Laurie Toby Edison

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Ovarian Cancer Chemo: Another Way Medical Profession Kills Fat People

Laurie and Debbie say:

We had a completely fun post planned for this afternoon, but it has been pushed aside by an urgent public service announcement (which has Debbie literally shaking with rage).

You may have read studies that say that fat people have shorter lifespans after certain cancers and chemo treatments.

Want to guess why?

Because chemo doses are based on “ideal weight,” that’s why. And SURPRISE! When chemo doses are calculated based on actual weight,

Obese and non-obese patients had similar progression-free survival (17 versus 11 months, P=0.14) and overall survival (48 versus 40 months, P=0.37) following primary cytoreductive surgery that resulted in similar rates of optimal debulking, Kellie Matthews, M.D., of the University of Alabama at Birmingham, and colleagues reported online in Gynecologic Oncology.

(This study is limited to ovarian cancer, and included 304 people. Some of the results, like why underweight women didn’t live as long, are not statistically significant. Nothing about other cancers was involved. At the same time, it’s not a 15-person junk study either.)

In plain English, this means that in general the doctors decide what you “should” weigh and calculate your chemo accordingly. Most likely, this means that they take your height and calculate your non-overweight BMI, but there are lots of other things it could mean. It may well mean that tall people are underdosed as well as fat people, and that short people get chemo overdoses. It may well mean that men and women get dosed differently regardless of their body weight. And you can bet that this applies to other cancers as well.

What it clearly means is that people die.

It means that, on the long list of ways you have to defend yourself in the doctor’s office (or get a family member or friend to do it for you), you have to add “Is this chemo dosage based on my actual weight?” and then you have to fight dauntlessly to make sure that it is. And you have to tell every one of your friends and relations to do the same. And you have to watch out for the people you know who might be less skilled at protecting themselves in the doctor’s office due to personality, or class, or education level, or anything else, and do that for them.

And you have no choice, because the medical system is not there to protect you on this, it’s there to decide what you should be like and medicate that person instead of you.

Debbie says: I’m deeply sick of having to carry all these burdens. I want to hand them off to the people who get paid inordinate sums of money to take care of me and mine. But that’s not happening any time soon, now is it?

Very very wry thanks to bearsir (S. Bear Bergman) for the pointer.

One Response to “Ovarian Cancer Chemo: Another Way Medical Profession Kills Fat People”

  1. Karen B. Says:

    All the news reports I’ve seen and heard (NPR, news.google.com) mention a National Cancer Institute study of 95,000 women over an average of seven years.

    I too wish that the people who need patient advocates the most could get them automatically, somehow. I had consumer ed in high school, but we never touched on self-advocacy for healthcare issues. Mind you, that was a while ago now, but I doubt that things have improved much.

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