Your Medical Mind_ How to Decide What Is Right for You - Jerome Groopman [57]
Successful treatment of Hodgkin’s lymphoma is one of the great triumphs of modern oncology. Over the past few decades, researchers in North America and Europe have systematically studied the optimal therapy for different stages and various subtypes of the cancer. These studies have developed and refined to a high degree therapy for Hodgkin’s lymphoma. Cure rates are higher than 70 percent for tumors detected in their early stages and more than 50 percent even for latestage, widespread Hodgkin’s lymphoma. There is still some debate among experts about the optimal timing of chemotherapy and radiation and exactly which drugs to use in order to limit long-term damage to the heart and lungs and the risk of a second malignancy like leukemia. While this research continues, patients who don’t want to participate in an experimental protocol can be reassured that there is a deep foundation of knowledge upon which to base their treatment.
“Oh, God, I feel so lucky. I mean, the first thing you think when you get cancer is, ‘Thank God it’s me, not the kids.’ And then there are people who don’t have a doctor, don’t have insurance, and don’t have a job. And the bottom line is, Hodgkin’s has a high cure rate. But I still had to go through the treatment. And the question was where?”
Angela felt anonymous in the cancer center. She wasn’t at all reassured by the comment that she was “typical.” Rather, she felt that she was seen as “just another case.” What might seem like a small gesture, the nurse’s silent shrug when Angela expressed dismay about losing seven pounds, reinforced this sense. When patients feel sick, frightened, and vulnerable, seemingly innocuous statements and actions can have tremendous impact. Angela’s experience that day clinched her decision to be treated at her community hospital. Other people have the opposite experience and find that a large, bustling cancer center gives them a needed sense of confidence.
Yet Angela still wondered if the oncologist in her community hospital was the right doctor for her. She wanted reassurance, and, like Julie Brody, she found it from a medical professional she knew and trusted. A friend of Angela’s was a nurse at the community hospital. “I called her right away. She’d been working there for twenty years. I gave her the name of the doctor that I had seen in oncology. She gave me the rundown on her.” The nurse knew the doctor Angela was asking about and told her that she’d been trained at the cancer center and that she was highly competent and very compassionate. Angela appreciated her friend’s words, then confided that she was dreading reading about Hodgkin’s on the Internet. “The nurse told me ‘You don’t have to look on the Internet if you don’t want to. It can get really scary. Often what you read about online is not the mainstream case. It’s not always reliable. It can be just more information to flip out over.’”
Angela felt comforted by her conversation with this nurse. “It was a tremendous relief to feel that I was in good hands. And also a great relief not to feel I needed to hear every person’s story about Hodgkin’s disease.
“In the beginning,” she said, “I put everything on my husband. For the first month, I just sort of sat in the corner and cried, so he was the one who was taking down all the information—what the drug protocol was going to be, managing all of the medications I had to take at home, scheduling family things.”
Angela restricted knowledge of her condition to a few close confidantes. She didn’t want every conversation to center on her illness and treatment. Many people seek out other cancer patients or survivors for information or advice, but Angela didn’t. When she was offered the opportunity to join a support group, she declined and explained, “The only help I want is someone lying on the table for me. That’s what I want. If you want to help me, that’s what you can do.