The talk around the cancer community today is all about the pharmacist who diluted chemotherapy drugs and the people who suffered and died as a result. It was such a deceitful action with such horrid effects that it is difficult to contemplate. It is hard to imagine a man with ten million dollars even dreaming of committing such a dastardly act.
But what I witnessed recently seems just as bad. An individual, who had lost a kidney to cancer 3 months ago and was told everything was contained and he needed no further treatment, was told on reexamination that he had a new tumor in his bladder with two enlarged lymph nodes. What a horrible thing to happen to a young man! But that wasn’t the bad part. The urologist suggested he see a medical oncologist for further treatment and got him the first appointment available one month hence!
Cancer is a disease that grows geometrically. Cancer is never as treatable as it is when first discovered. Time is of the essence. At some point in the future, every cancer, even one that is readily treatable, will become untreatable if left untreated. For an oncologist, when requested, to fail to see a cancer patient relatively promptly is as bad as diluting chemotherapy drugs. Here the patient is aware of the problem, thinks he is doing the right thing in relying on the oncologist, and the tumor being allowed to metastasize to a point where it might be no longer treatable.
I was diagnosed with terminal lung cancer on a Wednesday. I talked to an oncologist in another city that night on the telephone who said to fly there Thursday and he would see me Friday. I asked if I couldn’t come down Monday (after the weekend) and his answer was that if I was not there on Thursday, he would not treat me. He taught me the meaning of prompt treatment.
We operated a second opinion center at the University of Missouri, Kansas City. All patients were seen free of charge. We had a cardinal rule to see a patient within 7 days or find somewhere else for him to go for a second opinion. It worked for 15 years until we got so busy we couldn’t handle the backlog. We got 5 institutions in Kansas City to offer the same service so no one would have to wait as well as 150 institutions from coast to coast.
For a cancer center or an oncologist to offer a newly diagnosed cancer patient an appointment in more than 7 days is wrong. It is expressing complete disregard for the patient’s life. It is reducing the chance of recovery.
Recently (April 28, 2008) there was a lengthy article in the Wall Street Journal about the delay in getting treatment for a new patient at MD Anderson as well as other major cancer centers. There can be no excuse for jeopardizing a human life by delaying treatment unnecessarily.
There is no question that cancer centers and oncologists are busy. They are working probably as hard as they want. Many are not able to keep up the pace. But that is no excuse for diminishing a patient’s chance of recovery. I am not suggesting they work harder. That is their business. I am suggesting that if they can not see a newly diagnosed cancer patient with 7 days, they tell their caller they are closed to new appointments and to suggest a qualified place or doctor elsewhere. The center or oncologist should not imply that they approve of putting off treatment for an extended period of time. Prompt, proper, thorough treatment is still the keystone of recovery.