Wednesday, March 13, 2013

DON'T MESS WITH OC: Get the best available.


Linda Joyce Beck, field herpetologist
Galapagos Islands, about 1985.
The tortise is Lonesome George, the last of his breed
You were supposed to kiss him on the forehead, for good luck.
She faked it.
 
 
It is approaching 900 outside and is supposed to get hotter later in the week.  I just returned from Vista, near the coast, where I had a very pleasant visit with my friends John and Joan McManus.   John and I played  18 holes of golf at the Lawrence Welk resort.  Yes, that Lawrence Welk – the main drive through it is called “Champaign Boulevard” and when you hit your initial drive you are enjoined to count your backswing-forswing  rhythm by saying “ a onea twoa”.  (Only people of approximately my age will understand these references.)  John shot 75 and I handily broke 100 with a 97.  I must admit, somewhat reluctantly, that par for the course was 61 – only par 3s and par 4s.  It is what is known as an “executive course”, presumably because true executives are too busy to play the longer versions.  I played fairly well, but at one point very nearly placed my drive in the lap of a nice lady reading on her veranda.  She was kind.
Anyway, what I want to write about is an article in the NYTimes entitled “Widespread Flaws Found in Ovarian Cancer Treatment”, brought  to my attention by – you guessed it – Dick Ingwall.  The gist of the article is that a significant study has shown that far too many ovarian cancer patients receive treatment from practitioners that are, to put it politely, not quite up to speed.  The recommendation is that such patients should go to a major cancer center - think Fred Hutch – and not rely on their local gynecologist.  They are urged to rely only on gynecological oncologists  who work at hospitals that  perform more than 20 ovarian cancer debulkings per year.  Another recommendation is to use “IP (intraperitoneal)” therapy whenever possible.  IP therapy is proven to be more effective, but few non-specialists  even know about it.  It has been recommended since 2006. 
Linda had the benefit of a highly accomplished gynecological surgeon, at the best place for treatment  in the Pacific Northwest.  Even so, she did not get  complete “debulking” (which means the removal of all the tumor visible to the naked eye.)  Neither did she have IP therapy.  The reason for both lf these departures from best practice was that she had previously had major surgery – very major surgery – that had rearranged her insides.  Poor kid, she had to endure four – no, five - major operations during the last five years of her life.  Through it all she never complained.  I think she was more concerned about how Carolyn and I, and all her friends and relatives, were coping with her illness than she was about the illness itself.  I didn’t deserve her.
If you want to read the article for yourself, go to   http://nyti.ms/Y6BSZc
I will leave for Bellingham on March 26th.



2 comments:

  1. A follow-up editorial in the NYTimes further analyses this problem (http://nyti.ms/13WUgel).
    Of interest are some of the Comments. One theme seems to be that the problem arises because women are less valued by society than men. Do you buy that?

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  2. I buy that women are less valued than men in society. But I'm not sure that's the reason for the problem. Are you talking about women not going to major cancer centers for treatment, as the problem? Or something else? If I had ovarian cancer, I wouldn't WANT to have to go to Seattle for treatment, and I would only do it if someone told me I should. I think people don't know any better, think their oncologist in Bellingham is just as good as one in Seattle. They need to be educated.

    I heard Lonesome George died a few years ago. The last of his species. You got to see him! Pretty cool.

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