Lifelong Health by Dr. David Lipschitz

Like millions of other Americans, I watched with deep sadness and respect the documentary of Farrah Fawcett's journey through treatment of anal cancer.

In most instances, this rare type of tumor remains localized and is cured readily by surgery, often without radiotherapy. However, 10 percent of the time, the cancer spreads throughout the body. Sadly, that is what happened to Farrah.

Throughout the documentary, Farrah displayed an unwavering hope that she would be cured. Her positive attitude toward the cancer and her therapy is an ideal model for anyone facing serious illness. The research is clear: Patients who maintain hope have much higher chances of success than those without strong beliefs that therapy will be beneficial.

Fortunately, with the major advances in cancer treatment, maintaining hope for a cure is not completely unrealistic. In Farrah's case, her anal cancer is such a rare disease that our knowledge of how best to treat it remains limited — and hope for success is not always high.

But for other cancers of the large bowel and rectum, recent breakthroughs in treatment are truly encouraging. Thanks to improved screening, most cancers are identified early and removed with surgical resection, either alone or in combination with other therapies.

But even for those in whom tumors have metastasized widely, the prospects are bright. A recent study published in the Journal of Clinical Oncology analyzed thousands of patients with metastatic colorectal cancer. The results showed that the average patient diagnosed between 1990 and 1997 survived 14.2 months. Between 1998 and 2000, survival increased to 18.6 months, and after 2004, the average survival is 29 months.

Even more remarkable, although the disease remains present, many patients have excellent quality of life for many years. Between 1990 and 1997, the percentage of patients living five years was 9 percent, increasing to 30 percent in those diagnosed after 2004. The increase in survival comes from more aggressive surgical removal of liver tumors and from newer biological chemotherapy agents, which are more effective, target the tumors directly and have few side effects.

Sadly for Farrah, treatment has not been successful.

Even after all the conventional therapies, her tumor recurred. Like many other celebrities and those with the resources to afford it, Farrah elected to travel to Germany to receive therapy not approved here.

In Europe and Central America, numerous clinics offer combinations of traditional and alternative therapies, with the promise of potential cures. Therapies in these clinics include continued use of aggressive chemotherapy, injecting drugs directly into the tumors, and raising body temperatures to dangerously high levels (hyperthermia).

In addition, herbal and alternative therapies are prescribed that are said to treat the cancers, boost people's immune systems, and improve nutrition. The physician offers a tailor-made approach based on the type of tumor and the condition of the patient.

These clinics offer false hope to patients clutching at straws. It is an avaricious industry led by unscrupulous physicians, or "healers," who prey on the most vulnerable. The story of Farrah's journey through her therapies was harrowing, characterized by a great deal of suffering and sadly with no evidence of benefit. Now bed-bound, Farrah and her family still hope for a miracle, continuing to travel to Germany for care.

Is there hope when the future looks bleak and hopeless? With the help of compassionate and caring oncologists and palliative care, hope takes on a different form. You can hope that your final days will be peaceful, pain-free and dignified; hope that you will accept your ultimate fate; hope that you will be in a better place soon; and hope that your family will remember your courage and that you will be able to communicate honestly about the future, come closer and experience your joint and deep love.

For me, the saddest part of Farrah's story is the unwillingness of anyone to help her and her family accept the inevitable and to focus their hope in the realm of palliative care. One of the most important roles of any physician is to help a patient die surrounded by loved ones, in her own home, in peace and comfort, with the assurance that a dignified death means a better life.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.

COPYRIGHT 2009 CREATORS SYNDICATE INC.