Tumor Patient Quotes

Did any of you ever see Doctor Tetrazzini perform? I say perform advisedly because his operations were performances. He would start by throwing a scalpel across the room into the patient and then make his entrance as a ballet dancer. His speed was incredible: "I don't give them time to die", he would say. Tumors put him in a frenzy of rage. "Fucking undisciplined cells!" he would snarl, advancing on the tumor like a knife-fighter.

When I went on my first antidepressant it had the side effect of making me fixated on suicide (which is sort of the opposite of what you want). It’s a rare side effect so I switched to something else that did work. Lots of concerned friends and family felt that the first medication’s failure was a clear sign that drugs were not the answer; if they were I would have been fixed. Clearly I wasn’t as sick as I said I was if the medication didn’t work for me. And that sort of makes sense, because when you have cancer the doctor gives you the best medicine and if it doesn’t shrink the tumor immediately then that’s a pretty clear sign you were just faking it for attention. I mean, cancer is a serious, often fatal disease we’ve spent billions of dollars studying and treating so obviously a patient would never have to try multiple drugs, surgeries, radiation, etc., to find what will work specifically for them. And once the cancer sufferer is in remission they’re set for life because once they’ve learned how to not have cancer they should be good. And if they let themselves get cancer again they can just do whatever they did last time. Once you find the right cancer medication you’re pretty much immune from that disease forever. And if you get it again it’s probably just a reaction to too much gluten or not praying correctly. Righ

Because when you’re the caregiver, you’re just as much the patient as the actual patient.

Yes, there is no hope. But remember, some fuses are duds, some tumors are benign, some heart patients recover on their own. You have time to change your life.

facts matter a great deal. What a patient does for a living, what his background is, what level of education he has achieved…all of these issues must be addressed in great detail in order to put his complaints and his disease in the proper context. If I ask a man to take the square root of 100 and he cannot, I might take this as proof of a left-hemispheric brain tumor, unless I know that he has worked on a farm since childhood and never attended school. Likewise, I might find it normal that a patient could not tell me the current exchange rate of the pound in Japanese yen. But if I knew that person was a merchant banker, on the other hand, ignorance of this fact would indicate a grave illness indeed! Americans have grown so dependent upon their scanning toys that they fail to view the patient as a multidimensional person. To have the audacity to cut into a person’s brain without the slightest clue of his life, his occupation…I find that most simply appalling.” These

Doctor Benway is operating in an auditorium filled with students: "Now, boys, you won't see this operation performed very often and there's a reason for that ... You see it has absolutely no medical value. No one knows what the purpose of it originally was or if it had a purpose at all. Personally I think it was a pure artistic creation from the beginning. Just as a bull fighter with his skill and knowledge extricates himself from danger he has himself invoked, so in this operation the surgeon deliberately endangers his patient, and then, with incredible speed and celerity, rescues him from death at the last possible split second ... "Did any of you ever see Doctor Tetrazzini perform? I say perform advisedly because his operations were performances. He would start by throwing a scalpel across the room into the patient and then make his entrance like a ballet dancer. His speed was incredible: `I don't give them time to die,' he would say. Tumors put him in a frenzy of rage. `Fucking undisciplined cells!' he would snarl, advancing on the tumor like a knife-fighter.

A surgeon gets $500 for taking out a tumor. A pathologist gets five dollars for examining it, making a diagnosis, recommending further treatment, and predicting the patient’s future.

When I was a med student, the first patient I met with this sort of problem was a sixty-two-year-old man with a brain tumor. We strolled into his room on morning rounds, and the resident asked him, “Mr. Michaels, how are you feeling today?” “Four six one eight nineteen!” he replied, somewhat affably. The tumor had interrupted his speech circuitry, so he could speak only in streams of numbers, but he still had prosody, he could still emote: smile, scowl, sigh. He recited another series of numbers, this time with urgency. There was something he wanted to tell us, but the digits could communicate nothing other than his fear and fury. The team prepared to leave the room; for some reason, I lingered. “Fourteen one two eight,” he pleaded with me, holding my hand. “Fourteen one two eight.” “I’m sorry.” “Fourteen one two eight,” he said mournfully, staring into my eyes. And then I left to catch up to the team. He died a few months later, buried with whatever message he had for the world.

Drug addiction was a disease, and just as I wouldn’t judge a cancer patient for a tumor, so I shouldn’t judge a narcotics addict for her behavior. At thirteen, I found this patently absurd, and Mom and I often argued over whether her newfound wisdom was scientific truth or an excuse for people whose decisions destroyed a family. Oddly enough, it’s probably both: Research does reveal a genetic disposition to substance abuse, but those who believe their addiction is a disease show less of an inclination to resist it. Mom was telling herself the truth, but the truth was not setting her free.

