http://www.signonsandiego.com/uniontrib/20070703/news_lz1c03cancer.html
Diagnosis or distraction?
New ovarian cancer advisory could save lives, but it could also cause needless panic
By Cheryl Clark
“There have been so many women who complained about these symptoms but were blown off by their doctors,” said Goff, a gynecologic oncologist at the University of Washington. “We now know that paying attention could mean the difference between a 70 to 90 percent chance of a cure at stage 1, versus 20 to 30 percent at stage 4.”
“The biggest obstacle is that individual physicians not experienced in cancer are very likely to dismiss these complaints,” said Dr. Albert Deisseroth, an avid supporter of the advisory. He's president and chief executive of the Sidney Kimmel Cancer Center in Kearny Mesa. Deisseroth said that too often, patients complain about abdominal bloating and have their doctors respond, “Oh don't worry, we'll give you antibiotics.”
Citing her own research, Goff said ovarian cancer patients who complained of the pelvic symptoms often were told that nothing was wrong or that they had everything from depression to irritable bowel syndrome. Only 20 percent of those patients were initially informed that they might have ovarian cancer. Geri Danzig of Hillcrest is a classic case. When she complained about her pelvic symptoms to two doctors, she first was given an anti-depressant.
* * *
This is the same "treatment" that CFS patients get -- they describe their symptoms to doctors and are given a pat on the head and an anti-depressant, or told nothing is wrong and given a diagnosis of hypochondria.
There is no question that ovarian cancer is a serious disease, but because these are female patients, and the symptoms are considered "vague", they're dismissed by "physicians not experienced" in treating the disease as being psychological in origin. And then these patients die because they don't get sent to a specialist who does know how to make the diagnosis, until they've gone from the 90% chance in stage 1 to the 20% chance in stage 4. Similarly, CFS patients who could have been returned to work become permanently disabled because of the lack of early intervention.
Time and again, we hear doctors say that CFS is impossible to diagnose. But patient support groups have a near-100% success rate in making the diagnosis. Why? Because the patients are experienced with it. We know how to differentiate CFS from depression. In one, you have no initiative to start a project; in the other, you have initiative to start, but lack the stamina to finish. The reaction to exercise is another easy diagnostic tool -- there are only a few diseases where exercise makes the patient worse. Asking those two questions is absolutely free, no expensive testing required. But those questions aren't asked because the doctors don't know to ask them.
The real crime is the willingness of male doctors to brand women as psych cases so quickly. According to a statistic cited by Dr. David Bell, fully half of patients initially dismissed as hypochondriacs or given a psych diagnosis are eventually diagnosed with a real medical condition. The patient knows her own body and when things aren't right with it. It would behoove doctors to listen to the patients, not tell them they're imagining things, and not issue a psych diagnosis or prescribe anti-depressants until the patient has been evaluated by a psych professional who knows that there have to be emotional symptoms, not just pain and fatigue, in order to have a valid diagnosis of depression.
Every time I've been evaluated by trained counselors, they have concluded that the symptoms I have sound like the flu, because the emotional component is missing. When I take that evaluation back to the MD who thinks I'm just depressed, he refuses to accept the possibility that his amateur psych diagnosis is wrong and there's something physically wrong with me.
No comments:
Post a Comment