When I first wrote about my sister's health problems earlier this year, a Cedars-Sinai doctor I know called to ask if he could help in any way. Actually, I said, I'd appreciate a referral to a good oncologist.
What's happened since then is a cautionary tale for anyone who gets sick.
My sister Debbie, 57, was diagnosed with ovarian cancer about 2 1/2 years ago. She lives in Northern California, where we both were raised, and she got excellent care from her managed-care provider. I'm withholding the name of the provider because when I spoke with doctors there, it was as a concerned brother rather than a journalist.
A large tumor was surgically removed from my sister's abdomen. Then she underwent grueling bouts of chemotherapy and radiation, and began her recovery. Just when she was feeling herself again, she got more terrible news.
In June, an MRI revealed a brain tumor the size of a golf ball.
The doctors said it was possible the tumor was benign, unconnected to her previous cancer. Surgical removal showed otherwise. My sister's growth was a carcinoma. Her ovarian cancer had metastasized.
When Debbie was well enough to visit her oncologist, he strongly recommended she undergo whole-brain radiation over other treatments, so she resigned herself to the procedure. Meanwhile, I began doing a little research.
The median survival rate for someone who has surgery followed by whole-brain radiation, according to one often-quoted study, is 23 months. I also learned there can be significant side effects from whole-brain radiation, including memory, hearing and vision loss. I found the news so grim, I withheld it from my sister until she'd regained some strength. She had said, by the way, that her doctor had led her to believe that side effects from whole-brain radiation are often minimal and don't show up for years.
In the meantime, I called the doctor recommended by my friend at Cedars. When she heard the details of my sister's case, the doctor, one of the nation's leading specialists in women's cancers, strongly recommended that we get a second opinion -- because from what I was describing, whole-brain radiation might not be necessary.
She also disagreed on another point, saying side effects from the procedure were not uncommon, often immediate and potentially severe. In similar cases, she recommended gamma-knife radiation for her patients, a more localized treatment that doesn't kill anywhere near as many healthy cells.