The source of racist ideas was not ignorance and hate, but self-interest. The history of racist ideas is the history of powerful policymakers erecting racist policies out of self-interest, then producing racist ideas to defend and rationalize the inequitable effects of their policies, while everyday people consume those racist ideas, which in turn sparks ignorance and hate. Treating ignorance and hate and expecting racism to shrink suddenly seemed like treating a cancer patient’s symptoms and expecting the tumors to shrink. The body politic might feel better momentarily from the treatment—from trying to eradicate hate and ignorance—but as long as the underlying cause remains, the tumors grow, the symptoms return, and inequities spread like cancer cells, threatening the life of the body politic. Educational and moral suasion is not only a failed strategy. It is a suicidal strategy.

The main problems with America’s addiction-treatment system stem from its roots in the archaic notion that addiction is a choice, not a disease. One common symptom of the disease of addiction is relapse. Kicking an addict out of treatment for relapsing is like kicking a cancer patient out of treatment when a tumor metastasizes.

The tumor had interrupted his speech circuitry, so he could speak only in streams of numbers, but he still had prosody, he could still emote: smile, scowl, sigh. He recited another series of numbers, this time with urgency. There was something he wanted to tell us, but the digits could communicate nothing other than his fear & fury. 

Our deeply-rooted beliefs about the wholesomeness of milk and dairy products should be re-considered under careful, scientific evaluation. Given the tumor promotor effect of IGF-1, patients with tumorous disease should restrict consumption of milk and milk protein. The same applies to patients with coronary heart disease and with a family history of neurodegenerative disease.

Although Liston was renowned for his success stories—such as the removal of a forty-five-pound scrotal tumor in four minutes; prior to the operation, the poor patient had been forced to carry his scrotum around in a wheelbarrow—he also developed a reputation for the flamboyancy of his surgical failures. For instance, his joy at amputating a patient’s leg at the thigh in less than three minutes was hindered greatly when he realized he had also inadvertently sawed off the patient’s testicles. And perhaps, most famously, another leg amputation performed in less than three minutes had the unfortunate result of killing three people: the patient (who survived the surgery but died of gangrene several days later); his young assistant (whose fingers he accidentally sawed off during surgery and who would also later succumb to gangrene); and “a distinguished surgical spectator” whose coattails Liston also slashed. The man, who found himself surrounded by geysers of blood, was so convinced that the knife had pierced his vitals that he immediately “dropped dead from fright.” It was later described as “the only operation in history with a 300 percent mortality [rate].

Things changed after that between me and Mark. I stopped being mortified that people might mistake me for one of his acolytes. I was his Boswell, don’t you know. I interviewed him about his childhood—his father was a psychiarist in Beverly Hills. I cataloged the contents of his van. I followed him around at work, sitting in while he examined patients. He had been a bit of a prodigy when we were in college. After his father developed a tumor, Mark, who was pre-med, started studying cancer with an intensity that convinced many of his friends that his goal was to find a cure in time to save his father. As it turned out, his father didn’t have cancer. But Mark kept on with his cancer studies. His interest was not in fact in oncology—in finding a cure—but in cancer education and prevention. By the time he entered medical school, he had created, with another student, a series of college courses on cancer and coauthored The Biology of Cancer Sourcebook, the text for a course that was eventually offered to tens of thousands of students. He cowrote a second book, Understanding Cancer, that became a bestselling university text, and he continued to lecture throughout the United States on cancer research, education, and prevention. “The funny thing is, I’m not really interested in cancer,” Mark told me. “I’m interested in people’s response to it. A lot of cancer patients and suvivors report that they never really lived till they got cancer, that it forced them to face things, to experience life more intensely. What you see in family practice is that families just can’t afford to be superficial with each other anymore once someone has cancer. Corny as it sounds, what I’m really interested in is the human spirit—in how people react to stress and adversity. I’m fascinated by the way people fight back, by how they keep fighting their way to the surface.” Mark clawed at the air with his arms. What he was miming was the struggle to reach the surface through the turbulence of a large wave.

The history of racist ideas is the history of powerful policymakers erecting racist policies out of self-interest, then producing racist ideas to defend and rationalize the inequitable effects of their policies, while everyday people consume those racist ideas, which in turn sparks ignorance and hate. Treating ignorance and hate and expecting racism to shrink suddenly seemed like treating a cancer patient's symptoms and expecting the tumors to shrink.

He and his colleagues were finally able to get their trial underway and reported preliminary results in 2020. Their method, used in three late-stage cancer patients, was more sophisticated than the one used in China. They knocked out the PD-1 gene and also inserted into the T cells a gene that targeted the patients’ tumors. Although the patients were not cured, the trials showed that the technique was safe. Doudna and one of her postdoctoral students published an article in Science explaining the Penn results.

