Articles of Interest This Week

Cancer

cancer in canadaNot much new but Is the war on cancer an ‘utter failure’?: A sobering look at how billions in research money is spent provides a sobering look on cancer research and treatment, noting that most of the improvement has come from prevention (anti-smoking campaigns), with marginal improvements in most other outcomes. I do not think it is quite as bleak as all that; given the complexity of cancers, both at the individual and common levels, it was naive to expect early ‘cures.’ Managing cancer as a chronic disease does have real benefits to people such as myself. And the latest approach to cancer research, Cancer Dream Teams: Road to a Cure?, outlines how interdisciplinary teams, comprising researchers from a range of disciplines, recognize the complexity of cancers and will hopefully lead to promising results. Not sure how much is ‘repackaging’ of what was likely common practice already.

Much has been written about the links between environmental factors and cancer. Cancer Cluster or Chance? goes behind the science and uncertainty of accounts like Toms River: A Story of Science and Salvation, underlining the difference between correlation and causation, the wish to see patterns where they may be none, and how the politics plays itself out. I would still take a more ‘precautionary principle’ approach that the author, as I think the cumulative effects of our exposure to various chemicals and the like is not without impact, but important to understand the limits of what we know and don’t know. For the review of the book, more sympathetic than this piece, see Books: On the Trail of Cancer: A Review of ‘Toms River’ by Dan Fagin.

James Salwitz on The fine balance between hope and cope in cancer patients, reminds doctors and patients of the need for honesty in discussing the prognosis and usefulness or not of treatment. The rush to treatment, in some cases, can prevent a patient from doing more important things and enjoying life. In a related post, Oncologists vs Hospice, he comments on the need for oncologists to have earlier end-of-life discussions with patients to avoid unnecessary treatment and suffering. And Suleika Jaouad reminds us that not all of us make it through our journey, in A Friendship, Interrupted, about one of her friends who she met in the cancer ward.

The Semantics of Cancer, by Karin Diamond, is another in a series of reflections on the terminology of cancer, and the risk of insensitive comments. Some good examples of what not to say, could be strengthened by a stronger sense of grace and recognition that people, despite their best intentions, will sometimes say the wrong things, and one has to appreciate, in many cases, the intent behind the comment. But her closing remarks were spot-on:

Let’s turn up the love and respect and turn down the need to pounce with our own solutions to problems that may not even exist. The choices someone makes may be drastically different from how you’d approach a situation, but there is no single right way to survive and thrive in this wild and beautiful life. Let’s give each other the space and freedom to do that however we must, minus all the pressure and expectations.

And a reminder in Cancer patients who are positive in the face of terrible adversity that positive thinking doesn’t improve outcomes or survival. However, the article fails to acknowledge the importance that positive thinking can make to getting through cancer treatments, both for the patient and those close to them, and that it may help the patient be more active in their treatment, helping recovery time.

One of the cancer blogs I follow, Thinking Out Loud, has an all-so-true 10 Things I’ve Learned from Cancer. Conclusion says it all:

But to me, life isn’t about creating checklists to check off; to me, it’s about experiencing what you have, where you are, and who you’re with. …. Life’s a journey not a to-do list.

Health and Wellness

While I understand the need for ‘scripting’ in service and call centres, Scripting with patients is a silly game captures some of the absurdity in a healthcare setting.

A good reminder of Questions to ask before your CT scan, given the amount of radiation involved in CT (and PET) scans and how to minimize this over the long-term.

How a Healthy Heart Can Lower Risk of Cancer reminds us that healthy living, whether to reduce the risk of heart disease or cancer, comes down to the same general things: exercise, nutrition, avoid smoking.

The ultimate in online doctoring in The Doctor is In (Well, Logged In) strikes me more as hucksterism than quality medical care but others may disagree.

Mark Bittman, on Banning the Big Gulp Ban, provides his assessment of the court decision striking down the Bloomberg ban of large-size soda drinks. Good piece.

Other

Bruce Feiler’s The Stories That Bind Us details how family histories and stories, through their ups and downs, provide a solid grounding that life has its good and bad moments, and in telling these stories, we can increase resilience in kids.

And more from Evgeny Morozov, Open and Closed, on how online transparency may not be so transparent and helpful as thought. I particularly liked this comment (which applies in many countries):

Likewise, “open government” — a term once reserved for discussing accountability — today is used mostly to describe how easy it is to access, manipulate and “remix” chunks of government information. “Openness” here doesn’t measure whether such data increase accountability, only how many apps can be built on top of it, even if those apps pursue trivial goals. This ambiguity of “openness” allows British Prime Minister David Cameron to champion open government while also complaining that freedom of information laws are “furring up the arteries of government.”

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