Terry Thompson’s Blog

I am a pro-lifer, and that’s not limited to abortion.  To me, respect for life is one of the most basic of spiritual, ethical, and social values.  I do not believe an 80-year-old has any less right to live than an unborn, a child, or a 30-something parent.  Having said that, I must say that, as we grow older, cancer treatment decisions do take on a different set of factors to consider.  By 2030, Americans 65 and older will comprise 20% of the population, up from about 12% now.  Since the chances of getting cancer increase with age, there will be many more cancer cases involving seniors in the next few years.  How might cancer treatment decisions be different for the over 65 crowd?

I will only speak for myself.  I will be in that proud group of over-65-ers in less than three years.  As I consider what I would do if diagnosed with cancer, I become more and more opposed to opting for aggressive conventional therapies with every year that passes.  I hope to live to be a hundred, but if cancer hits me at 70, I truly believe that I would only accept conventional treatment that is essentially guaranteed to eradicate it with very little intrusion and physical harm.  Failing that assurance, I would not be interested in conventional treatment.  I am absolutely convinced that, if diagnosed with Stage IV incurable cancer, I would request the best immune system enhancing protocol and would focus on a mega-healthy lifestyle.  I would bring every spiritual, social, and emotional force available to bear on the experience.  I would then leave the rest up to God.  This might not have been my response 20 or 30 years ago.  Oh, I still have many significant goals to pursue, and I want to be with my family and friends for many more years.  But, essentially and realistically, I have lived a fulfilling life, and the last thing I would desire now is to spend it’s last months in the misery of conventional cancer treatment.

Everyone has the right to choose his or her health care at any point in life.  An 80-year-old has every right to pull out all the stops and aggressively fight cancer.  Nevertheless, there are good reasons not to take that approach in the waning years of our lives.  This is another example of how cancer treatment should be an integrative process involving the oncologist, the spiritual counselor, the family, and numerous other advisers.  That is an essential part of integrative oncology.

I know this is very presumptuous, but I want to share a health care proposal as an alternative to a single payer, public option.  Yes, there are many details to my proposal that I don’t understand enough about, but then, the plan that we are being asked to accept is missing a ton of details.

My plan would include the following:

* Place every health insurance company into the national competitive pool and establish a national policy board with representatives from each state.  States would no longer have separate insurance oversight, and all insurance companies would compete nationally.

* Require insurance companies to extend their group rates to affinity groups (social and professional organizations), government agencies, church groups, and small businesses.

* Implement health savings accounts available to all citizens to be managed by financial institutions as an alternative to health insurance

* Government assist in premiums for low income, unemployed, and disabled Americans. 

* Require proof of low-cost, catastrophic care insurance (cancer, major accident, chronic disease, etc.) as a part of the driver’s licensing process.

* Keep Medicare and Medicaid as is for the time being.

* Place reasonable caps on malpractice lawsuits through Medical tort reform. 

* Relax unreasonable restrictions on what doctors can prescribe and practice

* Relax unreasonable restrictions on the testing of drugs and treatments and shorten clinical trials.

* Open the market to the importation of drugs and medical equipment.

This plan would lower medical costs, thereby lowering premiums charged by an expanded, free-market health insurance industry.  Everyone would be insured except those who absolutely refuse which they have the right to do.  Quality would be increased through greater competition.  I welcome your comments as to why this would or wouldn’t work. 

Senator Edward Kennedy’s death from a brain tumor yesterday is a grim reminder to the nation of the high stakes of cancer.  Although the senator’s life is no more valuable than any of the other 1500 Americans who will die from the cancer today, it is certainly a more influential representation of the disease’s characteristics.  Cancer is an equalizer that takes down the mighty with the same vengeance as the commoner.  One big difference, however, in how cancer affects different people is in its impact on their finances.  For the wealthy and well-insured, treatment cost is of little factor.  But, for those of modest or low income, and with insufficient or no insurance, cost is almost as stressful as the disease itself. 