Yet the hunger to treat patients still drove Farber. And sitting in his basement laboratory in the summer of 1947, Farber had a single inspired idea: he chose, among all cancers, to focus his attention on one of its oddest and most hopeless variants—childhood leukemia. To understand cancer as a whole, he reasoned, you needed to start at the bottom of its complexity, in its basement. And despite its many idiosyncrasies, leukemia possessed a singularly attractive feature: it could be measured. Science begins with counting. To understand a phenomenon, a scientist must first describe it; to describe it objectively, he must first measure it. If cancer medicine was to be transformed into a rigorous science, then cancer would need to be counted somehow—measured in some reliable, reproducible way. In this, leukemia was different from nearly every other type of cancer. In a world before CT scans and MRIs, quantifying the change in size of an internal solid tumor in the lung or the breast was virtually impossible without surgery: you could not measure what you could not see. But leukemia, floating freely in the blood, could be measured as easily as blood cells—by drawing a sample of blood or bone marrow and looking at it under a microscope. If leukemia could be counted, Farber reasoned, then any intervention—a chemical sent circulating through the blood, say—could be evaluated for its potency in living patients. He could watch cells grow or die in the blood and use that to measure the success or failure of a drug. He could perform an “experiment” on cancer.

Lots of concerned friends and family felt that the first medication’s failure was a clear sign that drugs were not the answer; if they were I would have been fixed. Clearly I wasn’t as sick as I said I was if the medication didn’t work for me. And that sort of makes sense, because when you have cancer the doctor gives you the best medicine and if it doesn’t shrink the tumor immediately then that’s a pretty clear sign you were just faking it for attention. I mean, cancer is a serious, often fatal disease we’ve spent billions of dollars studying and treating so obviously a patient would never have to try multiple drugs, surgeries, radiation, etc., to find what will work specifically for them. And once the cancer sufferer is in remission they’re set for life because once they’ve learned how to not have cancer they should be good. And if they let themselves get cancer again they can just do whatever they did last time. Once you find the right cancer medication you’re pretty much immune from that disease forever. And if you get it again it’s probably just a reaction to too much gluten or not praying correctly. Right?

Drug addiction was a disease, and just as I wouldn’t judge a cancer patient for a tumor, so I shouldn’t judge a narcotics addict for her behavior. At thirteen, I found this patently absurd, and Mom and I often argued over whether her newfound wisdom was scientific truth or an excuse for people whose decisions destroyed a family. Oddly enough, it’s probably both: Research does reveal a genetic disposition to substance abuse, but those who believe their addiction is a disease show less of an inclination to resist it. Mom was telling herself the truth, but the truth was not setting her free. I

Another Damasio patient, “Elliot,” was a successful husband, father, and businessman until undergoing brain surgery on a tumor. The surgery damaged his frontal lobe and thereby affected his ability to carry through on plans. He would embark on a project only to lose sight of his goal in doing so. For example, asked to sort documents, he would go overboard: “He was likely, all of a sudden, to turn from the sorting task he had initiated to reading one of those papers carefully and intelligently, and to spend an entire day doing so. Or he might spend a whole afternoon deliberating on which principle of categorization should be applied.

Our deeply-rooted beliefs about the wholesomeness of milk and dairy products should be re-considered under careful, scientific evaluation. Given the tumor promotor effect of IGF-1, patients with tumorous disease should restrict consumption of milk and milk protein. The same applies to patients with coronary heart disease and with a family history of neurodegenerative disease. Milk consumption has already been identified as an aggravating factor in the acne “epidemic” among adolescents, and preliminary successes have been reported with reduced milk consumption. It is even more important that excessive milk consumption can promote diseases commonly associated with a Western lifestyle

Steve Harmon, thirty-six, had esophageal cancer growing at the inlet of his stomach. For six months, he had soldiered through chemotherapy as if caught in a mythical punishment cycle devised by the Greeks. He was debilitated by perhaps the severest forms of nausea that I had ever encountered in a patient, but he had to keep eating to avoid losing weight. As the tumor whittled him down week by week, he became fixated, absurdly, on the measurement of his weight down to a fraction of an ounce, as if gripped by the fear that he might vanish altogether by reaching zero. Meanwhile, a growing retinue of family members accompanied him to his clinic visits: three children who came with games and books and watched, unbearably, as their father shook with chills one morning; a brother who hovered suspiciously, then accusingly, as we shuffled and reshuffled medicines to keep Steve from throwing up; a wife who bravely shepherded the entire retinue through the whole affair as if it were a family trip gone horribly wrong. One morning, finding Steve alone on one of the reclining chairs of the infusion room, I asked him whether he would rather have the chemotherapy alone, in a private room. Was it, perhaps, too much for his family—for his children? He looked away with a flicker of irritation. “I know what the statistics are.” His voice was strained, as if tightening against a harness. “Left to myself, I would not even try. I’m doing this because of the kids.

If they’re not practicing deliberately, even experts can see their skills backslide. Ericsson shared with me an incredible example of this. Even though you might be inclined to trust the advice of a silver-haired doctor over one fresh out of medical school, it’s been found that in a few fields of medicine, doctors’ skills don’t improve the longer they’ve been practicing. The diagnostic accuracy of professional mammographers, for example, doesn’t get more accurate over the years. Why would that be? For most mammographers, practicing medicine is not deliberate practice, according to Ericsson. It’s more like putting into a tin cup than working with a coach. That’s because mammographers usually only find out if they missed a tumor months or years later, if at all, at which point they’ve probably forgotten the details of the case and can no longer learn from their successes and mistakes. One field of medicine in which this is definitively not the case is surgery. Unlike mammographers, surgeons tend to get better with time. What makes surgeons different from mammographers, according to Ericsson, is that the outcome of most surgeries is usually immediately apparent—the patient either gets better or doesn’t—which means that surgeons are constantly receiving feedback on their performance. They’re always learning what works and what doesn’t, always getting better. This finding leads to a practical application of expertise theory: Ericsson suggests that mammographers regularly be asked to evaluate old cases for which the outcome is already known. That way they can get immediate feedback on their performance.

