Hippocratic oath and cancer treatment

tachilders

It seems odd to me that one of the core principles of the Hippocratic oath (that all physicians take) is to do no harm, yet it is obvious that ALL chemo treatments eventually do harm to the recipient.  I fully understand that chemo is usually much better than not taking treatment, but it's a bit odd that oncologists seem to ignore the "do no harm" principle so easily.  They also don't seem reluctant at all to do a LOT of CT scans, even though it is known that the radiation is not good for you.  Seems like MRIs and/or PET scans would be preferable, from a patient safety perspective.  All this talk about big pharma, hospitals, insurance companies, etc... has made to start to wonder if ANYONE actually has the best interest of the patient in mind, including the doctors.... 

I am truly beginning to belive that the ONLY way to address this issue is to make the ENTIRE medical industry a not for profit enterprise.  You will initially take some hit on innovation in drug development and maybe medical procedures, but in the long run I think the system would be waaaay better off.

Tedd

PhillieG

Do No Harm - To Our Bottom Line...

I needed surgery but the scapel hurt me so I called it off!

Sorry if I sound like I'm poking fun but I find the post a bit amusing. Not to say that you're not making a valid point because I think you are but sometimes you have to crack a few eggs to make an omelet as the saying goes.

If they didn't scan with some frequency then they'd get hit with "well why didn't you catch it?" If they replied "I didn't want to expose you to side effects of scans so I let the cancer grow instead" that would not go over well...

When you talk about hospitals, big pharm, insurance companies, and the "business" of cancer I think the bottom line here, like it is with how our country (and others) operate is "make us profits - so what if we do a little harm"

tachilders

PhillieG said:

Do No Harm - To Our Bottom Line...

I needed surgery but the scapel hurt me so I called it off!

Sorry if I sound like I'm poking fun but I find the post a bit amusing. Not to say that you're not making a valid point because I think you are but sometimes you have to crack a few eggs to make an omelet as the saying goes.

If they didn't scan with some frequency then they'd get hit with "well why didn't you catch it?" If they replied "I didn't want to expose you to side effects of scans so I let the cancer grow instead" that would not go over well...

When you talk about hospitals, big pharm, insurance companies, and the "business" of cancer I think the bottom line here, like it is with how our country (and others) operate is "make us profits - so what if we do a little harm"

Big difference between a

Big difference between a scalpel and chemotherapy, or repeated CT scans, but I get your point.  I'm just questioning the use of CT scans versus other options that actually don't expose one to so much radiation.  My understanding is that one CT is like getting 500 X-rays.  With respect to chemo, it causes all sorts of problems (liver, kidney, immune system).  I'm taking it right now, but I have no idea what kind of long term damage it may be causing me.  It's obviously a choice between teh cancer and teh chemo, but cancer seems to be the only area in medicine where they will do a lot of harm to the patient.  As an example, my dad had multiple myeloma (he died 8 years ago from it), but when he was in the hospital near the end, he had a GI bleed somewhere (causing him to need 2 units of blood a day), but they refused to do a die test to find the bleed because it might destroy the tiny bit of kidney function he had left.  You can take dialysis if your kidneys don't work, but you can't survive long by taking 2 units of blood a day.  In his case, they basically chose to let him die rather than harm his kidneys, but his (and my) oncologists don't seem to follow that same belief.  I'm not even sure what I am trying to say, other than I wish oncologists would take a stand and demand options other than chemo...  The whole system is screwed up, and it's all due to money.

manwithnoname

tachilders said:

Big difference between a

Big difference between a scalpel and chemotherapy, or repeated CT scans, but I get your point.  I'm just questioning the use of CT scans versus other options that actually don't expose one to so much radiation.  My understanding is that one CT is like getting 500 X-rays.  With respect to chemo, it causes all sorts of problems (liver, kidney, immune system).  I'm taking it right now, but I have no idea what kind of long term damage it may be causing me.  It's obviously a choice between teh cancer and teh chemo, but cancer seems to be the only area in medicine where they will do a lot of harm to the patient.  As an example, my dad had multiple myeloma (he died 8 years ago from it), but when he was in the hospital near the end, he had a GI bleed somewhere (causing him to need 2 units of blood a day), but they refused to do a die test to find the bleed because it might destroy the tiny bit of kidney function he had left.  You can take dialysis if your kidneys don't work, but you can't survive long by taking 2 units of blood a day.  In his case, they basically chose to let him die rather than harm his kidneys, but his (and my) oncologists don't seem to follow that same belief.  I'm not even sure what I am trying to say, other than I wish oncologists would take a stand and demand options other than chemo...  The whole system is screwed up, and it's all due to money.

I agree

after brain surgery ICU wanted to do CT instead of the usual MRI, my wife hit the roof, the DR. backed down and after he left all the nurses congratulated my wife and said she was completly right, but imagine a parent that wasn't informed and finding out later they just did 500X x-ray dose to their kids head.

