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    seekthealth wrote on FreeBird's wall

    I would like to know if you consider that chemo was an important factor in your treatment and why.

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    Pancreatic cancer & medicine: Where is the progress?

    In 2012, after we both felt he won his battle with his first big cancer-- lung cancer-- I sat with dad in a little room and listened to the doctor give the diagnosis-- stage 4 pancreatic cancer, with a prognosis of months to live even with treatment. By 2013, I watched my dad take his last breaths in this world. During that year, I asked questions and searched for answers, where there were almost none to be found. It was tough to see not only my dad struggle, but people on this website who also want answers that nobody seems to have.

    The National Cancer Institute reports that most pancreatic cancer is stage 4 by the time it is diagnosed, and that stage 4 has a five-year relative survival of 2.3%. http://seer.cancer.gov/statfacts/html/pancreas.html I've seen it described as "the deadliest cancer." Estimated new cases in 2014 equal 46,420, and deaths equal 39,590. The U.S. deaths in 1975 were 10.7 per 100,000 people. In 1990, the U.S. deaths were 10.7 per 100,000 people. In 2010, the deaths were 11.0 per 100,000 people.

    In 1975, there were 11.8 new cases per 100,000 people, and in 2010, there were 12.3 new cases per 100,000 people.

    For decades, the chemo drug of choice was 5-FU (fluorouracil). In the late 90's, Gemzar (gemcitabine) came along, mostly making a difference of months if you're lucky. Several years ago, based on a clinical trial out of France, the combination FOLFIRINOX (FOLinic acid, Fluorouracil, IRINotecan, and OXaliplatin) came along as a first line option for people who could tolerate its toxicity. Again the difference is usually measured in months. Another option came into use last year-- Gemzar combined with nab-paclitaxel or Abraxane. I remember how excited everyone was hearing about this when it was announced in the company, and how interesting it was to see how it was described in the investment pages. When you look at it compared to the results from the other drugs, it makes you wonder what the fuss was about. There's not much change in the prognosis after all these years.

    Each weekly visit to the oncologist was $250. to see the oncologist for a few minutes, not counting everything else. From his first cancer, I remember the cost of one of the medications just to deal with the side effects-- it doesn't have anything to do with the cancer. It was to raise the white blood cell count at that time, Neulasta, and it was over $8,000. per shot. We sat in the doctors offices and watched drug reps come in pushing their brands. Dad usually ended up feeling worse with the treatment for this cancer than he did without it, with little to show for it. He would go in, have his blood tested, see the doctor, and then go to the chemo room, where there were rows of chairs and IV pumps-- over two dozen of them. I couldn't help but have a flash in my mind of cow milking stalls, and to think what an incredible money maker this business is. In fact, when we first went in, we went into a little finance office and I felt like we were at a car dealership. I wondered how people must feel when they do not have any resources to pay, when they stepped into that room, or maybe they decided not to go at all. When we left, we made a game of driving around the parking lot to look at the doctors' cars and joked that there's another payment on the Lexus and Mercedes.

    Fastforward to hospice care, where nurses expressed their disappointment that they saw a lot of older people at the end of their lives, with terminal cancers, in extremely poor condition, who still had treatments pushed by their doctors for reasons they felt were only because they had the financial resources to pay the bill. There are two sides to medicine-- the dirty business, and on the other hand people who are extraordinary, smart, caring, who make a big difference. One such person was my dad's thoracic surgeon for his first lung cancer-- an outstanding and smart doctor as much as he was compassionate and caring. But the other side of the business is depressing. When you look at the amount of money they're making, and they way they talk about their drugs on financial websites, it seems there's a bigger financial incentive to keep the disease around than to get rid of it.

    4 Comments
    • Rick1970's Avatar
      Rick1970

      Bravo!

      about 2 years ago
    • GregP_WN's Avatar
      GregP_WN

      I know what you mean Freebird. I was in the same position with my Father as you, only a different cancer. In our case they told him that his prostate cancer would never kill him, something else would. Boy were they wrong!

      about 2 years ago
    • AmyJo's Avatar
      AmyJo

      Well said.

      almost 2 years ago
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    Question: Stable?