PSiC section 16
P Henry 6July26
This article attempts to find human activities to deal with ‘having ‘, rather than ‘being’, cancer. As we need to maintain our individual abilities, while being a patient, this offers some tested ways. Our having a worthwhile life that we want to continue (QoL) is the cornerstone.
Are cancers curable? Science promised that in my childhood 70 years ago. Some things are getting better. Treatments have improved and maintenance of life can be better.
Some cancers are reducing; others are on the rise – often environmentally caused. There are also increases in some early onset cancers. The increased cost of medications also limits treatment choices.
Industrialisation intensifies our consumption of ultra-processed foods, frantic living patterns, decreasing social contact, using more computers and AI, with more intake of microplastics, air pollution and environmental toxins, with our sedentary life, diet changes, exposure to different bacteria, early and excessive use of anti-biotics/other drugs, and living longer all add cancer risks.
Increases also occur with additional detection. Some are victims of VOMIT (victim of medical imaging technology). These incidental findings of hyper-sensitive technology may lead to overdiagnosis and overtreatment.
Positive breakthroughs have occurred with immunotherapy for melanomas and kidney cancers. Their previous low survival rates, seen as treatment resistant cancers with poor outcome, now have an increased response up to 55% survival. Also, targeted chemotherapies are increasingly attempting to target, kill or repulse the invasive cancer growths, while reducing damage to healthy organs and body systems. The increased use of molecular targeted therapeutic agents has reduced side-effects and increased efficiency.
High-cost CAR T cells, that engineer immunotherapy from the patient’s own cells, has been successfully applied to challenging blood cancers. Effort is aimed at reducing its long-term side effects of secondary neoplasms, cytokines release or inflammation related syndromes.
These changes may lead to more successful personalised treatments. Appreciating the patient as an individual and highlighting QoL issues are improving. Constraints are financial and archaic attitudes.
Psychosocial treatments are more often included by cancer departments and widely offered by cancer charities. When fully integrated, they will produce superior overall outcomes. They significantly improve QoL. Patients can live more enjoyable, fruitful lives, with hope for more. This contrasts the medical cliché that “treatment was a success, but the patient died”.
Many of the impacts associated with cancer – worry, anxiety, reduced positive life activities, toxic relationships, financial problems – are starting to be addressed. Creating a more normalised life is a basis for improving QoL.
Various agencies are available to help with these things at no or low cost. In England, Penny Brohn https://pennybrohn.org.uk/, or Force https://forcecancercharity.co.uk/ and in Canada Wellspring https://wellspring.ca/, are examples of providers of good therapeutic supports. This increases general awareness and destigmatisation of cancer encouraging support for sufferers by neighbours, friends, or strangers. This destigmatised support is much needed.
Our various cancers with varied symptoms and presentations are still challenging. We wait anxiously between remissions and relapses. We think, what helps? It will be useful for our oncologists and other responsible professionals to have knowledge of the assorted therapies that go beyond their standard oncological care; they should help us act to use them.
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