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Cancer Inquiry#3: some what ifs « Previous | |Next »
March 23, 2005

I've been meaning to pick up on the previous posts on the newly formed Senate inquiry into cancer here and here. From what I understand submissions are currently being received by the Senate Community Affairs Committee. The first public submissions will be in Perth next week.

What I have noticed from reading some the public literature is how much the treatment of cancer operates within, and presupposes, the particular scientific paradigm of biomedicine. This relies on an essentially mechanical understanding of causation in which repairing a body is analogous to fixing a machine. Each disease has a specific cause that can be discovered by medical research.

This biomedical model or paradigm assumes that the cancer as the tumour is the disease; and not a sympton of a more systematic disease in the body.It holds that the tumour as disease starts locally, then slowly spreads through our body. Consequently, the treatment addresses the turmour by cutting it out (surgery); killing it or shrinking it (radiotherapy) or by poisoning it(chemotherapy). The aim is to eliminate the disease as tumour and achieve a cure.

Canceraph1.jpg

The biomedical model provides a clearly articulated scientific framework for understanding the disease process and mechanisms of remedy, and it excels at treating infectious diseases and acute or traumatic injuries.

Mechanism (ie., the "body as machine" metaphor) and reductionism (ie., the reduction of illness to a set of physical symptoms) dominate biomedicine. Disease is seen as an outside invader that atacks a particular part of the body; treatment repels the invader. Thus, some cancers are known as "malignant" tumors; chemotherapy aims to "attack," "fight," or "beat" the cancer. The metaphor of fighting and wining the war on cancer justifies the toxic side effects of some of the treatments.

What if our health deteriorate to near death from the war? What if cancer is not just the tumour? What if cancer is a chronic, multifaceted illness having multiple causes amenable and multiple therapeutic interventions? What if we are not winning the war against cancer? What if the number of Australians getting cancer each year has risen over recent decades, while our ability to treat and cure most common cancers has remained virtually unchanged? Should we talking in terms of "cure" rather than recovery?

Should we not be moving treatment towards non-toxic drugs that can tell the difference between healthy cells and cancer cells and so avoid the situation of chemotherapy drugs destroying all cells? Why not starve the tumour but fed the body so that the body environment is less favorable for tumour growth? Why not have treatments that rebuild our body and its immune system?

An alternative model, a healing paradigm, understands the tumour to be a symptom of an underlying disease that causes the symptons. So the tumour symptoms spread throughout the most suspectible body tissue. This approach places an emphasis on boosting the body's immune system and on some aspects of psychotherapy because human beings are not just physiological mechanisms. We have social and emotional bodies that interact with the environment.

What is needed in this situation is not an either or: it is a rigorous approach of an evidence based medicine to assess and evaluate the different treatments, to see how effective they are and what side effects they have. That basic information should be publicly available. If there is a politics of cancer then it should focus on the public's rights to know.


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| Posted by Gary Sauer-Thompson at 3:58 PM | | Comments (2)
Comments

Comments

The biopsychosocial model of health is a good starting point for the reconsideration of treatment options for a number of health issues. Cancer is but one of these. My professional experience and training suggests to me that the biomedical model is too simplistic and misses out on many psychological and social issues that can have a profound influence on the disease process.

Chorlto,
Michael Lerner emphasizes that national culture creates marked differences in the cancer treatment of those working within the biomedical model. I had inadvertingly mentioned the aggressive American approach.

Some of these national approaches (eg., the Germans) incorporate some aspects of the biophysicalsocial model of health.