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The Cure Word

Posted 4/2/2013

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  "Cure" is a word rarely heard in Cancer World. Generally speaking, the closest that our doctors ever say is something along the "You're doing fine" or "Everything looks good" or "NED" (which means "no evidence of disease"). For most kinds of cancer, and certainly for breast cancer, the five year mark is meaningless. For leukemia, if you are healthy for five years, you almost surely are cured. For solid tumors, including breast cancer, nope. Each year that you stay well, the odds increase that you will continue to stay well, but the possibility never goes away that the cancer might return.

  Discovering that we are never going to hear "You're cured" can be most distressing. Over time, we adjust our expectations and learn to live pretty happily with NED. This is an article from the Journal of Oncology Practice about that word. I give you the abstract and a link to read more:

Use of the Word “Cure” in Oncology

By Kenneth Miller, MD, Joseph H. Abraham, ScD, MS, Lori Rhodes, and Rachel Roberts

Sinai Hospital of Baltimore, Baltimore, MD; and Gallaudet University, Washington, DC

Sinai Hospital of Baltimore, Baltimore, MD; and Gallaudet University, Washington, DC

Abstract

Purpose: Useof the word “cure” in cancer care reflects a balance of

Useof the word “cure” in cancer care reflects a balance of

physician and patient optimism, realism, medico-legal concerns, and

even superstition. This study surveyed a group of oncology specialists

regarding the frequency and determinants of using the word cure.

Methods: Oncology clinicians at the Dana-Farber Cancer Institute

Oncology clinicians at the Dana-Farber Cancer Institute

(n!180) were invited to complete a survey regarding the word cure in

cancer care. Participants completed a 19-question survey regarding

how commonly their patients are cured, how often they use the word

cure in their practice, and details about its use. Three case scenarios

were presented to elicit participants’ views.

Results: Of the 117 participants (65%) who provided responses,

Of the 117 participants (65%) who provided responses,

81% were hesitant to tell a patient that they are

cured, and 63% would never tell a patient that they are cured.

Only 7% felt that greater than 75% of their patients are, or will

be, cured. The participating clinicians reported that only 34%

of patients ask if they are cured. For 20-year survivors of

testicular cancer, large-cell lymphoma, and estrogen receptor–

positive breast cancer, 84%, 76%, and 48% of clinicians,

respectively, believed that the patients were cured, and 35%,

43%, and 56% recommended annual oncology follow-up of

the patients. Twenty-three percent of oncology clinicians believed

that patients should never be discharged from the cancer

center.

Conclusion: Oncology clinicians report that patients are hesitant

Oncology clinicians report that patients are hesitant

to ask whether they are cured, and the clinicians are hesitant

to tell patients they are cured. Annual oncology follow-up was

frequently endorsed, even after 20 years in remission.

http://jop.ascopubs.org/content/early/2013/03/12/JOP.2012.000806.full.pdf+html

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