Is this woman, Mariangela, sort of lunatic with her zen-talk when cancer is involved?
At first it seems so, but Mari is an extremely clever person and, when it comes to research and strategic thinking, I haven't met one to keep up with her in a debate, which has been proved even in fields not typically 'hers'. Her analyses on movies are unique, plenty of insights touching several fields. Her readings of architecture and others pieces of art, including literature, are well beyond the ordinary, even though she has never undergone courses or training on such matters. She became a mother at 19 and her infant's medical doctor praised her for her 'maturity', responsiveness and competence when dealing with unexpected situations, acting as if she had already a lot of experience.
She has never faced cancer in any way before. Still, she has recently given her views on that (on prostate cancer, specifically) with a lot of emphasis, after, of course, doing research with the readiness usual with her.
Now she has found some more evidence supporting her seemingly 'radical' views, as follows:
a) she was especially worried with a friend's doctor declaring that, with surgery, incontinence and impotence were 'guaranteed'. She could find nothing to support that since she started searching. She soon realized that her friend's doctor was not good at surgery and thus was hard-selling radio. An article in Portuguese shows this:
A impotência, que se caracteriza por perda das erecções penianas, apesar do paciente poder atingir o orgasmo, surge em 95%quase todos os operados com mais de 70 anos de idade, em 50% a 60% dos indivíduos com 55 a 65 anos e em 15% a 20% dos pacientes com menos de 55 anos. Ressalte-se que os riscos de impotência diminuem significativamente quando o tumor é oculto, não palpável no toque digital e quando o cirurgião é experimentado. Incontinência urinária moderada ou grave surge em 20% a 40% dos pacientes submetidos à cirurgia em centros não-especializados mas acomete apenas 1% a 2% dos casos quando a intervenção é realizada por equipes habilitadas.
Translating all relevant parts (in red above):
Impotence... appears in almost all the patients (95%) going under surgery if over 70 years old; appears in 50% to 60% in those between the ages of 55-65 and in 15% to 20% in patients under 55. [Her friend is 58-59, history of very good healh, looks younger]. We must stress that the risks of impotence are significantly reduced when the tumor is hidden, not palpable in the touch test [stage A] and when the surgeon is experienced. Incontinence - mild or severe - appears in 20-40% of the patients after surgery in non-specialized centers, but hits only 1-2% [yes, one or two percent] of the cases when the intervention is carried out by qualified staff.
This part of the text is also relevant considering her caring about her friend:
Talvez por estarem conscientes da menor eficiência da radioterapia convencional, os radioterapeutas tem explorado novas técnicas de irradicação da próstata, incluindo-se aqui a radioterapia conformada, a braquiterapia (aplicação de sementes radioativas de iodo ou de ouro na próstata) e a associação de radioterapia com tratamento hormonal. Os resultados precoces com estes métodos, após 3 ou 4 anos, têm sido favoráveis. Contudo, todos os pacientes com câncer localizado de próstata sobrevivem cinco anos, independente do tratamento realizado, de modo que é impossível afirmar, no momento, se estas técnicas são superiores à radioterapia convencional. Enquanto não surgirem avaliações com 10 anos de acompanhamento, estas três alternativas devem ser consideradas experimentais.
Perhaps for being conscious of the lower efficiency of the conventional radiotherapy, the radiotherapists have explored new techniques of prostate irradiation... including the... application of seeds... The initial results with such methods, after 3 or 4 years, have been favorable. However, all patients with cancer located only in the prostate survive for five years, regardless of the treatment undertaken; therefore it is for now impossible to state whether those techniques are superior than conventional radiotherapy. While no assessments following 10 years of observation are made, these three alternatives [surgery, conventional radio and other radios (including seeds)] should be considered experimental.
The source is an article by Miguel Srougi, 50, post-graduate from Harvard and professor at Escola Paulista de Medicina in São Paulo.
http://www.uronline.unifesp.br/uronline/ed1098/caprostata.htm
Mari, as early as January, virtually begged her friend not to go on 'treatment'. She certainly must have caused an unfavorable impression, especially because she also showed to be authentically touched by her friend's situation. Despite, her analytical ability, once again, was not missing, as it can be now better noticed.
Now Mari is trying to answer one question: how hard would it be to undo a seeds procedure?
