Episode 130. Why Cancer Still Sucks with Dr David Stewart
Recently, I had the privilege of being introduced to Dr. David Stewart, Professor of Medicine at the University of Ottawa and a medical oncologist. He was kind enough to forward a copy of his excellent book, "A Short Primer on Why Cancer Still Sucks," in which he reviews various aspects of cancer medicine and raises important questions about the incidence of malignancies, treatment strategies, and the sometimes-flawed way healthcare systems and bureaucracies deliver outcomes. Ultimately, it is oncologists and primary care physicians who find themselves at the interface of providing real-time care to sick patients while navigating healthcare systems with many speed bumps.
Around the time David contacted me, an article was also published in The Australian (Sept 10-11, 2022), reviewing a book written by Emeritus Professor of Immunology at the University of Queensland, Robert Tindle, titled "Your Cash or Your Cancer." In this book, Tindle discusses the crushing cost of cancer treatment and the difficulties in procuring therapies, especially for the 25,000 or so uncommon cancers, which account for about a third of all cancer diagnoses in Australia. His concerns resonated with many of the points David raises in his book and highlight that David's concerns are international.
David's book offers a significant contribution not only for patients and families unfortunate enough to have had to deal with a cancer diagnosis but also for doctors and medical students embarking upon a career in primary practice. I give this well-researched and engaging 300-page book a strong recommendation. I have benefited greatly from reading it and especially enjoyed the chapter on screening and risk, as well as cancer biology.
In writing the book, David explains his three main objectives:
"The first objective was to give cancer patients, their families, other members of the public, healthcare trainees, and non-experts a better understanding of cancer. What causes it? Why is it so common? What are the limitations of screening? How does cancer cause symptoms? How do therapies work, and how do they cause side effects? Why might they fail?
The second very important objective in writing this book was to raise public awareness of 'systems' obstacles we face in the fight against cancer. We need allies in the struggle to make everything happen faster. To speed up the development and approval of effective new treatments, the funding for those therapies, the tests a patient must undergo to diagnose and characterise a cancer, and the initiation of a patient's therapy. There are too many impediments. It doesn't have to be this way. The rapid government response to COVID-19 demonstrates clearly what concerted action can achieve. When it comes to cancer, there are many reasons why things proceed at a much slower pace than with COVID, but there are no valid excuses.
The third objective was to give the family and friends of oncologists some insight into what drives many of us—why most oncologists love what they are doing and why our workdays can be so long."
With that said, please welcome David to the podcast.
References:
https://www.amazon.com/Short-Primer-Cancer-Still-Sucks/dp/0228871999
www.youtube.com; “Why Cancer still sucks" David J Stewart.MD, FRCPC
www.med.uottawa.ca Professor David Stewart
To be a guest on the show or provide some feedback, I’d love to hear from you: manager@gihealth.com.au.
Dr Luke Crantock MBBS, FRACP, is a gastroenterologist in practice for over 25 years. He is the founder of The Centre for GI Health, based in Melbourne, Australia, and is passionate about educating General Practitioners and patients on disease prevention and how to manage and improve their digestive health.