This happens way to often.

pete43lost_at_sea

thanks ted, great points

my take is like phils its profit driven, your best defence is being a very assertive shopper, demand what you want, state what you don't want.

re ct and radiation, excellent warnings, its on my blog, its over a year old, but your can get ultra low dose ct about 30% standard cts. but your got to insist and find the machines.

its worth the effort in my opinion, the risk of secondary cancer from ct abuse is estimated to be about 2%.

in germany i have monthly mri, they can see everything they need except for the lungs.

relax and use whatever medical services can help you the best, the realisations you are having occur when you become an informed independent patient.

i think thats an excellent prognostic indicator.

i think most doctors are not greedy, they are very decent caring fellows, basically trapped in a system that restricts there capacity to deliver they should. when you take responsibility i think you will be surprised how accomodating onc and surgeons are when you make suggestions about treatments, they would not legally be able to suggest, but if you say this is what i want, they probably will nod and say that its ok. cimetidine and psk come to my mind in my case.

hugs,

Pete

ron50

G'day Tedd
I have to agree that cancer has caused the Do no harm rule to be chucked out the window. Phil I acknowledge that sometimes drastic problems require drastic solutions. I am in a position to comment on the "was it worth it"side of the argument. I am getting progressively more ill and even the hardest to convince of my doctors are agreeing that my treatments have a lot to do with my current state of health.
What I do object to with the Do no harm rule is the medications that are being prescribed for arthritis and other problems like chrones and ulcerative coloitis. Technically these are not life threatening conditions in the same way ca is. The treatments being used are diabolical ranging from life altering steroids to a range of powerful immuno-suppressants and chemo agents. There just does not seem to be any nice alternatives for sufferers of these conditions. What alarms me most of all is that they are not only prescribed for old farts like me but for very young children. I am scheduled to see my rheumatologist soon. My nephrologist believes the state of my arthritis and spondyliitis have destroyed my quality of life . When I see him I am going to ask to go on a trial of ldn,low dose naltrexone. His preference is Humira or imuran. Ldn is used at full dose for heroin addiction ,usually 50mg but at low dose 4.5 mg at bedtime it is showing great promise in its ability to restart a normal immune system. It is being used in inflammatory bowel disease,MS,arthritis,aids and a host of other auto-immune disease. I hope he will agree. It is a very old drug and I believe out of patent so quite cheap. It has suffered from a lack of resaerch and only comes in the 50mg dose so lesser doses have to be made by a compounding chemist. The upside is that at 4.5 mg a night there have been minimal side effects and none that are considered dangerous. It appears to be at low dose a completely safe drug,I will let you know how I go. Ron.

So Worried

ron50 said:

G'day Tedd
I have to agree that cancer has caused the Do no harm rule to be chucked out the window. Phil I acknowledge that sometimes drastic problems require drastic solutions. I am in a position to comment on the "was it worth it"side of the argument. I am getting progressively more ill and even the hardest to convince of my doctors are agreeing that my treatments have a lot to do with my current state of health.
What I do object to with the Do no harm rule is the medications that are being prescribed for arthritis and other problems like chrones and ulcerative coloitis. Technically these are not life threatening conditions in the same way ca is. The treatments being used are diabolical ranging from life altering steroids to a range of powerful immuno-suppressants and chemo agents. There just does not seem to be any nice alternatives for sufferers of these conditions. What alarms me most of all is that they are not only prescribed for old farts like me but for very young children. I am scheduled to see my rheumatologist soon. My nephrologist believes the state of my arthritis and spondyliitis have destroyed my quality of life . When I see him I am going to ask to go on a trial of ldn,low dose naltrexone. His preference is Humira or imuran. Ldn is used at full dose for heroin addiction ,usually 50mg but at low dose 4.5 mg at bedtime it is showing great promise in its ability to restart a normal immune system. It is being used in inflammatory bowel disease,MS,arthritis,aids and a host of other auto-immune disease. I hope he will agree. It is a very old drug and I believe out of patent so quite cheap. It has suffered from a lack of resaerch and only comes in the 50mg dose so lesser doses have to be made by a compounding chemist. The upside is that at 4.5 mg a night there have been minimal side effects and none that are considered dangerous. It appears to be at low dose a completely safe drug,I will let you know how I go. Ron.

Tedd...

Hi Tedd,

I do agree with you somewhat. When my hubby was dx, we went to the onc to talk about possible treatment after his surgery. My hubby is stage 2 and the onc said, YES, chemo....wanted him to do folfox.  Well, in the first place chemo for stage 2 is pretty controversial. He didn't even tell him what to expect, just said "you'll be a little tired and you'll wear a bag with the chemo...etc, etc. Didn't really explain anything. We are brand new to cancer and back in July we did not know ONE thing. The only thing we knew is he had cancer and it was stage 2 and he had surgery and part of his colon removed. That was it!! Never knew anyone with cancer..nothing! (guess we are or were lucky)  So he says we can go right down the hall and get an appointment to get the port put in. So we walk down the hall and my hubby says to me.....bulls***, I'm thinking about this and he left and went out to the car while I checked out. The girl kept saying when are you coming to get the port? Tomorrow? How about Monday? on and on and I finally looked at her and said....we will call if he's getting it.  My point is, they were very pushy into him getting that port put right in. They couldn't get it in fast enough. I realize that they like to start chemo within a month to 6 weeks...but this was more "pushy".  My feeling is (and I know I'm right) that they saw what good insurance we had and they wanted that port put in asap =  $$$$$ in my opinion   To sum up really quickly...we went to a 2nd opinion onc who spent over an hour with us. Explained every single little thing, every single little percentage about doing it, not doing it, etc, etc.....drew pictures even....he could not have been more thorough!! He was out of town about 4 hours away and he was super. He told us to think about it (didn't tell us to go down the hall to get an appt for a port) He even gave me his email if we had any questions at all. Anyway, my hubby decided not to do the chemo.  Sorry, I think this post turned more into a comparison between oncs....hopefully I made my money point though LOL  

PhillieG

So Worried said:

Tedd...

