Saturday, August 9, 2008

What to do? AKA, The Ethics of Treatment Selection

In my free time I have been looking at treatment options on the web and MedLine, as well as thinkingabout the morality of cancer treatment. Hey, I know that my head can be a dangerous place, but this thought just might have some relevance...
  • Most of the treatments for advanced Renal CA only offer options for palliative care or a bit of life extension. It seems that the only definitive cure is to find the cancer early and remove it surgically. Once that is no longer possible the only options are various forms of chemotherapy.
  • Only one therapy seems to offer any chance of a "cure", Interferon and Interlukin 2. Of course, IFN and IL2 has a partial response for 40% of patients and a complete response for 6-10% of patients.
  • Currently the lesion on my head is down by 50% or more. Hard to tell as I can only feel the thing, but that is a pretty good response for the first week on the chemo.
OK, so here are the moral questions:
  • Is remaining with the main stream chemo agents tantamount to suicide? After all, I would be choosing this knowing that there is no evidence of a curative effect, and doing so only because chemo has a higher response rate.
  • Would choosing something like IFN and IL2--with it's low response rate, but a possibility of a cure--be the morally superior choice? At least here I would be trying something that can keep me alive for my family, but the choice could also hasten my demise if it fails.
Like I said earlier, my mind can be a dangerous place.

The headaches are resolving. Still no diarrhea (if anything, it is going the other way), but my mouth continues to hurt and taste like crap. Eating is not fun.

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