<p>Faline, thank you very much for the explanation of the bible college comment - I didnāt get that. The venerable (whoever used this word in their post to describe him, itās perfect) doctor is a graduate of another college in Virginia. So now it all fits. Thank you for letting me know because that was really, really bothering me. </p>
<p>SunnyFlorida, I appreciate and am very glad for your post; yes, I do understand the doctorās position - itās all much clearer now, especially now that I have all of the collaboration. </p>
<p>But there is another side of this thing too - todayās cancer patient, in my opinion, especially if they have an aggressive, fast moving disease like small cell, HAS to be very, very involved and deeply understanding of their care if they have any hope at all of survival. I have simply encountered too many doctors who will write off the patient as dead already when itās small cell - and - I guess itās hard to blame them, given the numbers. </p>
<p>I have a list of 16 long term survivors of small cell extensive; they are all three+ years out. Three of them somehow magically got a complete response in first line treatment and have had no recurrances. The remaining 13 have had recurrances, some with mets to the brain (they all had gamma knife, except one who had wbr), and, to a person, they were all treated very, very aggressively by āpush the envelopeā type doctors, and, they all were very intensely involved in decisions about their care, including acting almost as a peer with their doctors. </p>
<p>Two of the three who had complete responses to first line treatment and no recurrances since were a little bit the same way - one, now an eight year survivor, mets to liver, got angry at her first oncologist on her first visit because he told her she was going to die within weeks. She fired him, went on a two week long cruise that was already scheduled, and upon her return hired a new oncologist, and had her complete response, and is cancer free today. </p>
<p>Only one of the 16 refused to read anything or do any research on her illness, and did only what her doctor told her to do. </p>
<p>I have spoken to every one of these persons by telephone, some of them several times, and with those few exceptions, they are all very aggressive and a couple of them are rather iconoclastic - and ALIVE. </p>
<p>I think there has to be some way for doctors to be able to help their patients get to the bottom line information that they need to make informed decisions, or at least more readily, rapidly accept the only decisions available. āIām the doctor and I know best so just do itā may have cut it in, say circa 1950, but, it shouldnāt be the standard today. Iām a ātrust, but verifyā sort of a person, and I was that way long before I heard Reagan say it.</p>
<p>To the person inflicted with cancer, and probably especially those of us with grim prognosis, there is a very strong need for fast, accurate, credible information, and there is a need to have that information translated against the broader scope of treatment options. So far, I have found only two people who can or will do that to the level I require in order to feel comfortable with my treatment decisions - my current primary oncologist, and Epistrophy & company. And I am sure you will agree that the patient who is comfortable with and who has a high degree of confidence in their treatment is going to respond better, and live longer. </p>
<p>Of course, I realize this might be a difficult burden for doctors who are already faced with all of the economic realities tied to serving patients, and especially if itās true that there will be a serious shortage of oncologists by 2011 - word is there will be too much cancer and not enough doctors. So I cannot think how to fix this, but, I do know that it is badly broken, and as events this week have proven, very frustrating for the participants on BOTH sides of the desk.</p>