Race for better treatments instead of cure

WEST PALM BEACH, Fla. -- A lovely 81-year-old woman recently came in with a tiny gynecologic problem and a huge anxiety issue. She gets up too many times at night to empty her bladder and worries she might leak and, one day, need Depends. I examined her and found no abnormality. Despite reassurance, I could tell she was not satisfied.

Then we addressed her real concerns. Like many people her age, she is anxious. Anxious about getting older and anxious about getting sick. She wanted to review her medications and vitamins to be sure she is taking the "right" things. On the list were vitamin D, E, C, B, CoQ10, fish oils, calcium, glucosamine, osteoporosis medication, and pills for cholesterol, reflux, and blood pressure. This "cocktail" is one I see every day.

This patient is in great physical shape. But she spends many waking hours worrying about her health. She is really more worried about her death. I confronted her in a mild way and asked how she would like to die. She looked at me blankly and said she never thought about it. Then she was quite emphatic about wanting to die quickly and without suffering. Like most of us, falling asleep and not waking up at age 100 is acceptable.

Then she asked me how I want to die. I told her that it doesn't matter to me, but I would hope not to have my loved ones left behind suffer too much. I am not a martyr, but if I die of a more prolonged disease, like cancer, I believe there will be enough morphine to keep me from suffering.

Writing the chart note for this patient, it dawned on me that we have lots of medications and treatments to extend our life expectancy. With our advancements, we have created a death-phobia. Many patients spend most days trying not to die.

I glanced at my newspaper after finishing her note and saw an advertisement for the Race for the Cure and read articles about local cancer patients and survivors. Hard for me to believe that a decade ago I was pushed across the finish line in a wheelchair, too weak to walk or run.

Harder to believe that there are so many thousands more women in my situation. Besides the Komen Race for the Cure, there are hundreds of walks, fund raisers, and awareness raisers for breast cancer. Are we really closer to "a cure"?

We might call our efforts a "Race for Better Treatments." Admittedly, this title is not as gripping, but it is more accurate. Why? Every cancer, even every breast cancer, is unique. Treatments that work for one may not work for another. We are curing the majority of breast cancer already, but there is, and probably never will be, a cure for any cancer.