Monday, November 29, 2004

Individual biologies

As I learn to live with cancer -- there are some tough lessons on this syllabus -- it becomes increasingly clear that for all I discover about tumours and treatments, this objective approach will tell me little about how my own cancer might be cured. Because when you're looking for a cure, it's not about a given percentage success rate for a particular therapy or trial (especially for so rare a form of tumour as mine); the individual biology of your cancer is what counts.
My oncologist characterizes the idea that if 70% of treatments work then you have that chance of success as a neanderthal approach, and I can see his point. For example, it's no use putting patients through the most effective radiotherapy if they have lots of small metastases: it would take years to target all these mini tumours, during which period there would be further spread. The reason why people are put through mass courses of chemotherapy is not because the oncologist knows that it will work for those patients, but because it's statistically successful. Oncologists need more time with each patient to determine the correct solution: therapy shouldn't be a mass market but a heavily tailored solution.

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