As it happened, the child’s mother was a radiologist. The tumor looked malignant—the mother had already studied the scans, and now she sat in a plastic chair, under fluorescent light, devastated. “Now, Claire,” the surgeon began, softly. “Is it as bad as it looks?” the mother interrupted. “Do you think it’s cancer?” “I don’t know. What I do know—and I know you know these things, too—is that your life is about to—it already has changed. This is going to be a long haul, you understand? You have got to be there for each other, but you also have to get your rest when you need it. This kind of illness can either bring you together, or it can tear you apart. Now more than ever, you have to be there for each other. I don’t want either of you staying up all night at the bedside or never leaving the hospital. Okay?” He went on to describe the planned operation, the likely outcomes and possibilities, what decisions needed to be made now, what decisions they should start thinking about but didn’t need to decide on immediately, and what sorts of decisions they should not worry about at all yet. By the end of the conversation, the family was not at ease, but they seemed able to face the future. I had watched the parents’ faces—at first wan, dull, almost otherworldly—sharpen and focus. And as I sat there, I realized that the questions intersecting life, death, and meaning, questions that all people face at some point, usually arise in a medical context. In the actual situations where one encounters these questions, it becomes a necessarily philosophical and biological exercise. Humans are organisms, subject to physical laws, including, alas, the one that says entropy always increases. Diseases are molecules misbehaving; the basic requirement of life is metabolism, and death its cessation. While all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact. In addition, to the patient and family, the brain surgery is

The history of racist ideas is the history of powerful policymakers erecting racist policies out of self-interest, then producing racist ideas to defend and rationalize the inequitable effects of their policies, while everyday people consume those racist ideas, which in turn sparks ignorance and hate. Treating ignorance and hate and expecting racism to shrink suddenly seemed like treating a cancer patient’s symptoms and expecting the tumors to shrink. The body politic might feel better momentarily from the treatment—from trying to eradicate hate and ignorance—but as long as the underlying cause remains, the tumors grow, the symptoms return, and inequities spread like cancer cells, threatening the life of the body politic. Educational and moral suasion is not only a failed strategy. It is a suicidal strategy.

I suppose you could even position a remote-controlled scalpel in 4-D space and operate on a patient without ever cutting their skin. Tumor? No problem, just remove it from the inside-out.

The Cancer Center suffered from two hallmarks of organizations that are plagued with coordination snafus. First, powerful people ignore, dismiss, denigrate, and even undermine people and groups they need to mesh their work with. Oncologists saw themselves as being at the top of the pecking order at the center and the work of other specialists as secondary, trivial, or downright useless. They dismissed side effects, including fatigue, diarrhea, and cramps, caused by chemotherapy that they prescribed as “normal” and left it to patients to find specialists to treat such problems. Second, powerful people devote little attention to solutions for coordination problems. Executives, consultants, and physicians who launched the center gave lip service to collaboration across silos. Yet they focused on building strong teams and departments in areas such as brain tumors, breast cancer, and skin cancer—and ignored how to help the units work together.

Within the class of neuroendocrine cancers, carcinoid is the most common specific cancer, but there also is a wide variety of other, much less common neuroendocrine cancers such as gastrinomas, somatostatinomas, VIPomas, etc.  All of the neuroendocrine cancers have symptoms which can partially mimic mast cell disease.  However, in the vast majority of cases of these rare tumors, the total range and duration of symptoms, and the pattern of progression/worsening, don’t come anywhere close to what’s typically seen in mast cell disease.  Nevertheless, in part because of the partial symptom mimicry, patients who are ultimately found to have mast cell disease often have been previously suspected of having – and thus have been intensively tested for, and sometimes even treated for – a neuroendocrine malignancy for which definitive diagnostic evidence cannot be found.

Later, alas, when Mr. Wright learned that other patients did not respond so favorably to Krebiozen, and that doctors had begun to consider the chemical worthless against cancer, he became depressed and worried. His tumors began growing again, he returned to his bed, and he died.

The cancer patient doesn't treasure his tumor, simply because it's a part of himself; so why should I treasure the organs that are killing my immortal soul? Christ isn't ordering you to pluck out your eyes: he's saying that he knows, that if you knew what he knew you would know that it would be better for you, in the long run. That you would want to if you knew.

Dr. Warren agreed, and a demonstration was scheduled at the hospital. There, on October 16, 1846, before a considerable audience of doctors and medical students, Morton administered ether to a surgical patient, Gilbert Abbott; Dr. Warren then removed a tumor from Abbott's neck. The anesthetic proved completely effective, and the demonstration was an overwhelming success. That demonstration, which was promptly reported in many newspapers, was directly responsible for the widespread use of anesthetics in surgical operations over the course of the next few years.

