug 2001 09:55:31 -0700, Steph wrote:

>Question 1
>Does the cancer I have pose a threat to my life or health?
>If the answer to this is "No", then you probably shouldn't be taking
>treatment.
>If yes, consider treatment by going to the next question.

Steph, that's great! Thanks for posting.

How would you change this to help a patient who has two or more
treatments to think about?

--
Oisin "Curly++" Curtin http://pages.infinit.net/curlypp/
"Life is a non-renewable resource, use it well." ocu...@usa.net
oligodendroglioma grade 3, 2000/Jun/1, rad SURVIVOR

[Steph]

"Curly++" <ocu...@flash.local> wrote in message
news:slrn9mjqs2....@flash.local...

> On Wed, 1 Aug 2001 09:55:31 -0700, Steph wrote:
>
> >Question 1
> >Does the cancer I have pose a threat to my life or health?
> >If the answer to this is "No", then you probably shouldn't be taking
> >treatment.
> >If yes, consider treatment by going to the next question.
>
>
> Steph, that's great! Thanks for posting.
>
> How would you change this to help a patient who has two or more
> treatments to think about?
>

I think it would be the same Curly.
Ask yourself whether treatment is necessary at all, then ask the questions
for each individual treatment, I guess.