December 29, 2010 3 Comments
It was not long ago that cancer carried a painful stigma. Patients afflicted with this terrible disease not only suffered with physical pain, but the emotional stress of what was once considered a “dirty” diagnosis. In my practice, I have often encountered patients from various cultures who ask that I not mention the word ‘cancer’ to their mother or father when I describe the treatments I must administer. In some countries, the cancer diagnosis is never mentioned and the treatment employed must, wherever possible, avoid the obvious features of cancer chemotherapy — like hair loss. Indeed, in some Asian countries, immune and nutritional therapies are more popular than chemotherapies as these allow patients to avoid the obvious side effects of cancer treatment.
While we in the U.S. consider ourselves “enlightened,” some of these attitudes persist within our culture, particularly with regard to cancers that had historically been associated with lifestyle or other exposures. Unfortunately, lung cancers and some cancers of the upper digestive tract are viewed in this way even today.
While cigarette smoking remains a principle causative factor in lung cancer, the percentage of men and women who smoke continues to fall while the incidence of non-smoking related cancers is on the rise. We are now witness to a growing realization that more than 20 percent of lung cancers occur in patients with distinct genetic predispositions unrelated to lifestyle or cigarette exposure. In addition, our increasingly polluted environment provides us all an unhealthy helping of carcinogens with almost every breath.
To suggest that lung cancer patients in some way constitute a population less deserving of our care and attention is an affront to the very principles of medical practice.
I, for one, find my increasingly good responses in lung cancer among my most gratifying successes. This heretofore untreatable malignancy is now revealing responses that challenge the successes in the “treatable” cancers like breast and ovarian. As some of our patients with metastatic disease are now alive at five and six years, we are certain that rationally delivered treatments can have the same beneficial impact upon this disease as any other. Every patient deserves the opportunity to receive the best, most effective, least toxic treatment. Our job is to match our patients with their best options, regardless of who they are, how they got the cancer or any contributing factors that may or may not have been responsible.
No one deserves cancer.