53 - PHYSICIANS - A SOURCE OF HOPE

There has never been a more hopeful time in cancer medicine. We now understand more about how cancer cells behave and how to change their behavior, as well as how to kill them, than we ever have before. Boutique cancer therapy that tailors treatment to each individual, optimizing efficacy and minimizing toxicity was a dream yesterday and today a reality – but it doesn’t exist yet for every cancer and every person. The power of our research tools and the brilliance of today’s investigators is absolutely mind boggling. New ideas are born every day and new treatments every year, but again, not yet for everyone. All this good news doesn’t really change the prognosis you have just been given which incorporates everything learned to date. Today you are the benefactor of great progress and the chance further dramatic breakthroughs will come along is great, but the chance a miracle drug or any other treatment will come along that will dramatically change the prognosis for your disease, in your lifetime is actually pretty small (if the progress of medicine in the last ten years is any indicator) - therefore not worth calling it a big hope. Don’t be fooled. Yes it is a small one, so put a small hope in your hope chest and look elsewhere for bigger ones. 

False hope is like fool’s gold. Fool’s gold gets you excited at first, but when you take it to the bank they laugh at you. It is what people find when they are prospecting in the wrong place or when they don't really know what they're looking for. Once they have seen, held and felt the real thing, they're not likely to be fooled again by an imposter.

 I saw an advertisement the other day showing an exuberant woman with cancer recounting her meeting with a physician at an exalted medical center. She exuded, "The doctor said he had a plan for me, and another one after that. All I needed to hear from him was that there is hope." Doctors know what we all need and will cultivate your trust with hope every day that they can. The question is what happens when they run out of good plans?  Sooner, or later, most of them do. They often don't say so and people don't ask. One day they walk in and confess, "I'm out of tricks." Deep down everyone knows that day is coming.  I could see it in their eyes and hear it in their voices. That is why early on we would, and you should, start cultivating a whole portfolio of hopes that are not subject to the caprice of cancer and the limitations of research.

Medical treatment for cancer is marvelous, but not perfect and had better not be your sole basis for hope.  At some point, usually when things are getting desperate, it disappoints you like a mirage If that’s the only hope you’re standing on, you’ll soon discover it is quicksand and you’re going down - you just don't know when. Everyone who places all their hope in medicine knows this at some level and it doesn't feel good. They can feel the Dragon’s breath. They have let it get too close.