What we are mostly focused on presently is how we can help cancer victims pay for the treatment.  Health reform seems to be all about how to respond to the rising costs (about 7% annually) rather than how to reduce the costs.  As we continue research for more and better drugs with the requisite clinical trials, we push the cost endlessly upward.  What is needed is policy changes that encourage speedier clinical trials, less restrictive limitations on use of new drugs, and greater receptivity to natural complements that enhance the effectiveness and reduce the application levels of these drugs.  There are many proven practices of integrative oncology that can substantially reduce the dependency on and cost of conventional cancer treatment drugs.  Until we shift the paradigm of cancer treatment to a more integrative concept, costs will continue to escalate and insurance premiums will continue to spiral out of the reach of more people. 

Senator Kennedy was a champion for health care reform.  May his passing be a time for us all to rethink what this reform should entail, particularly for cancer victims.  It is all about cost, not payment.     

Cancernetwork.com reported that the central message  from the American Society of Clinical Oncology’s 2009 annual conference was that oncology will be singled out in the health reform debate for its high cost.  The report notes that, in 2007, the U.S. spent $2.2 trillion (that’s with a “T”)  on health care.  Of that, cancer represents 5% of all health care costs, or $110 billion (with a “B”). 

As we hear unending newscasts about the stimulus spending and health care reform costs, trillions and billions seem to become meaningless and beyond our comprehension.  Once in a great while, someone puts the numbers into perspective.  Here is once such perspective, courtesy of Cancer Network.  If we equate a dollar to a second, a trillion seconds takes us back to 30,000 BC, well before civilian as we know it or possibly even mankind as we know it.  Therefore, 2.2 trillion seconds from today would take us to 66,000 BC!  That’s how much money we spend on health in the U.S. in ONE YEAR!  Furthermore, the cancer costs of $110 billion viewed at one dollar per second would take us back to 3300 BC which precedes the biblical account of Noah.  No wonder most doctors, especially oncologists, medical centers, and the pharmaceutical industry are very nervous about the payment concept of the health care reform bill. 

The medical community and the pharmaceutical industry are being strong-armed by the government offices promoting the plan and are urged to reduce costs of medical care.  Supposedly, executives from both arenas are working diligently to come up with billions in cost savings for the patients and insurance companies.

For the rest of the week, this blog will focus on the high costs of treating cancer combined with the health care reform vision of reducing those costs.  Can it happen.  A better question is can it happen without loss of services and survivability potential?  An even better question is will the stakeholders let it happen?  Keep coming back this week.  Let’s dialog.  

I know, the title looks like another theory from the world of quack.  But, hear me out here.  It seems a doctor in Italy believes cancer is a fungus that can be cured with some sort of antacid solution.  Yes, he’s probably a quack and not even one with an original idea.  Cancer as a fungus has been theorized for years with very little evidence.  Also, the idea of cancer being acidic and, therefore, possibly suppressed with antacid has been around for a while.  Neither of these positions are taken at all seriously by conventional oncologists in general.  However, although the fungus connection is virtually unsupportable, the antacid, or alkaline, postulate may have some merit.

Ralph W. Moss, PhD, is a renowned cancer researcher with high credibility among both conventional and integrative oncologists.  Dr. Moss writes a newsletter which is found at www.cancerdecisions.com.  He says the belief that cancer is inherently acidic has been around for quite some time.  Several researchers have determined that solid tumors usually develop within an acidic environment.  The University of Arizona is presently testing the use of bicarbonate as a potential treatment for cancer.  Dr. Moss notes that the bicarbonate alkalizes the area around the tumor and has been found to stabilize its growth and inhibit its metastasis in mice.  Of course, no one is ready to recommend that cancer patients reject their therapies and turn to Arm and Hammer.  But, it is certainly an interesting research and worthy of continued testing. 