Relying on charity to solve global health is like placing a Band-Aid on a malignant tumor and expecting the patient to recover.

Burr was in. He enthusiastically sent one of his contraptions back with Langman to his wards, where, in an initial group of 100 women, he strapped one electrode to the lower abdomen above the pubis, and the other either on or alongside the cervix.6 Women whose troubles turned out to be caused by ovarian cysts or other non-cancerous medical issues almost always had a positive reading. Women with malignant tumors, however, showed an electrical “marked negativity” of the cervical region every time.7 Langman confirmed their diagnosis with a pathological examination. Cancerous tissues, it appeared, emitted an unmistakable electrical signature. Langman repeated the technique in about a thousand women to see whether his results stood up. They did: 102 of his patients exhibited the characteristic voltage reversals. When Langman operated on them, he confirmed that 95 of the 102 had cancer.8 Even more remarkably, often the masses had not even progressed to the point where the symptoms would have driven them to visit the doctor, never mind obtain a correct diagnosis. After removing these cancers, the electrical polarity shown on the electrometer would normally flip back to a “healthy” positive indicator—but it did not always. When it stayed negative, Burr and Langman suspected that this indicated that they either hadn’t got it all, or the cells had metastasized. Somewhere in the body, a cancerous mass was still sending its nefarious signals. What struck them as especially strange was that the electrode inside the genital tract did not have to be placed directly on, or even particularly near to, the malignant tissue for the anomaly to be detectable. It was like a distress signal was being sent over distances through the body’s healthy tissue.

twenty-nine-year-old patient she had recently cared for who had an inoperable brain tumor that continued to grow through second-line chemotherapy. The patient elected not to attempt any further chemotherapy, but getting to that decision required hours of discussion, for this was not the decision he had expected to make. First, the oncologist said, she had a discussion with him alone. They reviewed the story of how far he’d come, the options that remained. She was frank. She told him that in her entire career she had never seen third-line chemotherapy produce a significant response in his type of brain tumor. She had looked for experimental therapies, and none were truly promising. And, although she was willing to proceed with chemotherapy, she told him how much strength and time the treatment would take away from him and his family. He did not shut down or rebel. His questions went on for an hour. He asked about this therapy and that therapy. Gradually, he began to ask about what would happen as the tumor got bigger, what symptoms he’d have, what ways they could try to control them, how the end might come. The oncologist next met with the young man together with his family. That discussion didn’t go so well. He had a wife and small children, and at first his wife wasn’t ready to contemplate stopping chemo. But when the oncologist asked the patient to explain in his own words what they’d discussed, she understood. It was the same with his mother, who was a nurse. Meanwhile, his father sat quietly and said nothing the entire time. A few days later, the patient returned to talk to the oncologist. “There should be something. There must be something,” he said. His father had shown him reports of cures on the Internet. He confided how badly his father was taking the news. No patient wants to cause his family pain. According to Block, about two-thirds of patients are willing to undergo therapies they don’t want if that is what their loved ones want.

The oncologist went to the father’s home to meet with him. He had a sheaf of possible trials and treatments printed from the Internet. She went through them all. She was willing to change her opinion, she told him. But either the treatments were for brain tumors that were very different from his son’s or else he didn’t qualify. None were going to be miraculous. She told the father that he needed to understand: time with his son was limited, and the young man was going to need his father’s help getting through it. The oncologist noted wryly how much easier it would have been for her just to prescribe the chemotherapy. “But that meeting with the father was the turning point,” she said. The patient and the family opted for hospice. They had more than a month together before he died. Later, the father thanked the doctor. That last month, he said, the family simply focused on being together, and it proved to be the most meaningful time they’d ever spent.

Pomegranates inhibit breast cancer, prostate cancer, colon cancer, and leukemia, and prevent vascular changes that promote tumor growth in lab animals.55 2. Pomegranates inhibit angiotensin-converting enzymes and naturally lower blood pressure. (Angiotensin, as you may recall, is a hormone that promotes angiogenesis.)56 3. The potent antioxidative compounds in pomegranates reverse atherosclerosis and reduce excessive blood clotting and platelet clumping, factors that can lead to heart attacks and strokes.57 4. Pomegranates have estrogen-like compounds that stimulate serotonin and estrogen receptors, improving symptoms of depression and helping build bone mass in lab animals.58 5. Pomegranates reduce tissue damage in those with kidney problems, reduce the incidence of infections, and prevent serious infections.59 6. Lastly but impressively, pomegranates improve heart health. Heart patients with severe carotid artery blockages were given a daily dose of less than an ounce of pomegranate juice for a year. Not only did their blood pressure decrease by over 20 percent, but there was a 30 percent reduction in atherosclerotic plaque.60

You’re a legal scholar. You have the luxury of dissecting thorny questions one step at a time. I’m a doctor. If I were to remove a tumor one piece at a time—a bit today, a little next week, some more next year—the patient would die. To be effective, treatment must be immediate, swift, and thorough!

