So you have cancer? - Printable Version

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So you have cancer? - JBrunner - 01-19-2018

As a patient, what strategy to implement if you have just been diagnosed?
* First it is not your fault, you are not guilty, you are a good person. Even if you had drink or smoke too much, it is not helpful to remind it to you right now. More so we all have cancerous cells in our body, it is not something you "get", it is only bad luck that your immune system was not able to destroy enough of those cells before they organize themselves in a tumor.

* Do what your oncologist tell you. If you had just been diagnosed, it means it is not an early case. It is time to move. So the first thing is to ask to an oncologist, a general practitioner (family doctor) is not fit to the task. As an example most family doctors would not prescribe scans if there is no pain. But having pain means a tumor has grown enough to disrupt the normal physiology. And ultrasound or X-ray scans can only detect tumors bigger than a walnut, they are not adequate for cancer.

* One does not heal from cancer as one can heal from chickenpox. Most cancers are not communicable, there is no external agent that could be targeted, it is even not a single disease. You have to manage it and it is incredibly difficult.
It is always a different case because that stems from random mutations in your cells DNA that lead to neoplastic alteration of tissues. Each case is different and it is evolving quickly, in a few weeks it can "learn" to mitigate the effect of a drug.

* Collect information at serious sources, most diseases have a prominent and specialized nonprofit organization. It is the best place to go to find good health information and tips about practical issues.

* Get precise information. For example denominations like "cancer" or "lung cancer" are too vague. At the bare minimum one have a non small cells lung cancer, but it is preferable to know the gene and its main mutation. For example as in "T790M mutation of the epidermal growth factor receptor (EGFR)". In order to know that your oncologist has to order a sequencing of a biopsy of the tumor, eventually a liquid biopsy.

* If she does not want to do the tumor sequencing (it is quite costly), you know you are in troubles. How can your oncologist prescribe you the right drug if she does not know what condition you have? Find a more comprehensive oncologist

* You have to make life difficult to your cancer. First you have to get fit, get a BMI in the "normal" range, which is quite difficult, but it is a good metric because it is an easy and simple way to track changes you have to implement in your life.

* Something which is enough useful and available at the local pharmacy is NSAID drugs (Ibuprofen and the like). The best thing is to use the maximum dose of one molecule for a week, then use another molecule next week, and another one the third week. This is the best way to mitigate drug mutation resistance that is always building in the tumor.

* Most probably after the initial treatment your cancer will disappear from the usual medical imagery (scanner, MRI, ...). That does not mean it has disappeared, only that the initial treatment has done a good job and that now the tumors are smaller than one millimeter large. Celebrates this! But even if your oncologist tells you that you do not need anymore any medication, please keep using the cycling over NSAIDs and keep your BMI around 22.

* Most probably the cancer will come back a few years later. Again it is not your fault. It is simply that we do not cure of cancer, we have to manage that condition, like in diabetis. Your oncologist will prescribe you another drug.
  •     If she does not prescribe anything, find another oncologist.  
  •     A prescription of the same drug than initially is not a good idea as the cancer have probably become resistant to this drug.
* Your cancer may also develop a mutation that helps it to resist to the new drug. Sometimes the options for new drugs are very limited. So if you are at this point, things get very tricky as the normal healthcare system will not go beyond this point for most patients (price of cancer drugs higher than of a luxury car, patient too old, too heavy, having drinking/smoking behavior, doctor's aversion to risks). So here are your options:
  •     If you are old and/or frail, doing nothing is a real option. You have to think about life quality and about your dear ones, when you will not be around anymore.
  •     Find and enroll in a clinical study. It is not a silver bullet, but at least you will do something:
  •     Ask to a drug maker (through your oncologist) for a compassionate protocol. Your oncologist will get a limited amount of drugs for free.
  •     Find a state of art private clinic, this is however something very costly. Verify in advance that they publish their oncologist names, and that those oncologists have done some research, let say that they at least published one paper in the last three years. You can check that at:
  •     Some people go to more extreme measures:

* Finally: Please keep using the cycling over several OTC NSAID and keep your BMI around 22