What if we found that soda water, for pennies a day, could greatly enhance the efficacy of conventional cancer treatment and allow a much shorter duration of its application at significantly lower levels of toxicity and physical trauma.  This is just one more example of why it is so critical to do more research and testing of natural, non-toxic options which is what integrative oncology is all about.  Integrative oncologists are already practicing many proven methods of treatment that complement and enhance chemotherapy and radiation.  These integrative practices are just too limited and must be expanded.  As always, I urge you to read up on everything you can get your hands on to increase your knowledge of integrative oncology.  Then, armed with knowledge and passion for a new strategy for the war on cancer, become active in support of the movement. 

The heated debate over health care reform centers around what health insurance concept we are going to have in place for the future.  The big question is about the roles government will have relative to the private insurance industry.  Rather than get into that controversy today, I want to address a critical issue concerning insurance for cancer patients under a “reformed” health care concept.

When my wife was diagnosed with breast cancer in 1998, I had a good primary insurance plan and a good secondary supplemental policy.  The primary paid 75% of allowable costs of medical care, and the supplemental paid the other 25%, both after reasonable annual deductibles.  If the treacherous disease comes your way, this insurance set up is the best possible situation.  When Connie passed away in 2001, we had amassed a total cost of over a half-million dollars for her cancer treatment.  During those three years, my only out-of-pocket cost was the few hundred dollars in deductibles each year.  Everyone should have this type of insurance coverage.  Personally, I do not believe the government would or could ever ensure the type and level of cancer treatment we got for virtually no cost to us.  It would be a bureaucratic nightmare and bankrupt in a few years. 

The private insurance that we had, and that I still have, is the best of all worlds.  If that is unaffordable or unattainable for some people, there is private catastrophic insurance at reasonable cost that just covers such conditions as cancer or heart disease.  The unaffordability and inaccessibility of health insurance is more a factor of high health care costs and lack of employment benefit packages with sufficient coverage.  These are also complex problems, but problems we should be resolving rather than leaning on the government to pay for our high health costs and to cover our missing benefits.

Two major reductions in health care costs would solve much of the problem.  First, tort reform would permit doctors to avoid paying half of their income on malpractice insurance, so their charges could be less.  Second, progress in integrative medicine would mean drugs would be more efficient and less needed.  Encourage your government representatives to focus on the real problems.  

The readers of this blog would benefit significantly from reading cancer patients’ personal experience with integrative cancer treatment.  Since most of my readers are interested in integrative treatment, no doubt several are presently receiving  or have received treatment by integrative oncologists.  If any readers know of friends or relatives who have elected to seek out doctors who practice complementary therapy, please encourage them to respond to my request. 

Few experiences leave one feeling as lonely and helpless as cancer treatment.  Having access to stories of others going through the same thing is a great help in coping with the disease and the treatment.  Also, those who have chosen integrative oncologists may feel ostracized by other patients and medical professionals who are totally committed to conventional therapy.  I would like to see us develop a small network of cancer victims who are choosing complementary therapy by integrative oncologists. 

 Please do a reply post to this blog post or just email me at: terry@cancerchoices.org.  I look forward to hearing from you.

There is an interesting and controversial part to the House health care reform bill that involves end-of-life counseling.  The proposed provision is touted as being an advantageous opportunity for those who are seriously ill to request a personal consultation with their doctor about their preparedness for the future they face.  The promoted improvement is that this professional consultation would be paid by insurance.  All the rage over this provision comes from the suspicion that the government would influence the doctors to use this consulting opportunity to convince the seriously ill or elderly that they shouldn’t pursue further expensive and extensive treatment.  Therefore, some conclude, we would be sending our terminally ill and unproductive out to die. 

