Finding the balance

More tests or fewer, more meds or fewer. Does this mean fewer diagnoses and more deaths? I don't think it has to. We just need to find the balance.

We need to focus on finding, not what is the most we can do, to what is the best thing that can be done for the patient. Go read this article to learn more. I strongly agree with this theory.

I can't tell you how many times I have felt over-tested, -poked, and -prodded, because of 'my medical history, they have to be sure'. I can't tell you how annoying that is. Really? Can't they just say that's the best thing for you? Or is that not what they mean?

There is a current leaning in the medical/insurance world to cut down on the amount of tests, scans, and medications for patients. American medical costs are the highest in the world and American patients are blasted by ads and mailings from manufacturers on the newest, most expensive treatments, which are often unnecessary. And patients ask for more scans.

I get it. I have asked doctors why no more scans or tests? And the answer is 'there are no reasons to have any scans, there are no changes'. I can live with that. And I get mailings from Pfizer to go on Xeljanz, which is probably no better than my current drug combinations. And that new drug costs a fortune.

There is a tiny part of my brain that screams 'cure me', give me more tests, find a fancy pill, do something so I can go back to my former healthy self. But the rational part of me knows that isn't a reality. I can dream can't I?

Are any of these people who are so upset about not enough testing and medications patients? If my doctor says this is what's best for you, I'm happy. Its the right balance for me.

As patients we need to accept what our doctors say is enough. And we still need to be vigilant against under treatment, but that's another story.

Thyroid cancer information

Finally I have found a nice little compact resource on thyroid cancer. It is published by the Thyroid Cancer Survivor's Association (www.thyca.org). There is not a lot of information out there about thyroid cancer because it is relatively rare - about 30,000 cases annually out of the 1.6 million total cases of cancer in the US each year. Also, its is one of those so called 'good' cancers (and again if you say it to me, I'll be forced to smack you - no cancer is a good cancer) as the survival rate is relatively high.

However the result of treatment for thyroid cancer is a lifetime of monitoring to keep your thyroid levels right - your thyroid levels can affect all sorts of things in your body including blood calcium levels, metabolism, etc - and monitor for recurrence. That's right thyroid cancer is known to recur up to 30-40 years later. So never mind that you get through the first five years when most cancers recur, its the first 40 years that you have to worry about recurrence. According to this new book:

"After your treatment, you will receive life-long monitoring. This  is for two main reasons.
• First, long-term monitoring is important to make sure that your dose of thyroid hormone replacement is appropriate—neither too low nor too high for your specific needs.
• Second, you will receive testing to find out if there is persistent disease or possible recurrence. Many people with
differentiated thyroid cancer experience persistent disease or a recurrence, sometimes many years after the initial treatment. The prognosis for any person with a recurrence is better if it is discovered early. This is why life-long monitoring is important.
• The exact type of monitoring, and how often it takes place, depends on the size of the original tumor and whether the cancer had spread locally or distantly, as well as other factors.
• People free of disease receive less monitoring or testing than those with evidence of persistent disease.
• Also, testing is spread out and becomes less frequent when the patient becomes free of disease. You and your doctor should discuss a plan to fit your situation.
Monitoring will most likely include:
• Physical neck examination, including feeling the thyroid bed area. Typically, this is done every 3 to 6 months for the first 2 years, and at least once a year thereafter.
• Blood tests. Certain blood tests will determine if you are on the right dosage of thyroid hormone replacement. Your medication dose may change over time. Blood testing is also useful to monitor for cancer recurrence. The blood tests will depend on your type of thyroid cancer.
• Neck ultrasound. This test is increasingly used because it is a very sensitive way to find potential disease in the neck. It involves moving an instrument along your neck, without any pain, and there is no radiation exposure associated with it."

So it may be a good cancer in that you probably won't die from it right away, unless you have Anaplastic thyroid cancer which is only given a Stage IV diagnosis and prognosis, but you have to keep watch for the rest of your life. And cancer is cancer no matter how you call it. If you want to learn more, go here and down load your own copy of the new book.