Wednesday, October 10, 2012

Cancer casualty

A study has revealed that a quarter of all cases of cancer in England are diagnosed only when the patient goes to hospital as an emergency. Prospects for survival in such circumstances are poor, & the over-70s are disproportionately affected.

The immediate reaction has been that greater efforts must be made to identify all cancers at an earlier stage, through increasing public awareness of symptoms which may need to be investigated & by improving GPs ability to recognise those that do.

Hard to dissent from that, except for a small, but important minority.

In some of these cases the patient would have had a shrewd idea of what was wrong, but simply preferred to accept their fate.

Cancer treatment can be brutal, &, as one friend told me, your life simply gets taken over by doctors until one day they say, That’s it. We don’t need to see you again. Sounds a lot like we don’t want to see you.

And in today’s climate people fear that No treatment thank you is no longer an acceptable response to a cancer diagnosis.

The elderly know that they are much closer to the last day of their life than to the first one. For some that simply increases the value of any extra day that can be squeezed out.

But what most fear more than that is loss of independence, of mobility, or of mind.

We are promised that the physical pain can be eased, & some prefer simply to accept their fate, on their own terms & responsibility.

 English people will not accept efficiency as a substitute for liberty - RH Tawney

Link
Abstract only: British Journal of Cancer: Routes to diagnosis for cancer – determining the patient journey using multiple routine data sets