Thursday, March 18, 2010

The dreaded "C"

This morning I decided to release my bible in Internal Medicine from its prison cell that is called my bookshelf. I have decided to review on cancer. This timely, or maybe, untimely, act of reading was triggered by the recent events that have happened to B's uncle who is not really doing very well with his battle against the dreaded "C". ( I don't want to call it the big "C," because I feel that if I call it that, I am exalting it, placing it on a pedestal. If possible, and if we could help it, we should not feel overpowered by any disease.) B's uncle is lying very ill in one of the major hospitals in this city. If you have time, please do help us pray for Father Bong.

Here is the introduction on the chapter about Cancer by Dan L. Longo, in Harrison's Principles of Internal Medicine 16th Edition:

". . . patients experience the diagnosis of cancer as one of the most traumatic and revolutionary events that has ever happened to them. Independent of prognosis, the diagnosis brings with it a change in a person's self-image and in his or her role in the home and workplace. The prognosis of a person who has just been found to have pancreatic cancer is the same as the prognosis of the person with aortic stenosis who develops the first symptoms of congestive heart failure (median survival, about eight months). However the patient with heart disease may remain functional and maintain a self-image as a fully intact person with just a malfunctioning part, a diseased organ ("a bum ticker"). By contrast, the patient with pancreatic cancer has a completely altered self-image and is viewed differently by family and anyone who knows the diagnosis. He or she is being attacked and invaded by a disease that could be anywhere in the body. Every ache or pain takes on a desperate significance. Cancer is an exception to the coordinated interaction among cells and organs. In general, the cells of a multicellular organism are programmed for collaboration. Many diseases occur because the specialized cells fail to perform their assigned task. Cancer takes this malfunction one step further. Not only is there a failure of the cancer cell to maintain its specialized function, but it also strikes out on its own; the cancer cell competes to survive using natural mutability and natural selection to seek advantage over normal cells in a recapitulation of evolution. One consequence of the traitorous behavior of cancer cells is that the patient feels betrayed by his or her body. The cancer patient feels that he or she, and not just a body part, is diseased."

The introduction has a very palpable melodramatic tone similar to the script of a telenovela, which makes you forget that you are actually reading a medical reference book - the bible of this specialty. I almost felt like I was reading a novel. But this is real life and this is not fantasy. Cancer does erode the soul.

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