Beware the Jabberwock

There basic rationale behind "high-tech" cancer treatments should never be too esoteric for the end-user.

Sadly, a time comes when there’s little more than symptomatic management in your arsenal to fight stage IV cancer. These days, a surprising number of such heavily pretreated patients opt to try touted “high-tech” treatments. If there’s no ongoing mainstream protocol to conflict with, after stating that no personal judgement is possible in the absence of sufficient data, I do little to stop them.

If US$ 100,000 + is just a drop in their bucket, who am I to say that the cost of this hope is too high?

Upon their return, those patients who’d left in fair overall condition can even have a new gleam in their eye. I’m truly happy for them but, when they try to get me to concede that the treatments had worked, I resort to grunts & wordless Gioconda smiles. If pressured to speak: “Well, if you feel good, then it was useful”.  If pressured further, then one bites one’s lip to answer truthfully… in one’s head:

Patient: “The treatments are genuine breakthroughs– its the only explanation. If it walks like duck, and squawks like a duck, it IS a duck.” (Me: I used to think so, till Danny DeVito’s duck suit turn in “Batman”...)

Patient: “They’ve been published in journals. Its very scientific.” (Me: Both the NEJM & the JCO Editorial missed out on this paradigm shift?)

Patient: ”They use your language.  They did scans, cryotherapy, chemotherapy, and a gene thing. We don’t even have those therapies here or in the USA Centers yet.”

(Me: O frabjous day! To use "My Language", yet wax poetic in paraphrase: It really is brillig, the way these slithy toves do gyre and gimble in the wabe… Because all mimsy are the borogroves, and the mome raths outgrabe!)

No comments: