Cancer as a Commodity


Radio (Photo credit: Wikipedia)

So I’m driving home the other day, and on the radio I hear an ad for cancer treatment and I crank up the volume. I may be a couple years past my treatment for breast cancer, but I’m still alert to any news about cancer rates, diagnosis or treatments. As the cross-stitched sampler at the chemotherapy center said, cancer is a word, not a sentence, but is a very, very powerful word. My ears pick it up even when it’s whispered.

This ad, aired by the Seattle Cancer Care Alliance (SCCA), one of the premier cancer research and treatment centers in the U.S., solidified for me an impression that’s been growing in the back of my mind. That impression was reinforced today when I saw the announcement for the new bald Barbie.

Cancer may be an illness.

But it is also big business.

If you’ve been paying even the slightest attention to the news about health care in the past few years, you’ve surely noticed the increased numbers of ads not just for drugs, but clinics and hospitals. The competition is growing fierce, resulting in turf wars among care centers, and the folks hired to advertise and market these centers no doubt see the glowing dollar signs.

The radio ad boasted that survival rates for patients treated at SCCA “are highest among most cancer programs nationwide.”

When I first heard the ad, I thought – wow! How wonderful for SCCA, the place I’d gone to for a second opinion after my diagnosis. (Although my treatment took place at a local cancer center, my oncologist used the same protocol that is used at SCCA for patients like me.)

But something about that ad didn’t sit right.

It’s great that this center does so well (though if you read the fine print of the press release, you find this caveat: “The data does not compare SCCA to other cancer programs in the Puget Sound region or the Pacific Northwest,” and the data is from the period 1998-2002 – more than 10 years ago).

Most of us who live out here already know SCCA offers excellent care. We didn’t need the advertisers to tell us.

So why ARE they telling us?

Well, according to the American Cancer Society, “about 1,638,910 new cancer cases are expected to be diagnosed in 2012”  (not including nonin­vasive cancer or basal and squamous cell skin cancers). So you see, there’s a lot of money to be made. Cancer is a commodity. Whoever gets the most patients, wins. That was the underlying message I heard in the radio ad.

If you think I exaggerate the ties between cancer treatment and business, or am being too harsh, take a look at this article relating the development of a cancer drug to the stock prices of the pharmaceutical company that developed it. A savvy investor might just want to park her investments at Roche. The dividends could help her foot the bill for treatment when her time for cancer comes. As I mentioned last time, and one of my readers corroborated, cancer now seems to be a rite of passage, and the agencies and businesses instituted to conquer it are not necessarily interested in ending that rite.

If you win the war on cancer, what happens to all the profits made from the pink ribbons? With the sheer numbers of people who will eventually have their own cancer experience, what organization wouldn’t try to capitalize on the clientele, whether it be with T-shirt sales or survival statistics?

Make That a Double Martini Too

Though it’s the end of the day here, I have some energy to post an update. Maybe that energy is the result of snoozing through a part of the day in the hospital during the port implant and afterwards.

Yesterday, we met with a breast specialist at the Seattle Cancer Care Alliance, which is part of the Fred Hutchinson Cancer Research center, and is affiliated with the University of Washington.  We took along all the reports and images and spent quite a bit of time talking with her.  She concurs with the plan of the oncologist here as far as appropriate treatment:  standard course of chemotherapy (adriamycin, cyclophosphamide and taxol), followed by radiation.  She will connect with him to discuss the plan.

Though there is a variety of other treatments for different kinds of breast cancer, this is the standard for people in my situation.  And though there are clinical trials for other types/stages of breast cancer, currently there aren’t any that I could participate in.  The only details we need to pin down are when to start the chemotherapy (I still have the drain tube in since the surgery site is still draining, and that needs to heal since chemotherapy disrupts tissue healing), and the frequency and dose of treatment.  The usual approach is a larger dose every other week, but this doc is working with a group that gets a smaller dose once a week.  The idea is the more frequent, smaller doses are better tolerated and the drug levels remain more constant. The total amount of chemo ends up being the same.  We’ll discuss this with the local oncologist when we meet with him on Monday.

It was good to have the approach further discussed and clarified by the doc in Seattle. It helps us see the path.  I couldn’t help but express my frustration to her, though — that frustration coming from the fact that I’ve done everything I should have done to stay healthy, and except for last year, religiously followed the recommendation for yearly exams/mammograms.  Even the mammogram earlier this month didn’t show much of the problem, and when my husband saw the surgical pathology report, he said, “This must have been going on for a long time.”  So why didn’t the recommended tool catch it sooner?????  And with recent reports about mammograms and self-exams potentially not being so good at picking up problems in dense tissue like mine — why isn’t there a better way?  She understood my frustration and said, “Well, right now, this is the best we have.”

Other frustrations come from the fact that there are clinical trials for other types of this disease, and even for this particular type at different stages (before surgery is done, and after it’s metastasized), but there’s no clinical trials anywhere for people in my position — after surgery.  If we’d had any idea how extensive this was, we might have done chemotherapy first, then surgery.  But no one anticipated the spread, so we followed the usual path.

But I also have to say that I have tremendous appreciation and respect for the majority of people working in medical fields. (I’m also VERY grateful to have good health insurance.) During this frightening time, I’ve had excellent care and compassionate people helping me. (Of course it helps to have a spouse on the inside, but I don’t get the sense that their behavior would be vastly different for the average Jane.) These people are doing courageous things to take care of others every day.  But still, we have such a long way to go in solving so many health issues. It’s encouraging to see the improvements, even in chemo and radiation, but we’ve still got such a long, long way to go, with this and many other illnesses.

Anyway, for tonight I’m doing OK, even though I ‘m on a restricted diet (no sugars of any kind, including fruit, so I had to forego the beautiful strawberries we bought on the way home from the hospital). Tomorrow is the PET scan.  Let’s hope for the best.

And tomorrow night, I intend to have a martini and double dessert!