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Wednesday, August 29, 2012

If the News Isn’t Good, How Would You Spend Your Time?

By Heather Millar

Concerned Woman

For me, pancreatic cancer looms as a big, big bogeyman. A few years ago, at a family Easter gathering, my cousin’s husband looked unnaturally thin and pale. “He just had surgery,” she said cryptically, in that tone that makes you understand that you shouldn’t ask a follow-up question. Six months later, at only 42, he was gone. Pancreatic cancer. A couple of years later, I was hired to guest edit a couple of issues of an environmental magazine. The editor was on medical leave. She came back after I did two issues, but then she was gone for good six months later. Pancreatic cancer.

All cancer is scary; I think pancreatic cancer is doubly so, triply so. As most probably know, pancreatic cancer has one of the most dismal survival rates in the cancer pantheon. Almost no one lives two years beyond diagnosis, no matter how they’re treated.

So, if you had a similarly negative prognosis, how would you spend the time? Would you endure all the miseries of chemotherapy if you knew it would only buy you a few more weeks or months? Or would you choose to have less time, but more quality of life, fewer needle sticks and hospital days? As with most of life’s truly important crossroads, there is no correct path, just the one that works for you. And most of the time, we go on gut; what seems right to us at the time.

Now, pancreatic cancer patients have some numbers to consider as they choose their course.  Dr. Casey Boyd, a surgery resident at the University of Texas Medical Branch at Galveston, decided to analyze the records of more than 25,000 pancreatic cancer patients. Boyd used the National Cancer Institute’s “Surveillance, Epidemiology and End Results” (SEER) database that logs the outlines of medical cases.

Boyd and her team looked for two things that indicate the aggressiveness of treatment: the number of “hospital days” spent as an in-patient, and the number of  “medical days” spent getting tests, or infusions, or check-ups and so on. Then, they correlated those figures to the stage, treatment, and survival of the patients. The result? They compiled the first quantitative look at the experience of a patient with pancreatic cancer. The study has just been published in the Annals of Surgical Oncology.

“Really, this paper is about empowering the patient,” Boyd says. “We want to provide them with the information they need to make their own personalized treatment decisions.”

If I had pancreatic cancer, which I hope I never do, I’d seriously consider looking at the numbers that Boyd’s team has compiled. I’d be able to see how much time I could probably buy with how many hospital/medical days. I’d have some data to crunch as I decided what to do, whether I wanted more time with aggressive treatment or less time with less misery.

My gut tells me that I’d opt for less time with more quality of life. But I guess you never know until you’re in that situation. Maybe the data would lead me to the opposite conclusion.

What do you think? What would you do?

Photo: Stockbyte

Posted by: Heather Millar at 1:00 am

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