The mind plays a big part in your survival time. (Countries like China, who practice Qigong, have known this for years. As the US in-fights over a medical system that treats the mind and body as two separate objects).
Case in point; At Harvard Medical School they did an experiment. They had a kid who was diagnosed with cancer. They had him do a simple mental exercise every-night which sent his cancer into remission. That exercise was, to close his eyes and imagine he was playing a video game, and flying a spaceship through his body while shooting cancer cells. (Did I mention his cancer went in to remission?)
Either way, with a country that ranks 9th from the bottom in the world when it comes to an education, god forbid we ask people to use their mind for healing purposes... (And big pharmacy continues to profit in a heath care system, which by-the-way, ranks 29th in the world)
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A Death Sentence Reexamined
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Rather than be depressed about the long odds, Gould, who was comfortable with statistics, was aware that he might be among the small group of patients who lived well past the median survival. Buoyed by his optimism, he enrolled in an experimental treatment program—and lived for 20 more years. Though most of the evidence suggests that having a positive attitude does not correlate with longer survival, having a realistic expectation of what is to come may improve one's quality of life.
The flip side to underestimating survival is overestimating it, and Dr. Ethan Basch, a clinical oncologist at Memorial Sloan-Kettering Cancer Center, says that oncologists who focus on the upper expected limit of survival may be doing their patients a disservice. "The risk for an individual patient is that we give an overly optimistic prediction and he is surprised when it doesn't go well for him," says Basch.
The common issue here is that a useful prognosis can't be reduced to a single number. As Gould noted, variability is one of the biological adaptations coded for by evolution—resulting in a population where one person may respond favorably to a treatment that doesn't work for another. At the very least, it would be useful for doctors to talk with their patients about the probabilities associated with surviving over a range of times.
Oncologists can clarify this point by presenting more of the data behind a prognosis, and doing a better job explaining what the data mean. Edwards suggests that instead rattling off statistics, oncologists might show a graph of population-based survival times for a specific type of cancer, explain what percentage of patients live for how long, and discuss the potential treatments with the patient.
Basch says that he sometimes uses nomograms—computer models of survival, based on the broadest possible sets of data from cancer registries and clinical trials—a tool Vickers says more oncologists should be discussing with their patients. A patient or her doctor can enter the patient's information directly into a computer loaded with the nomogram to get individually tailored predictions about survival, the effectiveness of different treatments, and even the relative risks of treatment side effects.
While nomograms and other computer models will continue to improve the ability of oncologists to provide accurate and specific predictions, there is no substitute for communication between the patient and his medical team, says Basch. Knowing the potential outcome of a disease can have an impact on what type of treatment a patient decides on, what lifestyle choices a patient makes, and whether declining treatment might be the best use of one's time.
To some, the information contained in a prognosis causes too much anxiety, or creates what feels like an expectation of survival, says Basch. The biggest pitfall, then, may actually be the first a patient confronts: whether he wants to know his prognosis at all.
© 2009
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