I would have never predicted this.
Submitted by Dr.Kattlove’s Cancer Blog
Like most oncologists and all other people, I am lousy at predicting the future. Surveys of oncologists have shown that they are overly optimistic. They typically predict that their patients with advanced cancer will live longer than they actually do. That is why hospices complain that their cancer patients are referred too late. Once I actually made the opposite mistake. I sent a man with widespread prostate cancer into a hospice program. His ex-wife, thinking this would be a short obligation, moved in to help him in his final moments. Two years later, I was still making house calls to see him and she was climbing the walls.
I would have made the same mistake with Sally, had I seen her early in her fight with breast cancer. A few weeks ago, she walked into the Saban Free Clinic where I volunteer to see primary care patients. She complained of swelling over her left ribs. A few months earlier, she had lost her job and with it, her health insurance, so she needed a free clinic like ours for her care.
When I reviewed her history, I was astonished to see that she had been treated for breast cancer 19 years ago. Even more surprising was that she was treated in my office by one of my partners and received her mastectomy from my favorite surgeon. In addition to the chemotherapy she got in my office, she was also given a full dose of radiation across the street at Long beach Memorial.
The reason Sally received such extensive treatment is that she had stage IIIB cancer. It had spread to many lymph nodes and had actually infiltrated the lymphatic channels in her breast. This is called inflammatory breast cancer because it looks like the breast is infected and is almost invariably incurable. Yet, here she was. I would have never have predicted such a wonderful result.
A recent article from the MD Anderson Cancer Center pointed out that women like Sally with extensive breast cancer will do well if they make it past the first few years. At that point their chance of recurrence is lower than that for women who started with more favorable breast cancer. And Sally made it. I would like to think that it was because she received extraordinary treatment in my office and home hospital at the time, but we treated her just like other oncologists would have. Oncologists are information freaks. We are always scanning the literature to find better ways to save our patients so we all tend to think and practice alike.
And the rib swelling? Just a side effect from the damage done to her lymphatic system by the surgery and radiation. I reassured her and we are best of friends now. I hope I keep seeing her again, although, I would prefer that in the new President’s administration, we provide health insurance for everyone and put me out of my volunteer job.
