Since nearly all-chronic diseases are essentially incurable, treatment ought to keep the patient in remission. Since each remission has a different tolerance (health), treatment ought to induce remission with highest tolerance. This is embodied by the Cancer Yogi metaphor. A cancer yogi maintains remission with highest tolerance, and so does his counterpart in other chronic diseases.

Cure is therefore irrelevant. Moreover, one never knows whether a patient is cured or in remission, since cure depends on the final outcome and even this is not certain:

-A patient with micrometastasis in cancer remission may die from heart attack. Her death would be attributed to the latter, and unless examined by a pathologist, she would be regarded as cured.

-Or the same patient may have died of "natural cause", and also regarded as cured.

This quest for cancer cure, that generally cannot be attained, causes anxiety in patients that feel as if condemned to death. On the other hand the same women might take a heart attack much easier. The ICCU physician would smile at her and say: "You sure got a heart problem, but don't worry. We shall fix it in no time". Her heart will never be the same, her chances to get another attack, rise, but she is satisfied.

Now imagine an oncologist approaching her bed with a simile: "Hi there! You sure got a cancer problem but don't worry. We shall fix it in no time". Why can't he say so? Each specialist views cure from a different perspective. When a cardiologist promises to "fix the heart" he would never imply that this would cure arteriosclerosis, while the oncologist believes that by removing the tumor he actually cures cancer.

In all chronic diseases, physicians fix, maintain, and keep disease under control, only oncologists seek cure. Since generally failing, cancer is regarded as a demonic disease and the patient feels condemned to die. Generally the oncologist knows that cancer is incurable projecting his helplessness on patients.

It all started with Dr W.S. Halsted 1852–1922, who believed that cancer starts as a localized pathology that can be cured surgically. Majority of women who received Halsted's treatment, radical mastectomy, died from cancer. Yet the concept of local cure persists. Failure is attributed to micrometastasis that spreads before cancer detection. The conclusion is to screen and kill micrometastasis with chemotherapy. Local cure may fail, but the quest for systemic cure prevails.

All this might be avoided by admitting that cancer is systemic (see also colon cancer) in the sense of arteriosclerosis, and all that oncology may achieve is remission. An oncologist would then turn to the patient and say: "Hi there! You sure got a cancer problem but don't worry. We shall make you a cancer yogi".

 

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