Remission - the new kid on the block

We live in a world of specialists. I mean medical specialists. The human body is no longer treated as an individual whole, with its idiosyncrasies and quirks and its unique way of perceiving, reacting to and feeling things. This aspect of medicine died with the demise of the good old family GP who knew you better than you knew yourself. He would treat the person, not the disease and would modify and fine tune his treatment in accordance with the person he was healing. In modern medicine you are dissected into infinitesemal pieces and each piece has a specific specialist who will only treat what he is specialised in. Let me elucidate.

Yesterday we went to see Ranjan's oncologist with the results of his latest scan. I was very apprehensive as I was terrified that the said specialist would utter something that would alter reality. My prayers went unheard as when Ranjan asked if he was 'cancer free', the doctor in question said yes! My heart skipped a beat. Everyone knows that no cancer is cured with a few cycles of chemotherapy! If that were the case there all cancer patients would be cured.

You would be justified in thinking that Ranjan, like any educated human being, would be aware of the course cancer takes, with remission and five years protocols. I guess at one level he is. But at another he is just a scared human being who is yearning to hear the words: you are cured. Two days ago he asked me the same question: am I cancer free and it took all the skills of a diplomat's daughter to give a well sugar coated answer that would assuage his fears within the spectrum of reality. So you can imagine how angry I was when the doctor answered a convenient YES!

I knew how wrong he was. True Ranjan is better and doing the best possible but he is in no way cancer free. My Tibetan doctor did not even want to see the latest scan done shortly after his last chemo as she said it was nothing short of useless. The chemo after 6 months will reveal the true picture and that is what we are all working towards.

True there are no more FDG avid cells at the moment but only God can tell us whether they will or will not reappear. The doctor was referring to the present moment in its shortest definition. His next 'diagnosis' would be post the June scan and there is no guarantee in their books that the Yes will remain a Yes! I was also surprised when the oncologist said nothing about the enlarged liver. When I mentioned it he simply said that this was for our family doc to deal with. Specialists, remember specialists.

You simply need to type the words remission in Hodgkin's lymphoma on Google search and you will get the answers you seek and nowhere do you find the kind of YES I heard yesterday! In one article I read the following words: Remission means that your lymphoma has been either eliminated or reduced. When the tumor is completely gone, doctors call it "complete remission." When the tumor has been largely reduced but it still remains, it is called a "partial remission." Even if your disease stands eliminated after treatment is over, it is still not called a cure. Lymphomas have a chance of recurring, and the doctor will often wait for a few years before he is confident that your disease will not return. Only after that can he tell you that you are cured.  The questions are endless and the answers vary. The reality is that one has to remain on guard for all times to come as in a minority of people with Hodgkin's the disease relapses after treatment; this is most likely to happen within the first two years of remission. One has to be ready for all eventualities. That is what wisdom suggests.

For conventional medicine, if the disease relapses we get more of the same: chemotherapy, stem cell transplant etc. They have no real cure as their approach does not target the possible causes. But blissfully we are also using a host of alternative therapies and nutrition. These aim at making the body strong enough to fight any recurrence. When my Tibetan doctor read through the PET report she was concerned about the enlarged liver and the non avid nodes in the lung. She immediately fine tuned the medication to deal with these issues. But her main concern has been the bone marrow and the immune system as if these kick in then most of the other issues are taken care of.

Keeping all the above in mind, the new kid on the block - remission - is another challenge that will need me to be on my toes. So no question of the adrenaline dropping. The first thing is to gently explain to my darling man the true meaning of the doctor's YES!