Ian Gawler Blog: Cancer, Four Corners and hope

Anyone with advanced cancer who watched the recent Four Corners program Buying Time (ABC TV 26 8 13), could be forgiven for thinking they were in a pretty bleak position. For patients and families, as I suggest in the attached letter I sent to the Four Corners team, the message bordered on the hopeless.

The suggestion of Buying Time was clear – find a new drug, find a way to meet the incredible cost of the new drug – or die. No real mention of quality of life. No mention at all of other possibilities.

So this week we go way Out on a Limb and ask, why no options? Why no choices? Why does a great program like Four Corners focus on these new cancer drugs with their incredible price tags, multiple side effects and marginal benefits; and at the same time give the impression to the uninformed that there is nothing else on offer?

What do you think? What did you think of Buying Time? (Link below). What sort of program would you like to see? But first

Thought for the day


So long as you write what you wish to write,
That is all that matters;
And whether it matters for ages or only for hours,
Nobody can say.

     
        Virginia Woolf, A Room of One's Own




                                                                                        The daffodils are out in force - delightful!
Dear Four Corners
I have had the chance to speak or communicate in writing with quite a few people now who saw your program Buying Time and I feel it important to share the feedback and ask for your help.

The program did a good job of clarifying how the modern cancer drugs are offered as a new hope, yet cost vast amounts and produce incredibly modest gains at the additional price of serious side-effects.

I would love to be more positive, but I think you need to know a number of patients I spoke to turned the program off early into the story. Many others report feeling deeply despondent. Where was the hope?  In fact, for patients and families I suggest the message of Buying Time actually bordered on the hopeless. The suggestion was clear – find a new drug, find a way to meet the incredible cost of the new drug – or die. No real mention of quality of life. No mention at all of other possibilities.

Sure, what Buying Time did achieve was to accurately portray the modern cancer dilemma. Many new drugs are coming onto the market, often heralded with the words “significant new breakthrough” and building the hope of major benefits.

However, when the reality is examined, these drugs commonly improve survival times in terms of a few weeks; at best a few months. To achieve these modest gains, they have price tags that can run over $100,000 per person per year and they have even higher side-effect profiles than the old chemotherapeutic agents.

Obviously there is a limit to how many of these new, expensive drugs we the taxpayers can afford to fund. Already the real growth in healthcare spending over the last decade has gone up 5.3%, close to twice the average annual growth in GDP for that time of 3.1%.

As you now know, Yervoy, the new drug for people with advanced melanoma, adds 4 months to average survival times, has multiple side-effects and will cost the public purse up to $60 million dollars a year. Is this the best way to spend $60 million dollars? As a community, we are not very far away from needing to make difficult choices about how we spend our health dollars.

However, for people directly affected by cancer, the problem is more immediate, more dire. The program clearly portrayed these drugs as being out of reach financially and not very effective; yet people were still clinging to them anyway. What people affected by cancer need is realistic hope. They need genuine options. At the very least a good quality of life and a good quality of death. But more, they need to know that there are real possibilities available to them through things they can do for themselves.

In my opinion and from what I hear from others, this is where Four Corners failed. By focusing on the medical dilemma, the program omitted the imperative for modern cancer management to be more inclusive. A huge resource; an affordable, credible resource was overlooked.

There are constant reports in the media and the scientific literature of people surviving against the odds. At the same time, there is an impressive body of evidence for the quality of life and increased survival gains to be had through the application of nutrition therapeutically, through the generation of positive states of mind and the practice of meditation.

Lifestyle Medicine, the study and implementation of what people can do to help themselves, empowers the patient and their families. Lifestyle medicine offers the promise of dramatic improvements in quality of life – and the research establishes that it delivers on this promise. Lifestyle Medicine offers the prospect of significant increases in survival times – in a highly cost effective manner with almost no adverse side effects.

Maybe Lifestyle Medicine is complementary to the current mainstream cancer treatments. Synergistic. But what if the benefits of Lifestyle Medicine were actually more cost effective than these new high-powered cancer drugs?

What if as a community we had the basic common sense to push our cancer authorities to fund serious research to investigate this compelling question? Why not a three arm trial to compare one, the standard medical treatment with two, standard treatment plus the lifestyle options with 3, the lifestyle options on their own. If a super expensive, high side effect drug trial qualifies as being ethical, surely there is enough grounds to compare it to the cheap, almost side effect free lifestyle option. What does help a person with cancer the best?

I call on you all at Four Corners to prepare and screen the logical follow up to Buying Time. The public needs to know. What does the patient bring to cancer management? Why has mainstream oncology spent years blocking or even attacking the growing cancer self-help movement? When will researchers cast their nets wider and investigate the many, many stories of long-term survival? When will the patients and their families, the public and the doctors realise just how much lifestyle has to do with the successful management of cancer?

How many people do we need to watch suffer and die? How broke does the health budget need to become before Lifestyle Medicine is taken seriously?

As I said, I would like to have been able to be more positive about the program. It did open discussion around the cost/benefits of modern cancer drugs and that is a very good thing. The public needs to engage in the conversation around how the health budget is allocated. But as I mentioned to you when the decision was taken to drop lifestyle factors from the program, from the patient's perspective there was the risk of lowering hope, increasing despondency.

So now I look forward to when you are ready to do the next part of this story; the part that has the chance to be uplifting and foster evidence based hope as it focuses on the role and potentials of the patients and their families to contribute to their own health and wellbeing through the therapeutic application of Lifestyle Medicine.

Many people would offer to contribute to such a program. Many would welcome it. Many would be informed by it.

be well

Ian Gawler

RELATED BLOG

Cancer, facts and fiction

RESOURCES
Link to view Buying Time: CLICK HERE

The Gawler Foundation for Lifestyle Medicine information and programs

You Can Conquer Cancer - a comprehensive, integrated lifestyle based, self-help approach to cancer

NOTICEBOARD

IMAGES, WORDS and SILENCE 
Training/retreat for those interested in mind made healing – either for personal use or as a health professional.
With Dr Nimrod Sheinman, Ruth and myself in the Yarra Valley. Details: CLICK HERE

MEDITATION UNDER the LONG WHITE CLOUD
Ruth and I are leading our first meditation retreat in New Zealand in December at the beautiful Mana Retreat centre that has a similar high reputation for a good environment and great food as the Foundation. Details: CLICK HERE

5 DAY FOLLOW-UP CANCER PROGRAM
Specifically for people who have attended a CanLive program in NZ, or Gawler Foundation program. November 18 – 22 at Wanaka out of Queenstown - one of the most beautiful environments there is. Details: CLICK HERE

 

               More daffies   

      
      A couple of early tulips 
      glistening in the sun