The sad case of Ashya King shows how bad it gets when trust is lost in medicine. How can the full weight of the law have been brought to bear on a clearly loving, intelligent family just doing what they think is best for their boy?
When I was first a consultant we never discussed cancer with patients. Now little old ladies with trivial skin cancer are bombarded by counsellors with armfuls of leaflets. I felt distinctly uncomfortable when patients started bringing in laptops to show me treatments that I didn’t know existed — but I got over it. Humility is an essential quality in a doctor
There are more than a billion internet sites for cancer. Many are selling something, others are offering dubious advice and only a minority are of real value. In this country CancerResearchUK and Macmillan are the two most authoritative sources, as is the National Cancer Institute in the US. But the danger is that no two cases are the same. So seeking out your own treatment plan is fraught with danger.
I’ve had my fair share of challenging patients. The most difficult have been those wedded to alternative therapies. The highly educated owner of a travel agency wanted some extremely unusual treatments abroad, including shark’s cartilage and coffee enemas. I couldn’t dissuade her. I kept measuring the size of her breast cancer and showing her how rapidly it was growing. I knew that orthodox medicine could in all probability cure her. The cancer spread to her liver and brain before she agreed to conventional care but by then it was too late.
Another patient — a rich industrialist — decided that my proposed treatment and the likely outcome for the pancreatic cancer that had spread to his liver was too negative. After spending an enormous amount on conventional care in New York he returned to London and admitted that they had told him the same thing. I should have talked him out of going, apparently.
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So my advice is always to talk to your consultant and GP about your concerns and hopes. New treatments, whether drugs or devices, always get a great fanfare. The drawbacks are never mentioned. You have to be able to trust your cancer treatment team — most people do. If you have concerns, then voice them right away. The internet is a great pointer to novel approaches but it can never be a solution on its own.
Professor Karol Sikora is medical director of Cancer Partners UK