Cancer: On The Rise But Still Preventable

Our little practice has acquired a number of new cancer patients in the past two years. Breast, colon, skin, cervical, brain… we’ve seen our share. These patients vary in age, sex, socioeconomic status and general health but they all are looking for the same thing: alternatives to standard treatment of cancer. Are they crazy? Are there other ways to manage cancer?

One of the charges to the primary care physician in the 20th and 21st century has been to early diagnose the most common cancers to enhance outcomes. The earlier the diagnosis of breast, colon, cervical and skin cancers, the better the outcome with traditional cancer therapies. We aggressively, annually screen patients. I’d say cancer screening is about 1/4 of my job each year and women are better at doing screening than men. So it concerns me that the 1/4 of my job that I still believe is essential to human well-being and longevity suddenly loses all meaning when a positively screened patient wants nothing more done the second an “abnormal” is found. What is going on?

First off, main stream medicine’s credibility and approachability have been severely damaged due to the pandemic. People who were cut off from care in clinics and hospitals or who were separated from loved ones while they were hospitalized are skeptical that anyone cares. They are concerned about their autonomy once they enter the system. Some of our patients with a positive screen for cancer have no desire to even pursue a tissue diagnosis, thanks to ridiculous barriers like maintaining mask requirements and CoVID19 screening. These gestures smack of taking medical freedom away from the individual. In this light, hospitals are no longer viewed as open-armed places of “care” but instead as darkly guarded places to be distrusted and avoided. To those who are venturing out to finally return to “normal screening” and receive a positive result, the idea of getting intimately acquainted to such a villainous bunch seems out of the question.

Second, “cancer” is a scary, loaded word. The urgency with which the modern medical community charges after a hint of cancer can be intimidating. They forget we all have options in regard to our health: second opinions, watchful waiting, doing nothing at all or doing all of the above. Because of the intense fear that the word “cancer” evokes, modern hospitals have organized themselves into teams of specialists ready to jump on a new diagnosis of cancer. This feature used to be the shining glory of many competing hospital systems. In these post-pandemic days, it appears that some people find that off-putting. I never thought I’d see the day that a cancer patient would refuse rapid consultation with the oncology team assembled to help them and expedite care. But today’s patient is jaded… and better educated. They distrust big hospital systems that advertise compassionate, patient centered care because compassionate, patient centered care flew out the window during the pandemic years. People found solutions for their own health care when they were barred from clinics and hospitals and are not so easily led down a path of “one way or no way” in regard to treatment options. It falls on me, then, to gently restore trust and offer the gift of time and careful consideration. Chances are that cancer didn’t just show up yesterday. Depending on the type of cancer, there may not be an emergency here and more information may help this skeptic come back to the negotiation table.

Third, oncologic care is the only standard we have. Regardless of how you feel about oncologic kick-backs, the astronomical cost of cancer treatment, the vulgarity of dosed poisoning regimens, etc. traditional surgical, medical and radiologic oncology are the mainstays of cancer treatment in America. Most mortality data is measured by the efficacy of these treatments, so prognosis hinges on traditional approaches. Patients still need traditional approaches to cancer care, but to some this is a hard sell.

I mentioned that patients are more educated than ever before. Information is at their fingertips but laymen often have huge gaps in understanding and applying what they learn. A major hurtle in helping cancer patients in my practice is sorting through all of the information and advising what is good and what is not. Therefore I applaud Dr. Paul Marik, of Front Line Critical Care Alliance, for publishing his recent manuscript “The Role of Repurposed Drugs and Metabolic Interventions In Treating Cancer.” It has been a gift to me and my patients. Cutting through all of the competing ideas out there about holistic cancer care is daunting even for a physician, much less a patient. Dr. Marik’s manuscript meets the standard for evidence-based information I can count on.