Hope springs eternal
Two words no doctor ever wants to include in a diagnosis are pancreatic cancer. In my clinical experience, this cancer has never ended well – it is a very difficult beast to control.
Tragically, it recently claimed the life of Kiwi icon Sir Colin Meads and, back in 2011, Apple cofounder Steve Jobs. Two great men with a tough diagnosis but who did their best to battle an aggressive form of cancer.
My understanding of cancer at a molecular level is down to error messages. The cell, be it skin, bowel, pancreatic or a neuron, has had its DNA damaged through a variety of ways, (many of them which we don’t understand yet).
It’s a lost misguided cell that doesn’t know what to do, so it replicates, it reproduces itself like an alien and begins to take over your body. It forms lumps (tumours) that then shed cells and metastasise to other parts of your body before forming more lumps.
So, the mainstay of cancer treatment is to try to remove or kill the errant cells that have gone on the warpath. Like any war, there can be collateral damage to surrounding cells and structures.
Three hundred years ago, French enlightenment writer Voltaire said: ‘‘Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing’’.
Despite his gender bias, I think some of what Voltaire said is still true for pancreatic cancer today. We can’t seem to beat it yet.
In my relatively short clinical lifetime of 30 years, I have seen major developments in cancers that were once fatal but are now curable.
I’m sure we will win the war on pancreatic cancer and there are very clever people working very long hours so we don’t have to suffer the fate of Jobs and ‘‘Pinetree’’ Meads. So, there is hope.
Which is the message of this week’s article: How to balance hope with the claims of others who have magic cures for diseases doctors have said there is nothing more they can do.
If I was given the same diagnosis would I travel to Mexico for a revolutionary treatment or take some magic Taranaki water much closer to home?
When my friends and colleagues whom I love and trust look me in the eye and say, ‘‘Mate we can’t do anything more except keep you comfortable’’, would I look for the magic and seek alternative therapies? I don’t know because I haven’t walked in those shoes.
Would the money spent be balanced by hope, however slim a thread? Would it be better spent on something else rather than cures that have little or no evidence of extending your life?
Are the people who promote such therapies convinced in their beliefs, or are they taking money from the desperate and vulnerable?
As the denial, anger, bargaining, depression, hope and acceptance swirl around like the palliative cocktails we administer at the end of life, decisions are often clouded.
The knowledge, compassion and support of the health professionals who do this day in, day out in palliative care are 123RF humbling and reassuring.
Hope springs eternal and despite the science suggesting otherwise, you can hope for an afterlife. You could also hope that you’d get your money back if the therapies sold to you didn’t give you the value promised or delivered. ● Dr Tom Mulholland is an Emergency Department Doctor and GP with over 25 years experience in New Zealand. He’s currently a man on a mission, tackling health missions around the world.