Let us be reminded that it is hard to feel overwhelmed when you are in familiar territory. It is easy to be overwhelmed when you are on unfamiliar ground no one wants to traverse.

The diagnosis of a brain tumor can leave patients and their loved ones in a mental fog;

Some patients choose not to pursue treatment out of a sense of denial about the tumor. They may think, “Maybe they’re wrong. Why take these risks associated with treatment? I don’t want to put my family through this and my insurance won’t cover it.

molecularly targeted agents into the treatment of early-stage NSCLC. At this time, however, such an approach cannot be recommended outside a clinical trial. In the NCI-C JBR.19 trial, which was terminated early when gefitinib lost its U.S. Food and Drug Administration (FDA) approval, administration of the EGFR inhibitor gefitinib after resection of stage I to III NSCLC did not improve OS. Surprisingly, a subset analysis of patients with tumors harboring activating EGFR mutations, a population expected to derive particular benefit from such an approach, suggested the possibility of a detrimental effect from gefitinib. Similarly, the use of antiangiogenic agents and ALK inhibitors after surgery for advanced disease remains investigational.

Homeopaths make medicines out of such unlikely substances as dog’s ear wax, dental plaque, vomit, tears from a weeping young girl, polyurethane, Braille paper, mercury, Stonehenge, arsenic, New York City, live scorpions, blood from an AIDS patient, and cancerous tumors. Some homeopathic remedies are not material but “imponderables” such as moonlight (luna), computer-terminal rays, wind (ventus), the north pole of a magnet (magnetis polus arcticus), and a vacuum (i.e., empty space).

Michelle shrugged off Sam’s aggression. Her eyes misted with memories. “Our curveball was a brain tumor. A grade IV astrocytoma, to be specific. He tried all the treatments—chemo, radiation, even surgery. Nothing helped alleviate his symptoms or his suffering. He was dying in the most horrible way. Seizures, nausea, blinding headaches, memory loss like an Alzheimer’s patient. I didn’t know what it was like to watch someone I love suffer so much, but I can relate to Julie’s pain because the experience was utterly excruciating.

If we didn’t kill the tumor, we killed the patient. —William Moloney on the early days of chemotherapy

Activation of the androgen receptor (AR) is crucial for tumor cell progression and survival of prostate cancer, and androgen deprivation therapy remains the main clinical approach in men with locally advanced tumors ■ Current therapies incompletely suppress the androgen–AR axis, but a multiple therapeutic approach, targeting androgens and their receptor, has potential to improve clinical outcomes ■ Treatment of prostate cancer cells with 5α-reductase inhibitors (5ARIs) inhibits cellular pathways regulating metabolism, cell growth and proliferation, triggering apoptosis and decreasing prostate size ■ Although 5ARI treatment reduces the risk of developing prostate cancer, patients treated with these drugs have tumors with higher Gleason scores than those who receive placebo ■ Use of 5ARIs to prevent and treat prostate cancer remains controversial, and further investigation is necessary to understand the presence of more-aggressive tumors in patients receiving these drugs

Watching Sadiqa's courage to break down her body to rebuild her body inspired me to accept the source of racist ideas I found while researching their entire history - even though it upended my previous way of thinking. My research kept pointing me to the same answer: The source of racist ideas was not ignorance and hate, but self-interest. The history of racist ideas is the history of powerful policymakers erecting racist policies out of self-interest, then producing racist ideas to defend and rationalize the inequitable effects of their policies, while everyday people consume those racist ideas, which in turn sparks ignorance and hate. Treating ignorance and hate and expecting racism to shrink suddenly seemed like treating a cancer patient's symptoms and expecting the tumors to shrink.

There are two ways to do ACT. First, we can take a sample of a patient’s tumor and isolate those T cells that do recognize the tumor as a threat. These are called tumor-infiltrating lymphocytes (TILs), but there may only be a few million of them, not enough to mount a complete response against the tumor. By removing the TILs from the body and multiplying them by a factor of 1,000 or so, and then reinfusing them into the patient, we can expect to see a much better response. Alternatively, T cells can be harvested from the patient’s blood and genetically modified to recognize his or her specific tumor. Each of these approaches has advantages and disadvantages,[*4] but the interesting part is that ACT effectively means designing a new, customized anticancer drug for each individual patient.

What’s good for you isn’t necessarily good for others—and vice versa. Consider this story: In 1985, a discovery by a major U.S. pharma firm led to a significant success in breast cancer treatment in two animal species. The phase I human trials showed no major safety concerns, but the study failed in phase II. The problem was with the cohort that was used. Half the patients had a gene that failed to metabolize the drug and they developed toxicity; the other half had a gene that metabolized the drug so quickly that it had no effect. When this problem was finally discovered in 2010 after gene sequencing of humans and of their tumors became more common, researchers realized that this beneficial drug had not helped the hundreds of thousands it could have since 1985. The point: The Human Genome Project has led to a better understanding of why something can be bad for some but good for others. That has led to scientific progress that is letting us live younger for longer.

