Monoborracho

Last night I suprised Mrs. Mono with flowers and a card when she got home from teaching Kindergarten, a profession she resumed four years ago.

It has been five years, to the day, since she finished chemo and radiation for breast cancer.

I've told this before but am putting it here again after the recent publicity regarding mammmograms...

Five years and 7 months ago a routine mammogram detected a tumor that the radiologist diagnosed to be cancerous (think about that for a minute) and about the size of a pencil eraser. Again, think about a radiologist being so certain as to make a call of cancer. Our GP pounced on it, thankfully, with the comment that "most radiologists want a bone scan to diagnose a compound fracture, so if he says it's cancerous.....".

There was NO HISTORY of breast cancer in her family.

Four days later it was biopsied. Ten days later it was excised after a sentinel node procedure and the tumor was about the size of a peanut or pecan. (a 3x or 4x growth in 10 days) The diagnosis was Stage II invasive ductal carcinoma of an aggressive nature. Two weeks later the lymph nodes were excised and, hopefully, the terminus of the cancer was found. Five months of chemotherapy was followed by two months of radiation treatments.

Last night we went out for a 20 miler on the tandem. It was a warm TX night and a fun ride, followed by a fun evening at home with family and friends to celebrate.

Never take life for granted.

And, regardless of some government panel's recommendation, have your wives and daughters get a routine screening from age 30 onward.

At the risk of having this kicked to P&R......you can ration health care with either money, or time, and I fear that this week's recommendation of "screenings not necessary until age 50" is a harbinger of things to come. Such a policy would have cost me the life of my wife.

'47

Good to remind us of the impact of possible "pragmatic" and supposedly sensible solutions that look expedient on a spread sheet but can wreak pain and unhappiness on real flesh and blood. Bravo for your wife and for you....and for many 20 milers into the future.

Retro Grouch 

Yup. If this is rationing (and it sure looks like it to me), keep in mind it's coming through our existing healthcare program with payments through independant insurers that we have no control over.

'47

And you actually think you'll have control over an indifferent, policy driven bureaucrat....on what planet might that be? More likely, you'll fall back on the second tier, private coverage that will spring up to augment the inefficient, slow and arbitrary public rattletrap program-- if you can afford it.

*(I know, I know....this is inappropriate for 50Plus (yet especially relevant for us) so I'll break off)

BluesDawg

Whether public or private, there will always be indifferent, policy driven people looking for ways to cut costs. As intelligent and informed people we have to make our own decisions about the things that affect our lives and the lives of those we care about. Neither the government nor private enterprise cares about our families as much as we do.

Kurt Erlenbach

I hear you Mono-b. Congrats to your wife, and to you.

The confusion over the new guidelines result because they confuse what's good for an individual with what's good for a population. It's probably completely correct that mammograms before age 50 do not result in extended lifespan for a population overall. For an individual, however, that's not the point. I, personally, don't care much about expanding the lifespan for the population as a whole, I care about extending my lifespan. All the talk about testing not being worth the anxiety that false positives can cause is ridiculous. Overtreatment, however, is a significant problem and it makes sense not to go overboard on every slightly abnormal test. Sometimes waiting and watching is a good thing, as research into prostate cancer treatment is showing.

The debate about rationing, I think, is misleading. Health care presently is rationed based on insurance and abiity to pay, which is nonsensical. Health case for the insured is rationed based on the insurer's policy and practices, and no one should think otherwise. "Death panels" already exist - I frequently see jars put out at stores collecting donations for someone who needs a serious medical procedure. They effectively have gone before their "death panel" (either their insurer's or Medicaid's) and been turned down. That's why they are pleading for donations for that transplant or something else.

We pay so much for mdeical care becuase we all demand the best and most comprehensive care, even if it is not effective. 60 Minutes last Sunday had a good story about all the medicare money spent in the last 60 days of a person's life. We can all agree that futile care should be eliminated, but defining exactly what's "futile" comes best only in hindsight, and it's a bit difficult, looking forward, to know just when those last 60 days are coming. That metric is best applied looking back, not ahead. I don't think doctors practice so much "defensive medicine" to stay ahead of the big bad malpratice lawyers, I think patients demand more tests and procedures than best practices would require. Plus, docotrs, hospitals, and testing centers getting paid by the amount of service they provide results in a tremendous incentive to give more care, rather than the best care. Kind of like asking the butcher how much steak you should buy.

It's truly great that your wife is healed. I really hope that the health care system in the US is overhauled the make those results typical for everyone in the same situation.

Kurt Erlenbach

Absolutely and completely correct. But we as medical consumers also have to know and understand that more care frequently is not better care. I'm set for my second PET-CT of the year next week, and I'm thnking of cancelling. I've had way too much radiation over the past few years, and it might result in a new cancer in 10 years or so. My CEA is good, so there is no sign of a recurrance of cancer. Do I need a $5000 test to say so? I'm not sure.

Retro Grouch 

Keep in mind that I'm personally on the public option now and, so far at least, liking it.

qcpmsame 

Good to hear of a 5 year survivor from breast cancer. My best wishes to your wife and nice job on the flowers for her. I shuddered when I first heard about the new guidelines for breast cancer. Now the back tracking and blame assignment has begun. Just encourage your ladies to have a mamogram and keep all their appointments no matter what.

God bless you both.

