How far should treatment go?by Catriona Chatfield / June 20, 2012 / Leave a comment
Published in July 2012 issue of Prospect Magazine
© Annie Cavanagh, Wellcome Images
There’s an old joke in the healthcare profession that makes fun of a tendency among cancer specialists to pursue “treatment at all costs”: “Why do they put nails in coffins? To stop oncologists having one last try…”
If his latest book is anything to go by, Karol Sikora, an outspoken oncologist, is unlikely to lay the cliché to rest. Entitled How to Beat Cancer, and self-published in e-book form, it contains useful and practical advice about how to maximise the often labyrinthine and not always equitable NHS system, and plenty of expert (if sometimes indigestibly dense) details on the latest developments in treatment. For all this, however, How to Beat Cancer seems to me to embody a single, largely unexamined assumption: that every cancer patient should seek out every single drug that might give him or her another drop of life.
Now, this may be true for some people. I remember some patients I cared for while working in oncology as a junior doctor—a 20-year-old girl dying of colorectal cancer, for example—to whom I might certainly have recommended this book as an aid to navigating the NHS. Sikora is a vocal critic of the lack of availability of cancer treatments in the NHS, and runs a private service providing cutting-edge radiotherapy. It is easy to see how this may be informed by a strong desire to provide the “best” possible treatment for each patient. What I find jarring within Sikora’s account, however, is the presumption that, were I to be diagnosed with cancer tomorrow, my only rational and “best” course of action would be to extract the maximum possible quantity of treatment out of the health service, no matter what the cost.