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Why Yes, We Should Treat Cancer

This article is more than 9 years old.

In a recent column in the BMJ blog, Dr. Richard Smith – a former editor of the British Medical Journal – wrote that dying of cancer is the best death.

He explains why he considers cancer a preferable way out, better than a sudden death: “You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music…” He offers romantic view of death by cancer, “achievable with love, morphine, and whisky.”

Seriously. He cautions: “But stay away from overambitious oncologists, and let’s stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.”

Smith refers to the calm passing of Luis Buñuel, the Spanish-born film-maker, in Mexico City in 1983. He contrasts Buñuel’s final days with the death of Franco, who died after receiving protracted and intensive care in a Madrid Hospital in 1975. As if there’s been no progress in oncology since.

The notion that it’s best to let cancer go untreated is cruelty disguised as kindness. Surely, every reader knows someone who’s had cancer treatment and moved on, forward – to resume work or school, raise a family, cook, teach, be productive in one way or another, if not indefinitely, at least for a meaningful period of time.

Just last week, the American Cancer Society released a summary of its annual Cancer Facts and Figures report, for 2015. The fact is, deaths from cancer have dramatically declined in the past two decades. Treatment is much better than it was, though still imperfect. The image of a person retching or in pain, afraid to ask questions of his doctor and not being offered palliative care is outdated by several decades.

Today, cancer surgery and medicines can extend and improve the lives of people who live for years and decades after treatment. Malignancies that were notoriously hard-to-treat just a few years ago, like some forms of lung cancer, melanoma, T-cell lymphomas, Her2+ breast cancer and other conditions have become, in many cases, manageable.

The BMJ post wouldn’t matter much except that Smith is an influential physician who has held leadership positions with several health-related ventures and edited the British Medical Journal for over a decade, until 2004. And his view resonates with that expressed by another powerful editor, published by the New York Times last January. In that op-ed, Bill Keller suggested that Lisa Bonchek Adams, a woman in her early forties, stop taking treatment to shrink or slow her metastatic breast cancer. Keller served as executive editor of the New York Times from 2003 until 2011.

Worrisome, that two individuals who’ve been in positions to decide what health news gets published and featured express such fatalism about malignancy. We do, after all, treat people with heart disease, infections including hepatitis and HIV, diabetes, cystic fibrosis, sickle cell anemia, rheumatoid arthritis and asthma, to name a few. Why not treat people who have cancer?

Cancer therapy is a choice. No adult should receive medical care they don’t want. And yes, we’re all mortal – no argument there. And I wish for every person a death with dignity, according to his or her preferences, free of pain.

To deny new treatments that might prolong the lives of cancer patients in a good way, possibly for cure or a remission, or even just to tame the disease, is a misguided proposition.

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