Bill

BluesDawg

I hear that! I've had 3 PET scans this year. The first was with older equipment without the concurrent CT and it gave such inconclusive and vague results that I had to have the second with better equipment just to have an idea what it was showing. The 2nd test showed something that didn't really look like cancer, but was too bright to ignore, thus the 3rd test 3 months later. This one still showed something in the same area, but much less intense. Still inconclusive, but not consistent with how cancer works.

So I have another PET-CT scan scheduled for January. I'm going along with this one mostly to appease my wife, but that will be the last one no matter what it shows. I fully expect it to show no problem, but really, if it did show cancer returning in my throat, there's nothing they could do about it that I'm willing to live with. Radiation has already done as much damage as I can take and still function anything close to normally.

Kotts

I agree with the sentiment, but let's get all our facts straight. The recommendation was from one independent panel. Oher panels have reviewed the same data and concluded that the existing protocol should NOT be changed.

Nobody either inside or outside government (aside form the eedjits on that panel) is recommending a change.

Monoborracho

BDawg and Kerlenbach...great posts and thoughts from both of you on the debate. Kerlenbach is bang on with your statement

It's probably completely correct that mammograms before age 50 do not result in extended lifespan for a population overall. For an individual, however, that's not the point. I, personally, don't care much about expanding the lifespan for the population as a whole, I care about extending my lifespan.

As the soldier says, during a war the most important (or only important) foxhole is the one you are in. Good thoughts from all involved.

stapfam

As a cancer survivor I can relate to the anguish that your wife and you have gone through in the last 5 years. Despite all the ops and treatments that are done to eradicate Cancer- there is still the lingering thought of "Will it return" I was declared Cancer free at 5 years and a further 3 years on- I am still free.

But getting the diagnosis in the first place is often the difficult part. I was lucky in that I had an on the ball doctor. Went into to see him about a problem and all he said was "You are of that age- so drop your trousers and bend over. 6 months later after all the scans- tests etc- I was sitting in hospital waiting the op and for what tomorrow would bring.

Over here in the UK- Breast cancer is one of the problems being watched for, diagnosed and treated on a priority basis. Prostate Cancer is just beginning to go the same way.

Glad to see your wife is a "Survivor" but tell her to get fitter- 20 miles on a Tandem should be just the warmup after 5 years.

doctor j

In response to the OP, good on you! Congratulations to you and the Mrs. A great Thanksgiving!

Bud Bent

Congrats to you and your wife, Mono! It's great that she's doing so well.

Sometimes, even annual scans aren't enough to detect an aggressive cancer early. My wife's supposedly routine annual mammogram in May ended up not being so routine at all: three tumors, the largest of which was over 7 cm long, stage III invasive ductile carcinoma.

Thankfully, the cancer responded well to chemo, and after four rounds of AC, only a single tumor about a half inch in diameter remained. Three weeks ago, she had a bilateral mastectomy and reconstructive surgery. Twenty some-odd lymph nodes were taken, and all tested negative. So, in spite of the late diagnosis, her chances of long term survival are looking pretty good. In fact, her odds of long term survival are probably better than mine. But it's a long and brutal treatment ordeal she's enduring. There will soon be more chemo, weekly for 12 weeks, followed by more reconstructive surgery.

I get my health care from the VA; my wife has only my work insurance, so she receives her care from the private sector. If I wasn't an advocate of government health care before our cancer ordeals, I certainly am now. With the VA, every doctor I see only needs to step to a computer to look at every detail of every single VA visit I've had, no matter what facility or doctor I saw, right down to the doctors comments for every visit. When I got my scan three months after surgery, the first words the scan tech said to me were, "You've been through a lot!"

With my wife's care, every doctor seems to not know what the other doctors are doing. My only real issue with the VA was handled quickly after a ranting and raving note that I dropped in the hospital "Director's Box". Issues with my wife's treatment have been much more difficult to handle.

But wherever you get your health care, I think that it's important to make yourself knowledgeable and informed. In anyone's system, being a strong advocate for yourself will usually bring better treatment results.

HAMMER MAN

Monoborracho, Bud,Blues dawg, really outstanding news, my best wishes to all of you and your families.
Have a wonderful Thanksgiving

Red Rider

The 50+ forum is sparkly with good news today.

Happy news, indeed, Mono. I find myself, as I'm reading these posts from you cancer survivors, nodding in agreement and silently rooting for you all.

ModeratedUser150120149

Absolutely!!

People are scared of government health care while in most places in the US private health insurance companies have a near monopoly and are not answerable to the public but are focused on profit and "cost effectiveness". While private insurance companies are so concerned about profit that they deny routine preventative care to their insureds. I was once told: "We don't pay for preventive care unless required by the government because there is no data such care will result in lower costs to us".

Never forget that, in fact, the patient is not the customer. The customer is who pays the bills and that is mostly the insurance company or the government.

rdtompki

The government is so troubled in so many areas that it's difficult to understand how direct government involvement in health care can be an improvement. There are HMOs, Kaiser Permanente being one of them, who seem able to deliver very good care at a reasonable cost. I've been fortunate to avoid major illness, but I've found KP to be very efficient; I needed a head CT scan and was scanned in a few days. Similar situation for other types of testing. I do think the government needs to incentivize efficiency of health care delivery and reduce fraud through the tools already at hand. Tests and procedures that have the greatest health and economic benefit should be widely available and affordable. At least congress for better or worse if having the argument; in California ourlegislature through the proposition process has completely abrogated their responsibility to govern.

Retro Grouch 

And yet, the vast majority of users seem to like Medicare.

Bottom line, we pay twice as much for healthcare as the rest of the developed world, double, and we don't get as good outcomes.