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Posts with tag risky

Thought for the Day: When options run out

Today I offer you not so much a Thought for the Day but a Question for the Day. Before I ask my pressing question, though, I want you to consider this story.

Diagnosed with a rare malignant melanoma on her retina in 2001, Ann Guthrie, a South Carolina wife and mother of two grown sons, endured radiation and chemotherapy. The treatments shrunk Guthrie's tumor, but another mass appeared two years later, forcing the removal of her right eye.

At about the same time Guthrie lost her eye, cancer was discovered in her lungs. It was inoperable. Then cancer landed in her brain. And now, without any approved treatment avenues, Guthrie is out of options.

Like many people with terminal illnesses, this woman is willing to try just about anything -- a clinical trial, experimental drugs, risky treatments -- to extend her life. If she's going to die anyway, why not? She just might live longer. And if she doesn't, she could at least help advance science by offering herself up as a sort of guinea pig.

While the Food and Drug Administration (FDA) has proposed changes that would make it easier for patients to access options like these, it's just not that simple right now.

There are ethical issues -- like weighing the needs of people who think anything is better than death against the need of society to prove drugs and treatments work safely. The only way to ensure a sort of balance is through clinical trials -- and letting anyone participate in clinical trials, for example, would make the results harder to interpret.

And there are medical and legal risks. What if terminally ill patients end up in worse shape after a treatment with an experimental drug, for example? What if the FDA or a physician is considered responsible for adverse drug reactions?

Denying terminal patients their last bits of hope is difficult. "It's a hard discussion to have with a patient and his family," says one doctor. "There's a lot of tears. We all would love to be able to get them access to some form of therapy."

And now for my question:

What do you think about terminally ill cancer patients and their access to anything that might extend -- or save -- their lives?

Lung cancer screening not up to par

It seems screening for lung cancer doesn't save lives and it doesn't prevent advanced disease. But it does lead to potentially unnecessary and harmful treatment.

This isn't the final word on the use of CT scans to screen smokers and former smokers for the disease. But right now, the hope some experts had for the special X-rays to detect tiny lung abnormalities has been diminished by a large study that is still in the works. And until conclusive evidence says the screening is useful, the American Cancer Society will not endorse the test.

While CT screening did increase diagnosis and treatment -- those screened were three times more likely to be diagnosed with lung cancer and 10 times more likely to have lung surgery than predicted -- study co-author Dr. Peter Bach of Memorial Sloan-Kettering Cancer Center in New York says, "We don't see a trace of evidence that a single life was saved, that a single case of advanced cancer was avoided."

And because CT scanning led to more biopsies and surgeries, patients were put at risk for complications such as lung puncture, bleeding, and infection, according to Bach, whose work is published in the Journal of the American Medical Association.

"Getting screened for lung cancer with CT scanning is not only unproven, it's potentially a risky endeavor," he said.

Until an effective screening tool emerges -- possibly still years away -- experts say there is one surefire way to protect yourself from lung cancer. Stop smoking.

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