When less is more in cancer care

I just saw a headline in the Medscape Journal of Medicine that could have come from a page in my own book. The headline read: “Solution to U.S. Cancer Care ‘Crisis’ is Less Cancer Care.”

Dr. George Lundberg, my respected colleague, is the founding editor-in-chief of Medscape (and former editor of the Journal of the American Medical Association). He has also been speaking and writing sensibly and wisely about the problem of cancer over-diagnosis and over-treatment for some time now.

I too spend a lot of time thinking about the “crisis” in cancer care. And in healthcare in general.

Tragically, cancer patients are trapped in this oppressive system. But they aren’t the only ones: Thousands of well-meaning health professionals are trapped too.

Unfortunately, I learned long ago that science alone doesn’t set the course for modern cancer care. Greed and fear do too. Along with an often duplicitous, “whatever it takes” mentality to keep the money coming in to the overweight, overbearing, fear-mongering cancer industry.

Without a doubt, cancer gets the highest priority in our health cancer system because people truly fear it. In fact, in a 2011 study, researchers found that Americans fear cancer the most (41 percent) out of any disease. While the phrase “cancer phobia”–first coined in 1955– is no longer politically correct, the psychology persists today.

And the U.S. government helps keep this culture of fear alive. In fact, the National Cancer Institute (NCI) receives more funding that any other federal health initiative. (And the non-profit cancer industry simply piles more of your money onto the same misplaced priorities.)

The NCI’s budget is so large it ranks as its own agency of the government. If a young scientist wanted to get work doing medical research in the 1970s or 1980s, he or she had almost no choice but to study cancer. Because funding for new scientists in other medical research fields just wasn’t there.

Unfortunately, as I’ve said before, the federal government’s misguided war on cancer completely ignores natural approaches. And they mismanage and waste hundreds of billions of dollars barking up all the wrong trees.

An article published in Health Affairs, the influential journal of public health policy, the authors argue we can find a solution to the troubles in the cancer care industry by studying geriatrics. Today, the practice of geriatrics uses approaches that emphasize a patient’s well-being.

By comparison, oncologists use all-out aggressive tactics to battle their questionable war against a shadowy enemy. You see, today’s oncologists treat all cancers aggressively…regardless of the patient’s age, health status, other health conditions, and expected longevity.

But age should be the factor we consider the most…even when it comes to cancer. Indeed, age is the biggest risk factor for developing the majority of all cancers–and for all of the most common cancers.

Overall, clinicians need to prioritize a patient’s illnesses, especially in older patients. And focus less just on the cancer and more on the patient and other aspects of health.

A new study–known as the National Social Life, Health and Aging Project– illustrates this important point.

The study looked at 50 health factors–including cancer status, blood pressure, depression, physical functioning, etc.–to produce an overall health score. The researchers found a prior diagnosis of cancer was not especially indicative of a participant’s current overall health status. In fact, people with very good or excellent health status were just as likely to have had cancer as those with only fair or poor health status.

These findings did not surprise me.

The truth is, cancer is not always as harmful as other diseases can be. And many common cancers are very treatable. In fact, women who get breast cancer and men who get prostate cancer most often die of something other than cancer.

So–what changes should we make to move oncology away from disease care to more holistic care?

For one, reimbursement should tie together payments for high-tech care (chemotherapy, radiation, or surgery) with “high-touch” care (like geriatric assessments, physical therapy and counseling).

Second, the FDA should require big pharma to test new cancer treatments in realistic trials with older patients who have multiple, other health conditions. They need to be sure even these “imperfect” patients can tolerate the new treatments.

Third, we need better incentives to encourage new health professionals to pursue high-touch specialties. Otherwise, the natural approaches hiding in plain sight may stay hidden forever. We also need to do a better job educating young health professionals about natural approaches to cancer. The information is out there, if only medical schools are willing to use it. My textbooks for health professionals covers thousands of published research studies that provide the scientific basis for using natural alternatives for cancer treatment. It also addresses their cost-effectiveness and compares these alternatives to mainstream practices. My basic textbook has been in print continuously for 20 years, and the new fifth edition is due out next month.

Lastly, we need to encourage patients to seek out natural approaches in cancer treatment. In my estimation, 80 percent of cancer patients would do better with natural approaches that are less costly, less dangerous, and less toxic to the system.

In Chinese, two pictographs comprise the character for crisis–that of “danger” combined with that of “opportunity.”

In this case, the “danger” is our unaffordable, hospital-based, disease-care system collapsing under its own weight. But this “danger” creates an “opportunity” for natural medicine. Perhaps it will lead more doctors and patients to seek the many safe, effective, and natural cancer treatment alternatives hiding in plain sight.

Sources:

  1. Reconceptualizing Health and Health Care: Why Our Cancer Care Delivery System Is In Crisis,” Health Affairs, published on-line, September 23, 2014

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