How to Interview Your Oncologist – Part 3

How to Interview Your Oncologist – Part 3

By Carlos M. Garcia, M.D.

Now let’s look at the choices between chemotherapy and immune enhancement therapies.  Initially, they are the antithesis of one another. Chemotherapy destroys your immune system and puts your outcome squarely on a generic algorithm endorsed by the medical industrial complex and reimbursement codes.  Your function is to present yourself and follow the generic, one fits all protocol. Your participation is irrelevant. What you think, eat, drink, feel or do, has no effect on the outcome. If it does not work, well you did what everyone else does. You are not a renegade and you may declare yourself unlucky that generic medicine did not work for you. No one takes responsibility. Everyone is sad. There is no blame.  You have no idea how often I have heard a phrase such as, “the cancer was stronger than the chemotherapy”.

From an oncology, pharmaceutical and hospital system viewpoint, sales become easier due to a lack of competitive or alternate treatment options or choices.  From a patient’s viewpoint, oncologist is presumed to have the power of being able to control whether or not a patient gets access to the ‘life saving treatment’. Thus the patient may feel that he/she is lucky to have access to this therapy and thus wants to placate the oncologist. The reality is that there is no shortage of access to chemotherapy or oncologist provided that you have medical insurance or a deep pocket.

When there is only one choice, life is relatively simple. When you believe that there is only one choice or certain death, i.e. chemotherapy, then the side effects become more acceptable. In this scenario, since the patient is misled into thinking that there are no other options, from a patient’s perspective it becomes either tolerate the horrible side effects or die. [In my opinion, most patients  with cancer treated with chemotherapy die because of the detrimental and overwhelming side effects of chemotherapeutic medications.]

However, when a second alternative is presented, then the patient is faced with a choice. Someone must make a decision. Whoever decides, has taken responsibility to the choice made.  Immune enhancement therapies, unlike chemotherapy, strengthens your immune system.  This treatment forces the practitioners to forge a relationship with patients, for which there is no reimbursement code. Patient-doctor relationships take time to develop. With natural treatments, patients feel better during the process. The patient becomes the focus of the protocol, not the generic, diagnosis driven synthetic drug administration. What the patient thinks, eats, does, and feels has immense value and directly influences outcomes.

Responsibility or accountability is what most people seek to avoid.  In order to facilitate avoiding either, as a society, we ignore the fact that not choosing is choosing. Thus we seek to simplify through justification, i.e. if alternatives to chemotherapy, radiation or surgery were viable, then many more would do it, or oncologist would recommend them.  [Remember oncologist recommend Boost, ice cream and soda pop, all high in simple sugars. They provide candy and doughnuts in their office. They do this with the knowledge that simple sugars are preferred by cancer cells as evidenced by the fact that a glucose molecule, a simple sugar, is the backbone for the molecule used to detect cancerous cells when ordering a PET scan.]

The questions below are important to ask if chemotherapy has been recommended:

Which drugs you are you going to treat me with?

Are these drugs selected specifically for me, or are they a generic formulary for my diagnosis and are used on everyone diagnosed with my condition?

If we are starting with a generic formulary, because no one knows how I will react to these drugs, then:

Will this formulary be changed for me?

What parameters will be used to make these alterations?

What is the half-life of this medication?

Is it true that chemotherapy drugs can make cancer more aggressive?

Does chemotherapy kill cancer stem cells?

I’ve heard that many chemotherapy drugs are carcinogenic?

Can this treatment cause more cancers in the body?

Do patients need different chemotherapeutic agents because cancer cells eventually become resistant to chemotherapy?

If our immune system is what keeps us healthy and defends us from diseases, including cancer, is it fair to consider cancer an immune compromised disease?

Since cancer is an immune compromised illness and chemotherapy attacks my already weakened immune system, please explain the mechanism by which further destruction of my immune army results in my getting well?

I’ve heard that immunotherapy specifically targets cancer cells, is this correct?

I have also read that immunotherapy, in some, causes one’s immune system to attack healthy organs?

Can this happen to me?

If it does how is it treated?

Can you stop my immune system from attacking my healthy, noncancerous organs once it starts?

How do you stop this autoimmune attack if it happens?

Can you stop it the autoimmune reaction or are you just going to suppress it with steroids?

If you use steroids, will they also further suppress my weakened immune system making me susceptible to other diseases and leaving me even more helpless?

Please provide me a list of medications that stops immunotherapy’s autoimmune attack mode?

If immunotherapy is so much better than chemotherapy, why don’t you start with the best treatment option possible?

Are there any other drugs that I might have to take?

Can I get a list of all the drugs that will be involved in my treatment?

What are the short-term adverse effects of these drugs?

What are the long-term adverse effects of these drugs?

May I have copies of the Material Safety Data Sheets on all the drugs I’ll be taking?

I would like to take them home with me today to review them.

Do any of these drugs have life threatening side effects?

Stay tuned for next month’s conclusion of How to Interview Your Oncologist