Wednesday, July 21, 2010

Slash, Burn and Poison: Is this the only way?

After the shock, denial and numbness a woman often feels after receiving a diagnosis of breast cancer, comes the time to discuss treatment. To my surprise and dismay, I learned that the current treatment options for breast cancer are basically one-size-fits-all. Regardless of tumor size, grade or stage there are basically three ways to treat breast cancer. Dr. Susan Love calls these traditional treatments; slash, burn and poison. In other words surgery, radiation and chemotherapy.

Now, please don't get me wrong. It's wonderful that there are treatments! It's also a blessing that medicine has evolved beyond radical mastectomy, which was the primary treatment for breast cancer at one time. This procedure resulted in removal of the entire breast, pectoral muscles, fat and all lymph nodes under the arm. Now that's radical! Thankfully, researchers decided to test another treatment. Some extremely brave women participated in clinical trials that led to breast conserving surgery (lumpectomy), along with radiation becoming a viable breast cancer treatment.

Not too many years ago breast cancer wasn't openly discussed.  There were no pink ribbon campaigns and not much breast cancer awareness. Now, money for research is being generated that's resulting in ongoing breast cancer studies.  This has lead to new knowledge and a greater understanding of breast cancer. Yet, with all this progress the reality is that regardless of the stage, grade or size of an individual's breast cancer, for the most part treatment still centers around surgery, radiation and chemotherapy.

Why hasn't treatment of breast cancer evolved as quickly as one would hope based on the amount of research and resources? Well, one reason might be a result of the way doctors have traditionally approached cancer.  The conventional thinking is that cancer needs to be wiped out as completely as possible from the body. This is often accomplished at the expense of healthy cells.  Even though the understanding of cancer is evolving, many doctors still adhere to the kill the cancer at all costs mindset. Some health experts blame our litigious society. This creates a fear of malpractice lawsuits and drives doctors to treat cancer as aggressively as possible.

Perhaps another cause of the lack of change to breast cancer treatment stems from our health care system itself, which tends to reward more treatment, rather than health outcomes (Kaiser). At the risk of sounding paranoid, one more motive might be a result of corporate greed. The fact is companies spend billions of dollars in research, development, testing and acquiring of government approval for their treatments. According to Breast Cancer Action, this results in corporations influencing the way breast cancer is treated. This can happen in one of two ways. The company that made the treatment can provide biased information about their product directly to doctors, or the company can give money to influential organizations in an effort to financially persuade "the type of information the organization provides to people."   

One thing is evident. The research and treatment of cancer is itself becoming a big industry. With this thought in mind, there is a growing need for accountability and transparency with regard to how the health care industry, medical community and government agencies approach cancer policy and treatment. To begin with patients should have access to unbiased information in order to make informed treatment decisions. Regardless of the reason for the slow evolution of the treatment of breast cancer one fact still remains. There are many kinds of breast cancer and it should no longer be treated with a one-size-fits-all attitude, nor should the only options be the slash, burn and poison approach. What do you think? Is this really the only way?


1 comment:

  1. I applaud your courage to put this debate on the table. I remember the comment in the book "The Shack"...Religion, Politics and Money are the seeds of evil that continually compete for our hearts and minds. We do have the gift of science and technology to continually discover and learn more about our bodies and what to do (and not do) to treat it properly. We need to get to the root of WHY we are doing the research and developing treatments and cures. that being, improve the quality of life for all. Another quote, I recall is from the CEO of Starbucks. "1 cup of coffee served by 1 Starbucks' Associate to 1 Starbucks' Customer". The applicability here? Focus on each individual, find the right treatment for that individual, regardless of religion, politics and money.