Cancer: a Philosophical Question

Kithani said:

Buying it in a back alley at your local flea market is probably cheap but there’s plenty of “expert clinics” in this country (I’m not going to post links) where they will range from charging you a small fortune to milking you for all you’re worth to get on their special protocol or whatever. I’ve seen people spend >50k in a month cash on “experimental” treatment in Mexico.

At the end of the day it just doesn't make any logical sense. The last true blockbuster drug in Oncology was probably Keytruda (and Opdivo) which you'll see on TV all the time. It had a new mechanism of action and has been effective in a wide variety of cancers and is even responsible for some of the "miracle" cases you'll occasionally see. Ironically, this is the exact fucking drug Mr Tippen was in a trial on and if you look at the data there was a small minorty of patients that seemed to have a miraculously sustained response to this drug even though the MEDIAN response only moved about 2 weeks. Keytruda is literally the best selling drug on planet Earth by total revenue. Think about that... of all the money big pharma makes, this single drug is THE HIGHEST PAYING drug they have. The idea that there is some other wonder-drug sitting out there in plain sight and Pharma just doesn't want you to know about it (instead of selling it to you) just doesn't pass the smell test on any basic level. All they would have to do is make a combined pill of Ivermectin/Febendazole and slap a new name "Iverbendazole" and they'd be off to the bank.

Now... maybe there is some secret trial going on that is going to do just that and if so I'll gladly come back and edit my post, eat some crow and celebrate with everyone, but I'm just not getting my hopes up.

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I'm not saying anything is or isn't effective. I have no idea, but they're able to charge $12k/month for that because they have the patent for it. They're certainly not going to run trials to see if they can replace the best selling drug on earth with vitamin c (or whatever).

Control said:

I'm not saying anything is or isn't effective. I have no idea, but they're able to charge $12k/month for that because they have the patent for it. They're certainly not going to run trials to see if they can replace the best selling drug on earth with vitamin c (or whatever).

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Technically correct but they would still run trials.

1) You would never run a trial of replacing something with Vitamin C. You would run a trial of whether <insert special vitamin C compound that they can patent> PLUS standard treatment vs standard treatment.

2) Even if you did think they wouldn’t want to kill the golden goose, only one company owns the patent on Keytruda, their competitors would be happy to discover some new alternative

Nothing is medically confirmed yet but I believe I am on this doorstep. I have a trust but now I am starting to wonder(it’s revocable) on my setup. The family would liquidate all I’ve built to give me 3 months. And calling her a fucking idiot doesn’t help my situation. Yet my sister is more pragmatic. I’d rather die in 3(it’s not that bad. Just saying) than live for 6 and cripple those I love.

For my wife, we weren't looking for the magic bullet (although we looked in to a number of them / fucking all of them), we were just hoping to find something that slowed it down for 6 months, or 3 months, and then move on to the next chemo or trial to buy time.

The things that are in trials now (or have been for the last few of years at this point): genetic therapies tailored specifically to you and your cancer. immunotherapies, other random shit I can't remember anymore. It felt to us, that if we could just buy enough time to find the right trial we might stand a chance. The research being done was so materially different from the types of chemo drugs that had been produced prior to established chemotherapies.

Hell, the "nuclear option" chemo drug that they put her on to start turned out to be a drug invented in the 70's. We were so fucking naive.

In the end, a couple of things were true.

We were adamant we wanted to fight no matter what, our oncology team knew the odds were astronomically against us and took a step back. So when they told her she only had weeks left, in our head we said "fuck you, we'll go it alone then."

So the truth was was, we had waited too long to go from established chemotherapy to clinical trials.

Had we still had faith in our oncology team, we would have listened to them, not attempted the trial we ultimately went with, and I think she would have lived longer. Weeks, maybe even months.

Its a hard balance to get right, don't throw in the towel too early and maybe have a shot at living longer with a high(ish) quality of life vs bankrupt yourself and potentially those around you and still wind up dead.

Cancer is such a cunt.

Sanrith Descartes said:

Something I learned going through this is there is a DNI as well as a DNR. I had never heard of a DNI. DNI is do not intubate. So they can do compressions and bag you while they do it. I think they can also shock and crack your chest, but they won't hook you up to machines to breathe for you for eternity.

There is so much little shit involved in the life saving process that the general public has no knowledge of.

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It's usually decided before, ideally. So we don't start hlr or tube you if the expectd outcome is you wont make it out of the icu, e.g. non-reversible condition = dependent on ventilator forever. Levels anyway. In other cases, I can decide dni and still do icu for vasopressors for instance. If we crack your chest during hlr you're going to need icu for months, usually, edc, painkillers, and you might need a ventilator anywho.

Sanrith Descartes said:

My mom refused being attached to any machine, but she allowed them to bag her if needed, compressions if needed and to put a mainline in for drug access. That's when they explained to use the differences between the DNR and the DNI. At least that was how I understood it.

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Ye, two (3) different scenarios. DNR, don't start hlr. DNI don't intubate, which to me means intubation which might lead to ventilator (machine). If you have a cardiac arrest, you'll most likely depending on length and reversible causes have cracked ribs, needing a long recovery period which some are in the icu, sometimes needing a ventilator. So having a DNI but not DNR means we try to get you back to life via HLR but you might need a tube or machine to get through it. Same-same in effect if the HLR is taking long due to the underlying cause. Over here we do DNICU, doesn't rule out a tube for HLR, but ICU is not an option, hence no ventilator.