Yeong Sek Yee & Khdijah Shaari
On June 05 2003, The New York Times published a short article written by Tom Nesi, a former director of public affairs at the drug company Bristol-Myers Squibb. The article was strangely entitled “False Hope in a Bottle.” Curious, we decided to read further. Interestingly, we came across the book “HOPE or HYPE” by Dr Richard Deyo, MD and a Professor at the University of Washington in Seattle who described the story as “Exaggerating Benefits.” The story below is summarised based on the New York Times article and Dr Deyo’s story (read pages 45/46 of the book)
Tom Nesi described his wife, Susan, who was 52 when she was found to have a highly malignant brain cancer. They were told that the average survival with this condition was about eleven months, but they hoped for more. For about a year, Susan had been offered numerous medications, including, in the latter stages of her illness, Iressa, which was just approved by the Food and Drug Administration despite limited data about its effectiveness.
They sought care from a prestigious medical centre that offered several innovative treatments. One, called a Glidel wafer, is a dime-sized wafer that is implanted in the brain when the tumor is surgically removed. The goal was to deliver chemotherapy directly to the tumour site. The Nesis were told that this would extend Susan’s life, on average, about two months.
In the ensuing months, Susan underwent 3 brain operations and 6 hospitalizations. After the third operation, she was almost totally paralysed and unable to speak or eat. In her final months, she required two weeks in a critical care center, a full time home health aide, a feeding tube and electronic monitor, home hospital equipment, occupational therapists, social workers and medication. The costs for her care were around US $ 200,000.
As Susan lived 3 months longer than average; many doctors described the innovative treatment as a success. After the disastrous third operation, her surgeon told Tom: “We have saved your wife’s life….we have given you the ability to spend more quality time with your loved one.” Two weeks later, sustained by the feeding tube, Susan wrote on a notepad, “Depressed…no more…please.”
But according to the medical profession, the experimental treatment had worked. Susan lived almost three months longer than the average patient with glioblastoma. Somewhere in some computer database, Susan’s experimental regimen will be counted a success. She was a ”responder.” And therein lies the terrible truth behind the approval of ”miracle drugs” on the basis of ”tumor shrinkage” or ”extended days.” Susan’s life was extended. But at what cost?
Tom Nesi then faced a decision as to whether to stop the feeding tube and withhold liquids. He concluded his story by noting, “I think we need to ask ourselves whether offering terminal patients limited hope of a few more months is really beneficial. The question is not whether days are extended, but in what condition the patient lives and at what emotional and financial costs”
This is a story of well-meaning doctors (?) and a desperate patient. The presumption of both parties must have been that new technology could only help. As usual, the bias was to do something, to be aggressive. In the end, the treatment may be worse than the disease itself.
In many such cases, doctors tend to see only the good side of their interventions. They often dismiss, discount, or are wholly unaware of the downsides, which often diminish quality of life. And although new treatments often claim great benefits, we need to critically ask what the benefits are, and what we are giving up in order to have them.
FOOTNOTE: To Tom Nesi, chemotherapy is likened to FALSE HOPE IN A BOTTLE but to the late Senator Hubert Humphrey, who had bladder cancer, the chemotherapy that he endured for 1 year before he died was described (by him) as “bottled death.” When diagnosed, he was treated with radiation after which his physician Dr Wilfred Whitmore, M.D. declared, “As far as we are concerned, the Senator is cured” Despite the cure declaration, they began treating the senator with chemotherapy. Shortly after the treatment started, Senator Humphrey regretted and called chemo “bottled death.”
(Humphrey was the 38th Vice President of the USA from 1965 to 1969 and passed away in January 1978 at age 66).
We would like to end this article with a very brutal statement by Dr Charles Huggins, MD who was awarded the 1966 Nobel Prize for Physiology/ Medicine. As a physician, physiologist and cancer researcher at the University of Chicago, he is no quack doctor when he described chemotherapy:
- ”There are worse things than death. One of them is chemotherapy”
For those who have undergone chemotherapy treatment, please do share with the rest of the world what your thoughts are on this subject.
We welcome your comments.
SOURCES FOR THIS ARTICLE:
1) HOPE OR HYPE –THE OBSESSION WITH MEDICAL ADVANCES AND THE HIGH COST OF FALSE PROMISES by Dr Richard A. Deyo, MD, MPH and Dr Donald L. Patrick, PhD, MSPH.
2) HEALING CANCER FROM INSIDE OUT by Mike Anderson