Worth a read.
Chemotherapy versus death from cancer
I know I've been writing a lot about the Daniel Hauser case, and forgive me if I may be beating a dead horse, but cases like these reprsent supreme "teachable" moments that don't come along that often. The antivaccine movement, for instance, will be with us always (or at least, I fear, as long as I still walk this earth and beyond), but cases like that of Daniel Hauser don't come along that often. As tragic as they are, they always bring up so many issues that I have a hard time leaving them alone.
This time around, I wanted to touch on an issue that has come up frequently in the discussions of this case, and that's the issue of chemotherapy. Specifically, it's the issue of how horrible chemotherapy can be. Again, make no mistake about it, chemotherapy can be rough. Very rough. But what is often forgotten is that it can also be life-saving, particularly in the case of hematologic malignancies, where it is the primary therapy. What is also often forgotten or intentionally ignored is that doctors don't use chemotherapy because they love "torturing" patients or because they're in the pockets of big pharma and looking for cash or because they are too lazy to find another way. They do it because, at least right now, it's the best scientific medicine has. And in the case of Hodgkin's lymphoma, for example, it's life-saving.
Yes, chemotherapy can make you feel nauseated and make you throw up. It can make your hair fall out. It can temporarily depress the immune system. It can cause bleeding complications, such as GI bleeding. It can cause kidney damage. It can cause heart damage. It can cause lung damage. it can cause nerve damage. It can make you lose weight. It can even result in your death from complications. In short, it is not something to be taken lightly. Unfortunately, the disease it's meant to fight is a formidable foe indeed. It is your own cells, and often the difference between the toxicity of chemotherapy against the cancer and against normal cells is all too often not that great.
But what does cancer do? How do cancer patients die? They suffer and die in protean ways. Cancer can do everything chemotherapy can do (with the exception of hair loss) and more. I've seen more patients than I care to know suffer and die from cancer. I've seen family members suffer and die from cancer, most recently my mother-in-law.
One of the most frequent claims of cancer patients who opt for quackery instead of chemotherapy and effective science-based therapies is that they want to remain healthy. Some, as Abraham Cherrix did, state that, even if they end up dying, they want to "die healthy." It's a dangerous illusion. There is nothing "healthy" about dying from cancer. Dying from cancer is anything but "healthy." What does dying from untreated cancer mean? What happens? What does it involve?
Dying from cancer can mean unrelenting pain that leaves you the choice of being drugged up with narcotics or being in agony.
Dying from cancer can mean unrelenting vomiting from an uncorrectable bowel obstruction. It can mean having a nasogastric tube to drain your digestive juices and prevent you from throwing up. Alternatively, it can mean having to have a tube sticking out of your stomach to drain its fluids.
Dying from cancer can mean bleeding because you don't have enough platelets to clot. The bleeding can come in many forms. It can be bleeding into the brain, in essence a hemorrhagic stroke. It can mean bleeding from the rectum or vomiting blood incessantly. And, because so many transfusions are all too often necessary, immune reactions can chew up new platelets as fast as they're infused. Yes, paradoxically, even when a cancer patient's immune system is suppressed in late stage cancer, frequently it does work against the one thing you don't want it to: Transfusions of blood products.
Dying from cancer can mean horrific cachexia. Think Nazi concentration camp survivor. think starving Africans. Think famine. Think having cheeks so sunken that your face looks like the skull underlying it.
Dying from cancer can mean your lungs progressively filling with fluid from tumor infiltration. Think choking on your own secretions. Think a progressive shortness of breath. Think an unrelenting feeling of suffocation but with no possibility of relief.
Dying from cancer can mean having your belly fill with ascites fluid due to a liver chock full of tumor.
Dying from cancer can mean so many other horrific things happening to you that they are way to numerous to include a comprehensive list in a blog post, even a post by a blogger as regularly logorrheic as Orac.
Modern medicine can alleviate many of the symptoms people with terminal cancer suffer, but it can't reverse the disease process. However, the relief of these symptoms requires that the patient actually accept treatment. Hospice can minimize such symptoms, often for significant periods of time. However, even with the very best hospice care, there is nothing "healthy" or pleasant about dying from cancer. It means a loss of control. It means being too weak to get up by yourself, to feed yourself, to go to the bathroom yourself, to bathe yourself, or do do much other than lie in your bed and wait for the end. Without such treatment, a patient who chooses quackery over effective curative or palliative therapy dooms himself to a painful and unpleasant death. He in effect dooms himself to the sorts of ends untreated cancer patients suffered hundreds of years ago, before there was effective therapy. It doesn't have to be this way, but the seductive promise of a cure without pain, without hair falling out, without nausea lures cancer patients to havens of quackery in Tijuana or to flee from authorities trying to see that a child obtains potentially life-saving treatment, all because of a magnified fear of chemotherapy, all because of the propaganda that paints chemotherapy as "poison," radiation as "burning," and surgery as "slashing."
Here's the dirty little secret behind "alternative cancer cure" (ACC) promises. They are seductive because it is true that cancer patients who stop their chemotherapy will do feel better than they did when undergoing chemotherapy. Of course they do, at least for a while! Often what's happened, as in Daniel Hauser's case, is that the tumor shrinks, and, once the chemotherapy course is done, the patient does feel better because the tumor is no longer causing B symptoms or compressing lungs and making him short of breath or whatever. It is also true that more chemotherapy will make the patient feel lousy again for a time. Unfortunately, in the case of Hodgkin's lymphoma, the additional chemotherapy is necessary to maximize the chance of cure. Hodgkin's disease frequently relapses without the additional courses of chemotherapy. Science and clinical trials have told us that. Daniel Hauser is living proof, an anecdote that is consistent with what science tells us.
In other words, the promise of ACCs is a lie. They promise that cancer patients will always feel the way they do after the first course of chemotherapy is over, and they lie. That's because cancer doesn't give up. It's like the Terminator. It can't be bargained with. It can't be reasoned with. It doesn't feel pity, or remorse, or fear. And, if it is not treated, it absolutely will not stop, ever, until the patient is dead. And it won't be a pretty end.
Chemotherapy or death by cancer? For cancers for which chemotherapy is so effective, like Hodgkin's lymphoma, it's really a no-brainer.
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