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JOHN GALT, M.D

A forum for discussion of regional topics including oil depletion but also government, society, and the future.

Re: JOHN GALT, M.D

Unread postby Quinny » Tue 22 Sep 2009, 02:56:19

All those Insurance sales staff must cost a hell of a lot as well.

Wages/Fees must make up the lion's share of the bill, I suppose it's the nurses and ancilliary staff who are a lot higher paid. :roll:
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Tue 22 Sep 2009, 18:45:54

$this->bbcode_second_pass_quote('rangerone314', 'I')nteresting short article about claims denials with profiles of 3 cases:


What that article outlines is three doctors practicing irresponsible medicine. IMHO insurance companies should be MUCH more aggressive about fighting stupid wasteful crap like that. The entire field of oncology is just run through with profiteering and idiotic waste. As a family practice doc, that's often the greatest benefit I can make in a patient's life is to prevent them from dying under the care of an oncologist. I seriously think that given the option, most oncologists would still be poisoning and irradiating your corpse six months after your funeral.
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Re: JOHN GALT, M.D

Unread postby Sixstrings » Wed 23 Sep 2009, 22:30:52

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('rangerone314', 'I')nteresting short article about claims denials with profiles of 3 cases:
What that article outlines is three doctors practicing irresponsible medicine. IMHO insurance companies should be MUCH more aggressive about fighting stupid wasteful crap like that. The entire field of oncology is just run through with profiteering and idiotic waste. As a family practice doc, that's often the greatest benefit I can make in a patient's life is to prevent them from dying under the care of an oncologist. I seriously think that given the option, most oncologists would still be poisoning and irradiating your corpse six months after your funeral.

None of the people I've known who had cancer and got chemotherapy made it in the end. If you were to guess, SPG, what percentage of people does chemo actually help? Seems to me this is one of the toughest dilemmas for patients.. do you choose to extend your life a bit, but be sick as a dog the whole time, or do you take six months of relative health with no hope of life extension..
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Wed 23 Sep 2009, 23:37:54

$this->bbcode_second_pass_quote('Sixstrings', 'N')one of the people I've known who had cancer and got chemotherapy made it in the end. If you were to guess, SPG, what percentage of people does chemo actually help?
It depends a lot on what kind of cancer you have. If you have Hodgkin's lymphoma, chemo is often curative. For lung cancer, the life expectancy from diagnosis is 12 months without chemo vs. 14 with chemo and you're sick as a dog the whole time. Overall, I'd guess that maybe 10% of the patients that get chemo get any real benefit from it. The patients that are most likely to benefit from it either have A: very chemo responsive tumors like Hodgkins, or B: have very early stage disease and have a possibility of becoming cancer free. An example of the later might be a patient with an early stage breast cancer where they've had a lumpectomy and the whole lesion is felt to have been removed and you're using chemo to clean up any few dozen cancer cells that might have gotten missed. That's a very sensible use of chemo.

$this->bbcode_second_pass_quote('', ' ') Seems to me this is one of the toughest dilemmas for patients.. do you choose to extend your life a bit, but be sick as a dog the whole time, or do you take six months of relative health with no hope of life extension..
Obviously that sort of decision is something that the patient has to make themselves. The problem is that oncologists, by enlarge, don't give patients balanced information, and don't adequately account for the roll of denial as a part of the grieving process. They'll tell patients things like "this tumor has an 80% response rate to chemo." What they don't tell them is that "response" means that the tumor gets smaller on a CT scan, not that the patient feels any better or lives any longer. On the one hand it's understandable. If oncologists weren't a bit delusional, it would be the worst job in the world. 80% of your patient visits would be basically "You're going to die. Nobody can do anything about it. So sorry. We'll try our best to keep the pain tolerable. Any questions?" On the other hand, they do a horrible disservice by giving dying people false hopes and spending insane amounts of money on what is a fairly well documented and invariable course. When you get diagnosed with stage IV colon cancer, the gig is up. Your five year survival is less than 1%. There's really not a whole lot of point in doing a PET scan every month. You're going to die and nothing can change that. It's time to focus on your family, your spirituality, and your legacy. IMHO what's needed from a doctor is compassion, along with consistent factual information that people can plan around. Giving people false hope really is just about making the doctor into the center of attention. It's a really cruel thing to do to a dying person. The last place they need to be spending their final days is getting poked and prodded in a hospital. They need to be spending what precious time they've got left on living.
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Re: JOHN GALT, M.D

Unread postby Sixstrings » Thu 24 Sep 2009, 00:19:38

$this->bbcode_second_pass_quote('smallpoxgirl', 'I')t depends a lot on what kind of cancer you have. If you have Hodgkin's lymphoma, chemo is often curative. For lung cancer, the life expectancy from diagnosis is 12 months without chemo vs. 14 with chemo and you're sick as a dog the whole time. Overall, I'd guess that maybe 10% of the patients that get chemo get any real benefit from it.
Huh.. so I guess it pretty much is as grim as I was thinking. On a brighter note, I was watching BBC news today and they spent a lot of time talking about a new tumor-shrinking drug:$this->bbcode_second_pass_quote('', 'S')cientists have presented results of an experimental new drug which in early stage trials has significantly shrunk skin cancer tumours. US rearchers from Memorial Sloan-Kettering Hospital in New York said their results were "unprecedented". While not a cure, the study of 31 patients with late-stage skin cancer suggested the therapy could improve the quality of life and extend lifespan.