Frontal gait disorder is an imprecise term describing a combination of findings seen in patients with cerebral tumors, subdural hematomas, dementing illness, normal pressure hydrocephalus, and multiple lacunar infarcts.

Early-stage lung cancer is still treated with surgery, which is still regarded the "gold standard." Patients with localized disease have the highest chance of being cured if the tumor and surrounding lung tissue are removed.

Consider what happens to patients with insulinomas—very rare insulin-secreting tumors, usually found in non-diabetics. The estimated incidence is only four cases per million per year. This tumor constantly secretes very large amounts of insulin, causing recurrent episodes of hypoglycemia (low blood sugar). But what happens to body weight? A prospective case series showed that weight gain occurs in 72 per cent of patients.9 Removal of the tumor resulted in cure in twenty-four out of twenty-five cases. Removal of malignant insulinoma led to rapid and sustained weight loss.10

AN INSULINOMA IS a rare tumor3, 4 that secretes abnormally large amounts of insulin in the absence of any other significant disease. As the patient’s insulin levels increase, his or her levels of insulin resistance increase in lock step—a protective mechanism and a very good thing. If insulin resistance did not develop, the high insulin levels would rapidly lead to very, very low blood sugars. The resulting severe hypoglycemia would quickly lead to seizures and death. Since the body doesn’t want to die (and neither do we), it protects itself by developing insulin resistance—demonstrating homeostasis. The resistance develops naturally to shield against the unusually large insulin levels. Insulin causes insulin resistance.

Dr. P. was diagnosed with a massive tumor in the parts of his brain involved in integrating visual sensory information and binding it into a whole scene. It is this “binding” capacity that allows us to recognize the sum of the parts as a person or a fire hydrant or a hat. Like other patients with this problem, Dr. P. could easily identify individual sensory stimuli but had lost the visual processing circuitry that binds these separate features into a recognizable whole.

a noninvasive tumor. Stage 1—before the cancer spreads to the lymph nodes—is curable, though lots of stage 1 patients have mastectomies. Triple positive is good—this means the tumors respond to hormones—though triple-positive patients often go on a drug called tamoxifen, and everyone hates it because it makes you gain weight and zaps your sex drive. In stage 2, the cancer has spread to the lymph nodes; they sometimes feel swollen. Tatum checks under her arms again; she thought she felt some swelling the other night, but tonight, nothing. HER2-positive breast cancer is aggressive—treatment is effective but it nearly always includes chemotherapy. You can order a “cold cap” so your hair won’t fall out, but it’s expensive. What even

PATIENT PROFILE: S.R. was diagnosed at age 48 with stage 4 non-Hodgkins B-cell lymphoma. Tumor was the size of a potato and choking off blood to the intestines. Underwent chemo regimen. S.R. used nutrition supplements in spite of oncologist’s hostility to the subject. S.R. was able to work throughout chemo, travelling to trade shows, though he did lose his hair. As of 2005, S.R. is in complete remission and has learned the value of good nutrition, living more joyfully, and faith in God.

When I first started seeing Julie, I imagined that it would be hard going from hearing about her CT scans and tumors to listening to “So, I think the babysitter is stealing from me” and “Why do I always have to initiate sex?” You think you have problems? I worried I’d say in my head. But it turned out that being with Julie made me more compassionate. Other patients’ problems mattered too: their betrayal by the person who’d been trusted to watch their child; their feelings of shame and emptiness when rejected by their spouses. Underneath these details were the same essential questions Julie had been forced to face: How do I feel safe in a world of uncertainty? How do I connect? Seeing Julie called forth in me an even greater sense of responsibility to my other patients. Every hour counts for all of us, and I want to be fully present in the therapy hour I spend with each one.

Ketones also interfere with the ability of cancer cells to obtain energy, making tumors more likely to respond to treatment when the patient is adopting a ketogenic diet. In lab mice with brain tumors, the ketogenic diet can shrink tumors by 50 percent and lengthen survival.

The push for diversity can lead to absurd results. Bone marrow donations almost never work unless donor and recipient are the same race, so non-white patients suffer because almost all the people who register as donors are white. In 2008, the National Marrow Donor Program announced that all marrow registries would be required to meet quotas for minority donors. Officials at St. Luke’s Mountain States Tumor Institute in Boise, Idaho said they would have to shut down their donor registry because the demographics of the region made it impossible to find more than a handful of non-white donors. Likewise, the largely white Amity Regional School District that serves the eastern suburbs of New Haven, Connecticut, stood to lose tens of thousands of dollars in federal money because it did not have enough non-white autistic students. The district had no control over who was diagnosed with the condition, but federal officials said a ratio of 38 whites, one black, and one Asian was “significantly disproportionate,” and threatened to withhold $67,000.

