To wrap up this mini-series, here's an excerpt from an NCI interview with breast cancer oncologist Dr. Schnipper, offering one perspective on why the top five in oncology are overused:
...the anxiety that a cancer diagnosis presents, the importance of not missing something clinically important, and the reality of an advanced cancer that's already made a person very sick....I think these are more than enough to motivate and frighten anybody, patient or doctor, to turn over any stone that can reasonably be overturned....
It's counterintuitive to a patient, and it can be counterintuitive to a doctor, to tell them that finding metastatic disease doesn't help us help them survive longer. That's really what the data that support our top five list tell us…and it's a difficult concept for the patient to absorb. Some day, novel treatments may in fact aid us in extending survival of those with metastatic disease sufficiently to warrant continuous surveillance. We are not there yet, and when evidence supports our arrival at that point, our guidelines must change.
One of the great strengths of science and its offshoots, conventional and investigational medicine, is that these forms of medicine are always works-in-progress.
Conventional clinicians and researchers see their treatments as conditional -- namely, the best we have right now, given to patients with hope that science will discover something better tomorrow to replace today's state-of-the-art treatments.
Healthy Survivors know that when choosing treatment, the "right" choice is to choose the "best" choice. For further discussion, read Right is Best.