Larger scale trials will now be needed to test the drug, PLX4032, further.
In the study, which has been unveiled at a major cancer conference in Berlin, researchers treated patients where cancer had spread throughout their system. They were given a new drug that blocks the activity of a gene thought to be involved in the spread of skin cancer, the so-called BRAF gene. Within two weeks they noticed what they described as a "rapid and dramatic" shrinking of the tumours in the cancer patients:

Lead researcher Dr Paul Chapman said: "We've seen responses in patients who didn't respond to chemotherapy before. So far 70 per cent of patients have responded. So that is unprecedented for us."

New treatments can often seem promising to begin with - but have disappointing results in later larger trials. However, the doctors involved in the trial - and those at the European Cancer Organisation who have organised the conference - have never seen a cancer drug act so quickly on such a high proportion of patients. link

Maybe you can clarify something for me.. while this is a drug for skin cancer, it sounds like it reduced the tumors throughout the body? If that's so, wouldn't this be a treatment for all types of cancer? (or is skin cancer that spreads different from other kinds of cancer that spreads?)
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Thu 24 Sep 2009, 00:56:53

$this->bbcode_second_pass_quote('Sixstrings', 'M')aybe you can clarify something for me.. while this is a drug for skin cancer, it sounds like it reduced the tumors throughout the body? If that's so, wouldn't this be a treatment for all types of cancer? (or is skin cancer that spreads different from other kinds of cancer that spreads?)


Tumor cells retain some of the biology of their tissue of origin. Most thyroid cancers, for example, will readily take up radioactive iodine regardless of where they've spread to. It's the tissue of origin, therefore, determines how a tumor will respond to chemo. The particular gene that this drug is targeting is apparently a common cause of skin cells becoming cancerous, but might not be a common problem in colon cancers for example.
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Of a thousand burning bridges
Sifting through the ashes every day
What we thought would never end
Now is nothing more than a memory
The way things were before
I lost my way" - OCMS
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Re: JOHN GALT, M.D

Unread postby rangerone314 » Thu 24 Sep 2009, 09:55:23

I wonder if the Palestinians recruit suicide bombers from people who are terminally ill? That would be a cost-effective solution there that probably wouldn't be too popular in this country.
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Re: JOHN GALT, M.D

Unread postby vision-master » Thu 24 Sep 2009, 10:12:59

THE REAL NUMBER ONE KILLER

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Re: JOHN GALT, M.D

Unread postby Pretorian » Thu 24 Sep 2009, 10:51:48

$this->bbcode_second_pass_quote('smallpoxgirl', ' ')The entire field of oncology is just run through with profiteering and idiotic waste. As a family practice doc, that's often the greatest benefit I can make in a patient's life is to prevent them from dying under the care of an oncologist. I seriously think that given the option, most oncologists would still be poisoning and irradiating your corpse six months after your funeral.

<Sigh> I've read " Cancer Ward" by Solzhenytsyn about his expierences of treating stomack cancer in some free hospital in Middle Asia in 1950s...Kinda hoped that 50 years and millions of dollars worth of treatments made somekinda difference, alas.
From age of 9 or so I lived under the impression that cancerotic cells are present in anyone at any time, and that immunity system is taking care of that 24/7, and development of any cancer is just a failure of IS to contain it.. In another words, once there is a failure , the whole system is compromised for good. Is this true for a skin cancer too?

PS As for treating one's corps-- if there was a way to maintain oxygen and nutrition suppply to a tumour in a dead body, how would this tumour behave? Would it just grow endlessly?
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Thu 24 Sep 2009, 12:44:41

$this->bbcode_second_pass_quote('Pretorian', 'F')rom age of 9 or so I lived under the impression that cancerotic cells are present in anyone at any time, and that immunity system is taking care of that 24/7, and development of any cancer is just a failure of IS to contain it.. In another words, once there is a failure , the whole system is compromised for good. Is this true for a skin cancer too?


It's a bit more complex than that. Cells have the ability to replicate themselves. That's the whole mitosis process that you learn in high school biology. There's also a number of safety breaks built into the cell that should tell it when no more cells are needed right now and it should stop reproducing and rest for a while. Those safety breaks are called proto-oncogenes, because if they fail, the cell reproduces uncontrolled. A cell reproducing uncontrolled is called a tumor. At that point it's benign. When it learns how to move into a new part of the body and recruit new blood vessels to supply it, that's called cancer. Basically it's a log scale thing. There are approximately 10 trillion cells in the human body. Say there are 10 proto-oncogenes, and each one has a failure rate of maybe 2/hundred cells/hour. 50^10/10trillion gives you one cancer cell occurring, once every thousand hours. Or about once a year. Say maybe your immune system finds and eliminates 99% of them. That would mean that half of people would get cancer by age 50. That's not quite the right statistic, but you get the idea. Your immune system has an important surveillance roll, but so do all the proto-onco genes. If you want to avoid cancer, you want to keep your immune system strong. You also want to avoid things like radiation and carcinogenic chemicals that cause your proto-oncogenes to malfunction.
$this->bbcode_second_pass_quote('', 'i')f there was a way to maintain oxygen and nutrition suppply to a tumour in a dead body, how would this tumour behave? Would it just grow endlessly?

That process is called a tissue culture, and yes it would basically grow forever.
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Sifting through the ashes every day
What we thought would never end
Now is nothing more than a memory
The way things were before
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