b) Mariangela is extremely concerned about the effects of the seeds procedure. Once conventional radio causes alarming effects in spite of its now admitted low efficacy, how can one be at easy with the more 'sophisticated' (and harmful) methods that do not even give the patient's body a 'break'?
Experimental methods. Doctors never tell patients are subjected to experimentation. They make them sign a term that exempts doctors from liability - and that should say to people involved that an experimentation is the case, but it does not. People are desperate. The situation is challenging especially to those - most of us in our western culture - brought up to believe we can control our lives, even a great share of the world around us. Then we are proved wrong in a dramatic way.
It may sound shocking, but we must consider that surgery meaning removal of the prostate is not of value to doctors with research ambitions. (Seeds procedure also means surgery to insert them...) In turn, the seeds stuff is being the focus of recent research (e.g.Relatório Final - Maryah
www.fsc.ufsc.br/~canzian/braquiterapia/braquiterapia.pdf) and finding a relatively young patient that can allow a long period of monitoring for the purposes of research is pure gold. Does Mari's friend know about the kind of seeds now nesting in his prostate?
It is startling to get even just a glimpse on the variety of 'sources' - radiactive elements - seeds can bear. Table 01 in the paper just mentioned (link above) provides us with a list. But there is much more to the whole procedure. There are unimaginable ways of inserting the seeds. How many patients ask about that before saying 'I do' to their doctor?
Anyway, the most intriguing question by far seems to be that addressing the so-called planning of the composition of the seeds. How much thought does a doctor give to it? Or does he simply follow a rule of thumb? I bet that it all depends on his interests - is he doing a PhD? Then he is likely to dare more. Is his waiting room crowded? Then rule of thumb would be the thing.
By reading the piece of research whose link I give above, one stays in awe as it emerges as outlandish that a doctor would dedicate so much time to just a single case, so as to study all (or most of) the possibilities the literature review presents.
It particularly startles Mari how much precision is implied in both determining the composition of the seeds and in reaching the exact location where to house them. Considering a 'cancer' as small as one that can not be palpable, how really plausible is all that 'tour of seeds'?
Mariangela has just learned that the seeds insertion can be temporary or permanent. So, one more decision for doctor to make. Again, based on what?
Certainly, money comes in. No doubts survive that any variation of such treatment - better, experimentation - is amazingly costly.
But now we should turn to a very different question: how fair is it to be so incisive about this whole issue, when talking to a patient? Mari's friend, just before starting his treatment, declared that the city where he lived was a good place to be ill, thus showing (over?)confidence about the treatment.
Wherever cancer has to be tackled, it is rare to find a voice that honestly admits is biased towards a certain method of treatment. Such a voice reports us to the professor mentioned in the previous part. Exactly, he was not playing the role of doctor then.
If doctors are actually playing dice, so is the patient. It is s/he who has to fast cope with conscious uncertainty - a journey full of silence, self-proving, creation. Has also to master her/his emotions. And has to learn to come up with the essential questions. If only to be asked just to her/himself.
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I have published more about cancer recently:
WHAT YOU MUST KNOW NOW ABOUT CANCER
12 Jan 2011
That very sentence in the beginning of the text says radiation "affects cancer cells only in the treated area". Ambiguous, it may mean, in addition, that, if you have cancer elsewhere, only the cancer cells in one specific area...
CANCER - How to lie with medicine - PART TWO
CANCER - How to lie with medicine - PART TWO
13 Jan 2011
Cancer causes: In most individual cases of cancer, the exact cause of cancer is unknown. The causes may include increased genetic susceptibility; environmental insults, such as chemical exposure or smoking cigarettes; lifestyle factors, ...
18 Jan 2011
Prostate cancer is the most common cancer in men, but immediate treatment may not be the right answer for everyone with this disease. See the NCCN treatment summaries for more information. When my friend told me about his condition, ...