After reading the language of this part of the bill and hearing the explanations from both sides, I am convinced that this is not some kind of a diabolical government plot to let grandma die.  However, I am still concerned that society feels we need to pay extra for such health coaching or consultation by our doctors.  The reason that this kind of counsel from our doctors would be an insurance claim is because most doctors are treating only our disease symptoms and not our whole person.  Specifically, if a person is being treated for cancer by an oncologist, that oncologist should be counseling that patient  on every aspect of the cancer experience and not just on how he plans to attack the tumor.  Oncologists should take the time to talk to a terminal cancer patient about their lifestyle, their finances, and their desires for or rejection of an extended life of pain and suffering.  This is integrative oncology, and it should be part of the core doctor-patient relationship and not billed as extra chargeable minutes.  An integrative oncologist cares for his or her cancer patients on a personal level including emotional, psychological, spiritual, as well as physical welfare.

Paying a doctor for a 15 -minute consultation about end-of-life decisions reflects a disregard for the whole-person treatment that the doctor is supposed to be doing anyway.  That is one thing I see wrong with the proposed health care reform and wrong with our nation’s present model of medical care.

An author friend of mine was scheduled to be interviewed on a national cable channel news show this morning but was preempted by all the late breaking hoopla over the health care reform plan.  The town hall meetings are consuming the news reporting at every level.

I can’t observe this national reaction without thinking about how beneficial it would be for Americans to get that spun up about the war on cancer.  Over 12 million Americans are presently being treated for cancer.  Each year, about 560,000 of them die of the disease.  Today over 1500 of our friends, neighbors, and relatives will die the ugly and excruciating death from cancer.

I know it’s a dream, but if we could win a victory over this enemy, we would have 12 million fewer people using the most expensive and manpower intensive health care in the country.  It would free up thousands of physicians and medical facilities.  It would lower insurance rates substantially, and it would allow increased supply, and thus lower prices, of drugs for other treatments.  I don’t believe it’s an unreasonable leap to say that, if we could factor out cancer, there wouldn’t be any health crisis.

At least one of the principal elements of health care reform should be to reform the war on cancer.  President Obama should reaffirm the 1971 cancer war declaration of President Nixon.  Then he should take the war to Congress and the public in the way that he can do so masterfully.  Actually, I believe he would find a gentler audience. 

One of the most heated debates about the proposed health care reform plan is over the possibility of withholding treatment for people with low potential for recovery and those with limited contribution to society.  The focus of this debate is primarily on the elderly.  There is logical and historical reason to not place the fate of any sector of society totally in the hands of government.  Of course, I do not believe that our government would ever take a Nazi approach to valuing human life.  Nonetheless, it is not good ethics in public policy to open the door to such a possibility.  The proposed public option, single payer health care concept certainly cracks that door open.  I think we should consider it a given that a public “option” insurance would eventually be a public “universal” insurance.  Insurance companies will ultimately not withstand the competition from government programs with unlimited taxpayer funds and enforceable policy in their favor.  Once the government is in complete control of funding and managing health care, medical practice will no longer be driven and controlled by the market place of consumer demand.  That would leave medical patients vulnerable.

God forbid that this nation ever gets to that point, but it could happen.  In addition to the issue of elderly patients not qualifying for treatment is an issue I have not heard anything about yet–terminal cancer patients.  At Stage IV, cancer becomes a chronic disease that, although sometimes controllable for a time, will ultimately claim the victim’s life.  Personally, if I am ever diagnosed with Stage IV cancer and can’t be guaranteed several years of reasonably healthy existence, I will refuse anything other than pain medication and give my immune system every advantage I can access.  However, the freedoms on which our country was founded gives each of us the right to choose how we want to treat Stage IV cancer as well as any other health problem.  Under our present system, most oncologists will continue to fight Stage IV cancer with everything they have available.  It is simply vital to our cultural values to extend life as long as the patient has the will to do so.  If, for any reason, a doctor or insurance company refused to honor our desires, we would seek other options.  Under government controlled health care, there would be no other options.  We can deny that the government would ever take such measures, and I don’t believe it would.  But, should we voluntarily accept that risk unnecessarily, particularly when there are reasonable alternatives?

Health care reform should be lower cost care (read tort reform and drug testing reform), increased choice of providers and medicines, more freedom in medical practice, and broader scoped medical research.