In Long Drive to "Cure" Cancer

Today's NYTimes story about the "Drive to Cure Cancer" highights the word "cure," a term that bothers many Healthy Survivors.

Before the 1950s, patients were considered "cured" after remaining cancer-free for 5 consecutive years. Since then, cancer "patients" became cancer "survivors," and an explosion of advances caused the public's hope for "a cure for cancer" to soar. Now survivors are walking, rowing and racing"for a cure."

Meanwhile many of these survivors are now living long enough to develop late recurrences and late effects, including second cancers. Consequently, in research and clinical settings "cured" is no longer a simple dichotomy like being pregnant (either you are or you aren't). 

Healthy Survivors understand that the word "cure" has multiple meanings.

In social and political contexts, "a cure for cancer" implies more than a cure for patients with cancer. It also implies a cure for the public health problem, such as a treatment that won't help someone with cancer but, instead, will prevent cancer from ever developing.

In doctors' offices and hospitals where clinicians are talking with individual patients, "a cure" is a condition that exists over a continuum. For many patients today (including me), the best treatment goal is not to get rid of every last cancer cell. The wisest goal for now may be to keep the cancer in check with the least toxicity possible.

Comments

[Kairol Rosenthal]

This was a great article in the NYTimes. The part that fascinated me was when they defined what it means when a treatment is proven to show "significant improvement" in fighting cancer. What they mean is statistically significant improvement, which in empirical data terms can mean that a drug extended life by days or weeks.

I hope that as the term "cure" begins to be dismantled publicly, that it leads us to more strategic agendas on how and what is best to research and solve in relationship to cancer incidence and mortality.

Kairol
http://everythingchangesbook.com/

[Wendy S. Harpham, MD]

Dear Kairol,
Thanks for emphasizing an important message from the NYTimes article.

A repeated theme on this blog is "Knowledge is power...but only if the knowledge is correct and properly understood."

The word "cure" is not likely to be banned from the vernacular. But as you suggest it can be "dismantled" or, put another way, the various meanings of "cure" can be clarified.

I have great confidence in the ability of non-medical people to learn important medical facts and nuances.

One of our jobs as writers of self-help health is to help clarify these terms, so our readers use them in helpful and hopeful ways.

With hope, Wendy

[Pat Foote]

Wendy, what is the best way to answer people who ask if I am "cured"? I am not in treatment at this time? I don't think "remission" is the best answer because there is always a new cancer to be dealt with.
thanks and in hope,
Pat Foote
itsurbis@sbcglobal.net

[Wendy S. Harpham, M.D.]

Dear Pat,

Every Healthy Survivor has to find an answer that serves his or her needs best at the time. Your answer may vary over time, even if your medical situation stays the same. And it may vary, depending on who is asking.

This is the answer that usually serves me well, since I have an indolent -- slow-growing -- lymphoma that keeps recurring: "My type of cancer is chronic. I'm in remission now and doing well, thanks."

I might add, "I can't know if I'm cured, so I really don't think about it."

I do have some goofy answers that I'd never say aloud but are fun to think to myself. Let me know if you'd like to hear 'em.

With hope, Wendy

[Finn]

I'd love to hear them.

[Wendy S. Harpham, M.D.]

Okay, Finn, I'll share some of my silly, stupid, awful answers to "Are you cured?"

"No, are you?" or "Do I look like a slab of bacon?"

Interestingly, someone said to me a few days ago, "I hope your cancer is now cured," and out popped my answer, "I hope so, too!"

Although I don't think about whether or not my cancer is gone for good, if someone brings it into my sphere of consciousness, reacting optimistically is easy and uplifting for the brief moment of interaction.

So whaddya think of my silly answers?

With hope, Wendy