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Cancer Care In The US Has A Long Way To Go It Seems

When I decided to write a blog about cancer, I thought it would be pretty easy. After all, my wife and I have been living with it for some three years come this Fall. And then there is the endless stream of great cancer research that anyone can track by simply signing up for an RSS published by the New York Time or so on.

What has surprised me, or should I say disturbed me, is how variable the quality of cancer care is in the US among cancer doctors and hospitals. No, let’s call a spade a spade. What has scared me is how bad the quality of cancer care in the US can be at the local hospital level. How else could you explain the comments of Dr. John H. Glick of the Abramson Cancer Center at the University of Pennsylvania who finds that he typically recommends major changes in the treatment plans of 30% to 40% of patients seeking a second opinion, and minor recommended change in an additional 30% of the patients.

An article by Diane Grady in the July 29th issue of the New York Times reminded me how bad the state of affairs really is with respect to cancer care in the US.

I was surprised to find out for example that it has only been within the last two years that cancer experts across the US came together to agree upon standard treatment guidelines for the most common cancer conditions. But having guidelines and getting cancer doctors to agree to not to mention follow the guidelines is an entirely different matter.

Here’s what I mean. According to the New York Times article, “among women with breast cancer, 15 to 25 percent who should have radiation do not receive it, and 20 to 30 percent do not take the anti-estrogen drugs that are a mainstay for most patients.”

But wait, things are even worse for early stage patients diagnosed with one of the most deadly cancers – pancreatic cancer. According to a study released this June by the American College of Surgeons, 38 percent of patients who were eligible for (by treatment guidelines) and could have benefited from surgery were not even offered it by their doctors.

Apparently the same is also true for ovarian cancer. Dr. Barbara Goff, a gynecologic oncologist at the University of Washington in Seattle is quoted in the New York Times article as saying “a third of the women in the United States are not getting the right surgery, not even close…we have so many resources, but we still do so poorly with ovarian cancer.”

I could go one with the statistics. But I think you get the point. Cancer patients and caregivers like me, and many of you, really are on our own when it comes to navigating the cancer care delivery system in the US. Sure my wife finally found the right doctors and the right treatments allowing her to remain cancer free for now. Many of you too hopefully have had similar positive outcome. But I bet that like my wife and I, it probably didn’t come easy for you either. Like us, you no doubt had to fight your local doctors and hospitals to end up where you are today.

What I want to know is why does it have to be this way? Anyone else have an opinion?
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