House: Big, Fat Lung Cancer
In last night's episode, Que Cera Cera, House pinpoints George's (a 600-lb. homebound headhunter and gourmet cook) mystery ailments as late-stage, terminal lung cancer. How? By taking the diagnosis in hand, literally. House noticed the patient had finger clubbing.
In fact, according to our sister site eMedicine.com, "Clubbing has been reported in 29% of patients with lung cancer, and is observed more commonly in patients with non-small cell lung carcinoma (35%) than in patients with small cell lung carcinoma (4%)." The site goes on to say clubbing is a tell-tale sign of "various underlying pulmonary, cardiovascular, neoplastic, infectious, hepatobiliary, mediastinal, endocrine, and gastrointestinal diseases. Finger clubbing also may occur, without evident underlying disease, as an idiopathic form or as a Mendelian dominant trait."
Now, clubbing usually can be readily identified in a sight exam. But for this particular patient, whose hands were swollen by obesity, the clubbing just looked a part of his weight issues. And about those weighty concerns...Dr. Chase felt that a morbidly obese patient like George didn't deserve the quality of care a normal weight patient would, because, obviously, he wasn't participating in his own health care. Why then should House and his team go out of their way?
The team did start with obesity as the first line of investigation of his problems, even though George said he'd been overweight all his life and it had never been a health issue. Is it a form of prejudice to start with being overweight as the cause of all your ailments?
I called Brenda, one of our Real Story writers, who two years ago was about 300 lbs. and underwent bariatric surgery, chronicling her dramatic weight loss in her online journal at WebMD. She TiVos House regularly.
"I believe that there are many people, not necessarily just those in the medical field, who agree with Chase, that obese people create their own situation so they should just live with it and not expect to be treated the same as a person who lives a healthy lifestyle," she says. "I believe that there is a similar attitude toward smokers. If they develop breathing problems or lung cancer, some people think they're getting what they asked for."
While no one asks for cancer or any disease, folks need to be responsible for their own health, Brenda says. "At the same time, every patient should have access to diagnosis and treatment."
Tell us what you think.
Related Topics: Surgery Options for the Obese
tags: House, HouseMD, lungcancer, fingerclubbing
Clubbing, or digital clubbing, is actually a medical term and can be a symptom of lung cancer, according to the Cleveland Clinic. "The nails appear to bulge out more than normal."
In fact, according to our sister site eMedicine.com, "Clubbing has been reported in 29% of patients with lung cancer, and is observed more commonly in patients with non-small cell lung carcinoma (35%) than in patients with small cell lung carcinoma (4%)." The site goes on to say clubbing is a tell-tale sign of "various underlying pulmonary, cardiovascular, neoplastic, infectious, hepatobiliary, mediastinal, endocrine, and gastrointestinal diseases. Finger clubbing also may occur, without evident underlying disease, as an idiopathic form or as a Mendelian dominant trait."Now, clubbing usually can be readily identified in a sight exam. But for this particular patient, whose hands were swollen by obesity, the clubbing just looked a part of his weight issues. And about those weighty concerns...Dr. Chase felt that a morbidly obese patient like George didn't deserve the quality of care a normal weight patient would, because, obviously, he wasn't participating in his own health care. Why then should House and his team go out of their way?
The team did start with obesity as the first line of investigation of his problems, even though George said he'd been overweight all his life and it had never been a health issue. Is it a form of prejudice to start with being overweight as the cause of all your ailments?
I called Brenda, one of our Real Story writers, who two years ago was about 300 lbs. and underwent bariatric surgery, chronicling her dramatic weight loss in her online journal at WebMD. She TiVos House regularly.
"I believe that there are many people, not necessarily just those in the medical field, who agree with Chase, that obese people create their own situation so they should just live with it and not expect to be treated the same as a person who lives a healthy lifestyle," she says. "I believe that there is a similar attitude toward smokers. If they develop breathing problems or lung cancer, some people think they're getting what they asked for."
While no one asks for cancer or any disease, folks need to be responsible for their own health, Brenda says. "At the same time, every patient should have access to diagnosis and treatment."
Tell us what you think.
Related Topics: Surgery Options for the Obese
tags: House, HouseMD, lungcancer, fingerclubbing
5 Comments:
Eating to that degree is a mental disorder. Would a medical professional withhold treatment for a physical condition from a severely depressed person on the chance that someday in the future, they MIGHT kill themselves?
If I came up against a doctor like that, I would tell everyone I knew, and spend lots of money trying to ruin their career legally and professionally.
It's a small step from "I won't treat that fat slob for diabetes" to "I won't treat that black man for hypertension."
It's immoral and unethical.
I hate going to the doctor because I am overweight. I am reminded of this at each visit (as if I don't already know this). But this is the reason given for any problem that I may have. "Lose weight and you will feel better...lose weight and your problem will go away". It is very frustrating and embarrassing to waste my time and money being told this. If I could lose the weight I would. I am not overweight because I enjoy it.
Going back to tuesdays HOUSE episode,the obese patient,George was informed that he is in the final stage of small cell lung ca.,the question here arises is that,even if the cancer were rapidly progressing,there should be some amount of weight loss if not cachexia(cachectin is produced by cancer cells which causes weight loss amd wasting).if he would be in the final stages he would have noticed atleast some weight loss and reported it to the attending,taht would have atleast them towards checkin the patient for cancer....any comments, ANINAM
As a nutrition and medicine major myself, this is a very sensitive area. I was previously overweight, having lost 45 pounds and due to that extra weight I experienced many health problems. Some of them have been resolved and some appear to not be related. It is important for both the patient and doctor to be proactive in treatment. I now have to commit to being in excellent shape to convince a doctor that my congenital conditions aren't weight related.
Well, I agree that eveyone deserves treatment and to have their symptoms taken seriously. but in many cases the advice of "loose weight" IS sound, important medical advice! And even though it may not be what the patient wants to hear the doctor would not be doing his/her job without mentioning it. In this day and age everyone wants a pill or quick fix, but in the end medication is not the most ethical choice if other options are avalible. Even the safest drugs have potential to cause side effects and damage the liver or kidney (organs that may already be under alot of stress in obese patients). And a good doctor with the patients best intrests at heart will continue to encourage and stress weight loss, and it would be in the patients best intrest to make a serious dedicated effort to do so.
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