
Oliver Sacks: My Periodic Table - benbreen
http://www.nytimes.com/2015/07/26/opinion/my-periodic-table.html
======
marincounty
These stories hit me hard. Liver cancer is one of the worst cancers--strike
worst cancer; they are all bad. My father died 10 years ago from liver cancer.

My father had a tumor for 10 plus years, and his new General Practitioner
attributed the bulge to a old umbilical hernia scar. Today's doctors vary
rarely palpate their patients. I don't know if the latest research shows it
doesn't pick up tumors, or doctors are just too busy? But, for ten years no
doctor touched his stomach(not one quadrant?). Never?

His previous doctor who saw him from a young man to around 55, always palpated
all his patients--including myself. We all used Dr. Shepard as the family
doctor. In every physical I had from Dr. Shepard he made sure to feel that
liver, and feel for unusual masses. I just figured all doctors palpated their
patients? I truely think if Dr. Shepard didn't retire, and my father had him
as a GP; my father would still be alive? He lived 10 years with a benign
tumor, and it eventually turned cancerous?

I don't blame anyone. I do know this, the pain my father went through was
beyond Hell--especially the last week. The nonprofit who took care of his
palliative care; under medicated him. They didn't give him enough opiates!
Along with enough benzodiazepines. I don't know why--they are overfunded?

My point is not to make this about me, but dying from liver cancer is horrid.
I have thought about the pain he went through every day since his death 10
years ago. I know a cure for liver cancer is a way off, but pain relief
shouldn't even be an issue? Give the patient all the medication they want? I
can't tell you how many times we needed to get the doctor to o.k. new
prescription, and then drive down to the pharmacy. My father literally thought
the doctor's thought he was abusing his meds? Who cares if he was liked the
effect of the opiates? He had a football in his stomach? If I could do it over
again, I would have hit the streets and bought him heroin!(yes, I would have
risked it. I was to young to know what to do, or even where to get the drugs?)

My point us we need a better way of managing terminal illnesses? Just thus
week, another "Death with dignity" bill died--I believe in a California court?

Good night people--

~~~
neuro_imager
I'm sorry to hear about your father and I empathise deeply with what you and
your family must have gone through.

Despite the solemn nature of your post, I feel the need to correct a few
points: (I am a doctor - a radiologist)

\- Palpating the abdomen is not a very reliable way of assessing an
individual's liver. Most liver lesions are not palpable and are normally
diagnosed (following blood tests) with ultrasound, CT or MRI scans.

\- There are several types of what you refer to as "liver cancer". the most
common, as in Oliver Sacks'case is metastatic liver disease (ie. the cancer
starts somewhere else and spreads to the liver, rather than being from the
liver itself - that is a true liver cancer (hepatocellular carcinoma).

\- There are several treatments for both primary liver cancer (hepatocellualr
carcinoma) and metastatic liver disease. Whether these treatments can result
in a "cure" or a prolongation of the patients life, or mearly an improvement
in their quality of life depends on the overall progression of the disease.

\- Some possible therapies include surgery, chemotherapy, radiotherapy(of
various kinds), ablative therapies(cryoablation, radiofrequency ablation,
focused ultrasound), embolisation(bland, chemo-embolisation etc.) as well as
systemic treatments and pain therapies.

\- I'm sorry that your dad went through what he did. He may not have gotten
the best possible care (I can't say, I don't know the details).

\- There are certainly problems with the healthcare system overall but its not
accurate to say that pain relief isn't something physicians and caregivers
don't think about or have potential options for.

~~~
spenczar5
This comment is an excellent example of how you can gently correct someone
while still showing empathy. What a difference compared to most internet
discussions! Thank you.

------
justinpombrio
I highly recommend Oliver Sacks' books. I've read "An Anthropologist On Mars"
and "The Man who Mistook his Wife for a Hat". In both, he talks about several
people who had various brain injuries and their strange consequences.

I love his writing: he simultaneously gives a detailed analysis and a very
humanistic perspective.

~~~
andrewem
I had read several of his books, and thought I had a pretty good picture of
him. Then I read his new memoir "On the Move", and I found out how little I
knew about his life, which turned out to be far more interesting than I'd
imagined. I can't recommend it highly enough.

------
jakeogh
Interesting discussion: Paul Davies on FQXi: The Physics of Cancer
[http://traffic.libsyn.com/fqxipodcast/Physics_of_Cancer.mp3](http://traffic.libsyn.com/fqxipodcast/Physics_of_Cancer.mp3)
From:
[http://fqxi.org/community/podcast/2014.10.02](http://fqxi.org/community/podcast/2014.10.02)