I do, however, struggle to reconcile what medicine has taught me so well with the very reasons that drew me to it in the first place. I want to cry for those in whose bellies I find disseminated tumors, but cannot for fear of being unable to see clearly enough to sew them closed. I want to sit and linger with my patients, but know that such inefficiency would never work in the clinical world. I want to be able to soothe my patients' suffering without the burden of knowing the inexorable future of their diseases.

no patients with solid tumors have been cured by targeted therapies over that time period. Zero [is] the number of targeted therapies that have prolonged survival by one year, when compared to a conventional treatment.

immunotherapy making use of Lymphokine Activated Killer Cells. These LAK cells, as they became known, were derived from a patient’s own blood. When grown in the laboratory with some special proteins, they had the ability to selectively attack solid tumor cancers, regardless of type, and destroy them with only minimal side effects. In short, it was the ideal treatment for persons afflicted with this terrible disease. “Unfortunately, there were two problems; only thirty-nine percent of the patients treated responded to the therapy, and the process of collecting and growing the killer cells in the laboratory was time consuming and incredibly expensive. Then, with Doctor Steinberg’s death, and the drying up of government funding, this work at NIH ceased.

CAR-T therapy in a very small subset of cancer patients with lymphoid disease is fantastically successful, albeit causing severe short-term toxicities and many known and unknown lifelong side effects. It is clear that much work lies ahead before this strategy can be scaled up for general use. Yet the hype surrounding CAR-T is such that practically every patient questions me about why they are being deprived of the magic cure. The results are not always magical: Despite high-target, cell-specific killing in vitro and encouraging preclinical efficacies in murine tumor models, clinical responses of adoptively transferred T cells expressing α-folate receptor (FR) specific CAR in ovarian cancer were disappointing. No reduction of tumor burden was seen in the 14 patients studied. The absence of efficacy was ascribed to lack of specific trafficking of the T cells to tumor and short persistence of the transferred T cells.

Many brain tumor patients face changes in memory, thinking, or emotions since the diagnosis of a tumor or its treatment. In fact, studies have documented cognitive impairments in as many as sixty to ninety percent of patients with brain tumors. Patients may experience any combination of changes, and even patients with similar tumors may have quite different experiences.” From the National Brain Tumor Society

LDL cholesterol stimulates the growth of breast cancer cells in a petri dish—they just gobble up the so-called bad cholesterol. Tumors may suck up so much cholesterol that cancer patients’ cholesterol levels tend to plummet as their cancer grows.76

The history of racist ideas is the history of powerful policymakers erecting racist policies out of self-interest, then producing racist ideas to defend and rationalize the inequitable effects of their policies, while everyday people consume those ideas, which in turn sparks ignorance and hate. Treating ignorance and hate and expecting racism to shrink suddenly seemed like treating a cancer patient's symptoms and expecting the tumors to shrink. The body politic might feel better momentarily from the treatment-from trying to eradicate hate and ignorance- but as long as the underlying cause remains, the tumors grow, the symptoms return, and inequities spread like cancer cells, threatening the life of the body politic. Educational and moral suasion is not only a failed strategy. It is a suicidal strategy.

Cancer demonstrates a spectrum of behavior. Some tumors are inherently benign, genetically determined to never reach the fully malignant state; and some tumors are intrinsically aggressive, and intervention at even an early, presymptomatic stage might make no difference to the prognosis of a patient. To address the inherent behavioral heterogeneity of cancer, the screening test must go further. It must increase survival.

than those who ate less.135 The quantity of phytoestrogens found in just a single cup of soy milk136 may reduce the risk of breast cancer returning by 25 percent.137 The improvement in survival for those eating more soy foods was found both in women whose tumors were responsive to estrogen (estrogen-receptor-positive breast cancer) and those whose tumors were not (estrogen-receptor-negative breast cancer). This also held true for both young women and older women.138 In one study, for example, 90 percent of the breast cancer patients

A three-fold approach, reduction of tumor burden without harming the patient, re-regulating the cancer to convert to normal health tissue, and nourishing the patient's recuperative powers, will be the human and clinically effective cancer treatment of the new millennium.

An extraordinarily grim academic article from 2009 looked at the marital outcome of 515 patients diagnosed with life-threatening diseases, observing groups battling malignant primary brain tumors, other forms of cancer, and multiple sclerosis. The study, which monitored male and female patients who were in heterosexual marriages over the course of five years, found there was a significant difference in the rate of "abandonment" depending on the gender of the patient. When the patient was male, and the supporting spouse female, divorce happened in 2.9 percent of cases. When the patient was female and the supporting spouse was male, divorce happened in 20.8 percent of cases-it was seven times more likely to happen.

The lower a patient’s overall tumor burden, the more effective our drugs tend to be—and the greater the patient’s odds of survival.

The history of racist ideas is the history of powerful policymakers erecting racist policies out of self-interest, then producing racist ideas to defend and rationalize the inequitable effects of their policies, while everyday people consume those racist ideas, which in turn sparks ignorance and hate. Treating ignorance and hate and expecting racism to shrink suddenly seemed like treating a cancer patient’s symptoms and expecting the tumors to shrink. The body politic might feel better momentarily from the treatment—from trying to eradicate hate and ignorance—but as long as the underlying cause remains, the tumors grow, the symptoms return, and inequities spread like cancer cells, threatening the life of the body politic. Educational and moral suasion is not only a failed strategy. It is a suicidal strategy. —