Rus Articles Journal

Treatment of oncology. What to choose alternative?

In fight against a damnation of the modern world - cancer, mankind in recent years achieved very impressive results. The medicine saved up and quite successfully uses a huge arsenal of means for achievement of a victory over this illness.

The surgery, drug treatment, radiotheraphy stand in the same row with such achievement of the human genius as chemotherapy. With its help thousands and thousands of patients had an opportunity to lead normal life for many years. This course of treatment is hard, but all sufferings with interest pay off and the patient is restored to usual life about which he any 15 - 20 years ago when made it the ruthless diagnosis, could only dream.

But, unfortunately, cancer is not won finally yet. And thousands of patients, already precisely knowing that they death inevitably, face a dilemma - how to spend these last months: to use “chemistry“ for extension of life or to leave everything on God`s will.

For oncologists as a guideline serves the condition of the patient: if he is confined to the bed and cannot provide himself to the most necessary for more - less normal life, then the answer to this question cannot. It is not necessary to torment the patient. Eventually, all of us are mortal. But for patients who quite can independently exist this type of treatment can and even has to be considered as the reasonable choice. Despite all by-effects of this type of treatment, and they are sometimes painful, doctors consider that the patient even with his terminal stage of development of an illness should trying to prolong to himself life or, at least, to make it rather tolerable.

However now the research conducted within several years (2002-2008) in the USA by the Center for research of leaving for fatally sick at Cornell University (Center for Research on End - of - Life Care at Weill Cornell medical Center), showed, as such quite independent patients do not receive any benefit from this type of treatment. For them life only becomes worse, and final days are comparable with the final of the patients who refused to prolong to themselves life. For many this treatment only worsens a situation with their state. This sensational research claiming that the chemotherapy does not promote either life expectancy, or improvement of its quality. the Published data are based by

on supervision over 312 patients who according to all forecasts needed to live no more than several months. And much and have less than that. They were observed in six different clinics over all country at different times, and all had tumors (most different) with metastasises. A half them them chose chemotherapy.

After their death researchers interrogated relatives and attending physicians - as people of the most familiar with a situation, asking to estimate a psychological and physical state deceased their last days. Fear that doctors can lie, was not confirmed because the description of a condition of patients coincided with opinion of patients.

For those who were dying, one may say, the situation remained former irrespective of existence or lack of chemotherapy. But for 122 patients, stronger, results were striking: 68 people noted that their state only worsened. Among those who did not receive treatment such there was only 31.

the Director of this center, d - r Prigerson, told that it and his colleagues expected opposite result: “The real shock was felt by those who expected improvement of a situation and did not receive it. Moreover, the patients who passed through chemistry, poluchilisilny psychological blow in addition to those sufferings to which they underwent“. But he added that future researches will have to include monthly estimates and bigger quantity of the questions asked patients.

Of course, the difference in deaths for both groups was not. But it is necessary to notice that in researches and the task of definition of a possibility of a survival was not set. Therefore experts very carefully treat this result. Could just coincide that nobody survived especially as also patients were selected very specifically - practically anybody had no chances. By the way, not all potentially useful information became property of the medical public. Types of chemotherapy were not specified, history of treatment of these patients stayed behind scenes too.

Other oncologists, based on results of this research, say that you should not generalize. They did not mention an overall picture at least because the questions asked patients concerning quality of life were very specific. Them was only three. Such quantity can be equated to a picture. And the photo in such cases does not give a full picture of the events. Generally, sceptics just specified that questions was obvious insufficiently.

Besides, these tests were carried out in the first decade of the 21st century. During this time the science as speak, did not stand still. There were new, more effective drugs. They give less side effects because are less toxic in relation to other body organs. Physicians learned to cope with such by-effects better. And doctors became better to understand whom to treat and who should not be touched any more. And the most important is deeply individual approach to each patient who needs chemotherapy. Someone clings to life up to the end, battles … And another appreciates quality of life much more and does not want to suffer more … The third - wants to live up to a wedding of the daughter, the birth of the grandson or the granddaughter, the great-grandson … Yes you never know the reasons for desire to live as long as possible!

But today the guides to chemotherapy are based on a problem of reduction of the tumor and metastasises. In the future improvement of quality of life will be included surely into instructions. But it in the future. Meanwhile these results say that honest conversation with the patient and studying of influence of such treatment on its qualitative state is always necessary. That the patient has to know precisely, so it not only the fact that treatment will prolong his life for several weeks (that, sometimes, is very important for it), but also what he will test during this term. Whether his life live hell will be or rather safe at least three weeks, or even all six, eight, ten … As it will turn out.

It is possible to give many examples when relatives of the dead regret that they pulled and pulled life of the person close to them though no hopes existed any more. Backdating they began to understand what could not be done it. It was necessary to let the person go in peace. They did not think of such integral component as quality of life. About what suffering they inflicted on the person loved by them.

And the example when future grandmother did not want to die, will not see the granddaughter yet. It passed through chemistry, she suffered, but managed to press before death a tiny lump to a breast and to tell: “As you are loved by your grandmother!“ Died happy thanks to chemotherapy. Her family did not regret for “useless“ treatment. They did not even consider alternative.

There is a wish to finish article on an optimistic note. Therefore it is possible to quote one patient. He is 75 years old. It has a pancreatic cancer. For today, alas, it is meanwhile that type of cancer which did not learn to treat yet. But the patient chose chemotherapy, and by-effects are meanwhile quite tolerant. He for many months endured the term which to it was released by doctors before an initiation of treatment.

“It does not become better for me, and I do not expect it, - he says. - But meanwhile it is possible to live. If it becomes worse or I will lose ability to normal existence, I will stop chemotherapy because I want to have an opportunity to smile till last days of my life“.