Hi Tedd,

I do agree with you somewhat. When my hubby was dx, we went to the onc to talk about possible treatment after his surgery. My hubby is stage 2 and the onc said, YES, chemo....wanted him to do folfox.  Well, in the first place chemo for stage 2 is pretty controversial. He didn't even tell him what to expect, just said "you'll be a little tired and you'll wear a bag with the chemo...etc, etc. Didn't really explain anything. We are brand new to cancer and back in July we did not know ONE thing. The only thing we knew is he had cancer and it was stage 2 and he had surgery and part of his colon removed. That was it!! Never knew anyone with cancer..nothing! (guess we are or were lucky)  So he says we can go right down the hall and get an appointment to get the port put in. So we walk down the hall and my hubby says to me.....bulls***, I'm thinking about this and he left and went out to the car while I checked out. The girl kept saying when are you coming to get the port? Tomorrow? How about Monday? on and on and I finally looked at her and said....we will call if he's getting it.  My point is, they were very pushy into him getting that port put right in. They couldn't get it in fast enough. I realize that they like to start chemo within a month to 6 weeks...but this was more "pushy".  My feeling is (and I know I'm right) that they saw what good insurance we had and they wanted that port put in asap =  $$$$$ in my opinion   To sum up really quickly...we went to a 2nd opinion onc who spent over an hour with us. Explained every single little thing, every single little percentage about doing it, not doing it, etc, etc.....drew pictures even....he could not have been more thorough!! He was out of town about 4 hours away and he was super. He told us to think about it (didn't tell us to go down the hall to get an appt for a port) He even gave me his email if we had any questions at all. Anyway, my hubby decided not to do the chemo.  Sorry, I think this post turned more into a comparison between oncs....hopefully I made my money point though LOL  

Hi

I'm glad you're husband is doing well. There are SO many options and schools of thought out there. Much of the time it's pushed on us without US knowing what may happen. The bottom line is that we need to get those second, third, whatever opinions and make the best decision that we can

PhillieG

ron50 said:

G'day Tedd
I have to agree that cancer has caused the Do no harm rule to be chucked out the window. Phil I acknowledge that sometimes drastic problems require drastic solutions. I am in a position to comment on the "was it worth it"side of the argument. I am getting progressively more ill and even the hardest to convince of my doctors are agreeing that my treatments have a lot to do with my current state of health.
What I do object to with the Do no harm rule is the medications that are being prescribed for arthritis and other problems like chrones and ulcerative coloitis. Technically these are not life threatening conditions in the same way ca is. The treatments being used are diabolical ranging from life altering steroids to a range of powerful immuno-suppressants and chemo agents. There just does not seem to be any nice alternatives for sufferers of these conditions. What alarms me most of all is that they are not only prescribed for old farts like me but for very young children. I am scheduled to see my rheumatologist soon. My nephrologist believes the state of my arthritis and spondyliitis have destroyed my quality of life . When I see him I am going to ask to go on a trial of ldn,low dose naltrexone. His preference is Humira or imuran. Ldn is used at full dose for heroin addiction ,usually 50mg but at low dose 4.5 mg at bedtime it is showing great promise in its ability to restart a normal immune system. It is being used in inflammatory bowel disease,MS,arthritis,aids and a host of other auto-immune disease. I hope he will agree. It is a very old drug and I believe out of patent so quite cheap. It has suffered from a lack of resaerch and only comes in the 50mg dose so lesser doses have to be made by a compounding chemist. The upside is that at 4.5 mg a night there have been minimal side effects and none that are considered dangerous. It appears to be at low dose a completely safe drug,I will let you know how I go. Ron.

Hi Ron

I have little doubt that if things didn't go like they have for me I'd have a different view on the eggs...while I'm not TOTALLY unusual with my results I certainly can't (and try not to) come off like my results are what everyone can have if they follow my example.

There are so many factors involved with cancer. In my opinion, NOBODY can tout a "Cure" simply because there isn't one cure.

I know you've had a heII of a time Ron, I wish things went better. You're certainly an inspiration to me. -phil

magikproductions

I totally agree with you, I

I totally agree with you, I had to sign a bill thing yesterday at my appointment at the cancer center and the first one with out insurance would have been $35,248.00 with medicaid it came to $7,329.00. That was for just a CT scan and Blood test, I am still waiting to even get medicaid they setup my appointment for medicaid on march 13th. O yeah they won't even start my treaatments until medicaid gives n answer