Answers?

soccerfreaks said:

2 questions
I think you are asking two questions: 1.) How did no one keep track of my mom's breast cancer to make sure it didn't go undetected as it moved to her lungs?; and 2.) How could a doctor possibly mistake an obviously aggressive lung cancer for bronchitis?

They are both reasonable questions.

Let me first express my sympathy for the loss of your mom. I lost my own when I was a lot older than you, and I know that it is painful and something that makes you both angry and sad, frustrated and miserable, regardless of how old you or mom is when it happens.

I am not a doctor or even a medical professional, so take what I say with a huge grain of salt (maybe a pound or two, even), but my take, based on my experience as someone whose mom died from breast cancer metastatis 20 years after her original diagnosis and surgery, and as someone, as well, who has survived two cancers of my own, one of which includes lung cancer, is this:

1.) As you must know, based on the time your mom got to live cancer-free (or apparently so), the docs seem to have a schedule based on the statistics of those who have gone before, and, I am sure, to be honest, on what the insurance companies will allow, but that is for another day. The bottom line is that as survivors, we WANT to get to the point where they are just checking us every three months. When they say our checkups are moved out to every six months, we are rather ecstatic, and when they become yearly, we are feeling like it may be behind us forever, even if it truly remains in the backs of our minds.

Mom, I am sure, got to the point where her checkups were being performed by her family doc rather than OncoMan. He, FamilyDoc, is not qualified to look for cancer by himself, although he would recognize signs if mom complained of certain things. Mom probably did not. Given her history, and assuming FamilyDoc was really a competent and caring doctor, I would assume that he/she would be especially on the lookout for any symptoms in mom.

Over time, though, the tests stop. CAT scans, PET scans, MRIs, these all become cost-prohibitive, even for the wealthiest of us. Let us just see if it comes back.

Or something like that.

I know that when my mom's breast cancer metastasized to her brain it was only because she had since been discovered with ovarian cancer that they discovered the stuff in the brain.

2.) I went to my GP (FamilyDoc) with a complaint of a sore throat in June of 05. He gave me an antibiotic and told me to come back when the prescription was completed. I did not, not right away. When I did go back, he took another look inside my mouth, and ordered a stronger medication. Cancer survivors, and especially caregivers, might argue that he blew the call, that when I subsequently called him in August and said I had a bump on my tongue and couldn't eat properly, he was way behind the eightball.

I would beg to differ. He acted on the symptoms I described, he checked the area I said was hurting, and when, and only when, I got down to the nitty-gritty with the bump on the tongue, did he realize that something very serious was going down.

He is still my trusted personal physician.

What I am saying is that he treated the symptoms I described (I had no previous cancer history at the time, although it was rife throughout my family). He looked, and he made judgments based on my descriptions and what he saw.

I assume it was the same for your mom. I assume that FamilyDoc listened to mom's complaints and decided that they sounded like bronchitis. Even if FamilyDoc took xrays, if mom smoked there is a strong chance that if FamilyDoc saw 'nodes' he considered them, at first go-round, scar tissue from smoking, from previous bouts of bronchitis, and from pneumonias, either known or unknown, in mom's past.

Obviously and regrettably, some cancers work very fast, very efficiently. When they are discovered, it is sometimes too late. Or other factors mitigate survival possibilities.

I have not answered your questions to your satisfaction, I know. I know, in fact, that your greatest question is a philosophical one, the simple and most complex one: Why?

In that largest sense of the question, I have no answer except to ask, as kindly as I can, why not?

My best wishes to you and your family.

Take care,

Joe