Things suck when prognosis is not good

The female DG has been thinking about this post for over a day. There’s just not a good way to say, “What are these people thinking?’ It’s easier to just blame big pharma – and probably in many cases, justly so. But just not in all.

The New York Times has been running a series on the 40-year “war on cancer,” which most experts agree has been waged largely without progress. One of the things that she’s often pondered – and has talked about more than once with the male DG since his glioma diagnosis three years ago – is what is the reluctance of doctors to speak plainly when a diagnosis has a poor prognosis, be that really short term as is the case in most pancreatic cancers or a bit longer term as is the case with grade III glioma. The outcome is the same: you’re going to die a lot sooner than you had hoped or expected.

Yesterday’s NYT article was about the man in charge of the FDA’s approval for new cancer drugs, Dr. Richard Pazdur, hailed as a hero by some and vilified by others. After reading the  article and the numerous excellent comments – many better than what she’s attempting here – the female DG’s gut feeling is that this is a man doing his job to the best of his ability, squeezed between pharmaceutical companies eager to get their drugs approved (and a big profit payoff) and cancer patients and their families grasping (often unreasonably) for hope.

That hope sometimes translates into a few weeks  – or months at most – receiving a drug that while prolonging life a little results in a much-reduced quality of life at an extremely great expense (to insurance companies, government or individuals who can afford to pick up the tab). The female DG understands she’s probably way over-simplifying this whole situation and hopes that the Obama administration has more knowledge and brain power. And she wishes that everyone involved would carefully consider the consequences of their decisions.

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1 Comment

Filed under Brain cancer

One response to “Things suck when prognosis is not good

  1. Sara

    Good comment, Linda. Ivan Illich wrote a book that touches on this called The Limits of Medicine. He himself chose not to treat his cancer and enjoyed the quality of life he wanted as his time ran out. These are not easy decisions but if the general gist of your comment is that sometimes we rush to treatment without all the deliberation that should possibly be taken I tend to agree.

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