The Truth about Cancer

I don't need medicaid & am not eligible for it. I have plenty of income, that's the reason I need insurance. if I was to fall ill the they would try to take everything which I feel belongs to my heirs. & I don't need dental or visual, I don't do doctors. but I[m nearly 78 & things happen especially to the old. I need it for back-up before catastrophy if any

AARP is a reliable source for information. Scroll to the section that deals with those who are over 65, but not eligible based on their or their spouses work history.

http://www.aarp.org/health/medicare-insurance/info...

It seems like a way to obtain Medicare, regardless of your work history.

Why can't you?

I never fail to be amazed, leggo, at how barbaric the treatment for breast cancer STILL is - cut, burn and poison. Yet with the zap of a lazer, prostate cancer can be cured. I fail to see how cutting, burning and poisoning an ill body back to health is supposed to work. What's the logic behind it?

I think the problem is that most people only start to wonder when they end up here and have to rely on the treatment available.
I'm no different. I thought this system had no faults, was doing only good, only had one interest. That is clearly not the case.
But it was not clear to me before. I would have been one of those people saying "you are paranoid, get real. Of COURSE they are doing everything they can - that's their job".

I watched my mom go through treatment for breast cancer in 1975.  She eventually passed away in 1981 at 57 yrs old.  I can assure you that I did not receive the same treatment as she did.  We both went through surgery, chemo, and radiation.  The options for surgery for her were limited to a radical mastectomy with no reconstruction. Her surgery left he disfigured. I had SNBs on both sides to determine how aggressive my surgery would be.  Even with positive nodes, I did not have a radical mastectomy.  I also was given the option of reconstruction (DIEP), which was not available for my mom.  We both had chemo.  She was deathly sick and obviously in great distress during chemo.  I worked full time throughout and was never sick.  Neither of my chemo drugs was available in 1981.  We both had radiation.  My mom received terrible burns, my skin survived with just a bit of irritation. My mom's treatment stopped at radiation, I can continue to fight this disease with AIs.  I don't know about anyone else, but I can say that, for me, treatment has come a long way since the 80's.

I also don't buy into the crap about treatment getting better. When almost everyone go through chemo and they have screened their way to lots of women who don't need chemo all of them - because the disease is chronic in some cases, because the disease disappears by it self in some cases, then it just makes it look better. The Progress in treatment will be when everyone, no matter stage and characteristics, have a chance of a cure.

The problem is that there are arguments on both side and as long as you are not open to the other idea you will just stick to the arguments on your side.

Why aren't Money spent for Experts to choose e.g. the 10 most promosing treatment strategies and the 10 areas of breast cancer we need more information about - and then scientists could be occupied with intense investigation of these areas. There are many new studies where it feels like ressources could have been used MUCH better. Is it just me who lack knowledge or is it true - it seems like there is little coordination, no control, no longterm plan with research and whats going on.

I recommend The Emperor of All Maladies, by Siddharta Mukherjee. It is an interesting and well written book.

Yesterday I was rereading one of the chapters, where he describes the invention of Gleevec, an oral, non-toxic medication that can keep a rare form of leukemia in permanent remission for the vast majority of patients. This particular leukemia used to be fatal in most cases, killing half of the patients within 2 years of DX.

The development of the drug cost some horrendous amount of money and for a cancer that something like 2500 people are DXed with annually in the US. Thing is that what used to be a very rare cancer is now a very common cancer, because people are living full life spans with this leukemia. The treatment is for always, similar to HIV or diabetes meds, so what seemed like a huge gamble for the drug company has actually paid off in spades.

Point being that even with the profit structure as it currently stands, there is plenty of incentive for coming up with better drugs and treatments.

However, with most of the common cancers, it is like looking for a needle in hay stack to identify the genetic vulnerabilities that might be targets for more effective and less toxic drugs than the standard chemos (the book explains why/how in detail). Herceptin, however, is the result of one such target that has been identified and exploited.

In the case of breast cancer, Mukherjee outlines that the advances in treatment greatly depend on what type of breast cancer you have. If you have a 3+ cancer and a small tumor, both your treatment and your prognosis will be vastly different than it would have been even 50 years ago. If you have a 3- cancer, then the advancement is far more modest and prognosis has not really improved much.

I suspect most such cancers will let you live at least 5 years if you do nothing except better diet exercise like that

Leggo, herceptin is a good thing, IMO. It is NOT a cure and it does not work for everyone. There is also the heart toxicity, as you mention. However, when it does work it can make a huge difference to a patient. The process that brought herceptin to the market on an accelerated schedule was largely the result of patient activism.

I am really sorry that herceptin did not work well for you. My main point is that herceptin works in a similar way to gleevec, the medicine for the rare leukemia that I mentioned. The drug targets specific protein pathways of the cancer. The reason herceptin is heart toxic is because the HER2 is present in cancer cells AND, unfortunately, in heart cells. In spite of such problems, many researchers believe that this kind of mechanism is the way forward in cancer treatment.

I agree, by the way, that the 5-yr thing is stupid and that we need much better stats on this disease.

June, I would love to see a cure too. At the same time, though, if I could take a pill every day, a pill that did not cause me any serious trouble, and that pill would keep my cancer in remission for the rest of my natural lifespan, then I would take it. My cousin has lived with HIV for 30 years. Yes, it is a bitch, and it has put some limitations on her life, but as long as she takes her anti-virals, she rolls on without any terrible problems. I would be OK with an "anti-BC" drug for me to take while they fiddle with the cure. Also, I agree that refining chemo regimes is not any giant leap forward. But I am still very happy that because of these refinements I was able to walk my dogs every morning, travel, work and play through 6 months of chemo.

Because the cancer I had was locally advanced, both my 5- and 10-yr prognosis improved by more than a single digit from the chemo. In cases where the benefit is much smaller, I do think the validity of chemo is anywhere from questionable to highly questionable. Thankfully though, doctors increasingly think so as well and are getting better at evaluating the cost-benefit ratio for any given patient.

momine,

Thank you for your thoughtful take on bc, tx and cure (or lack of). The Emperor of All Maladies is a great read, especially, for those like myself, who had little knowledge of the history of cancer and it's tx through out the ages. My grandmother passed away from bc in the mid -1960's. The tx she received and what was known about her bc were far, far different than my tx. What leaps immediately to mind is radical mx, a given then, virtually never done (at least in the US) now. My grandmother also had little to no involvement in her own care and tx, nor was she encouraged to. Many patients, today, are not only actively involved in their own tx and decision making but are encouraged to do so by their doctors. You may have to take the bull by the horns on this one, but those doctors do exist.

Lastly, we all want a cure but no need to tell you all how complex bc is. Like momine, I will gladly swallow a pill, or a few pills, until that happens. Oh, wait a minute...I already do. Grandma Esther didn't have aromatase inhibitors either.

Caryn

PS: it's also clear that we are colored by our own experiences. Mine has been a good one, even at stage IV. Is it my medical care? My particular bc? My diet or my attitude? All of these things? Darned if I know!

lots of interesting quotes from mukherjee's book on goodreads