They left the decision in our hands, and in many ways that's not better - how on earth are we supposed to decide? They also can't tell you with any certainty what the after-effects will be because no-one knows.
Probabilities and outcomes, or the process? Patients do get pretty good estimates and information these days. They don't have a good idea what chemo feels like though and what people think about the side effects. Doctors get that from seeing their patients.
a person who can be helped by a medical intervention will die no matter what, but if they get an organ transplant or a pacemaker or continuous dialysis or a cancer removed, they may live a little bit longer, as far as scientists observe, although sometimes with significant difficulties. immunosuppression and chemotherapy both deactivate certain organ systems.
no one can see the future. cancer treatments seem to help some people and be useless for others, and it might all come down to something like, "uh cancer stem cell #13491340 was not destroyed, and there was metastasis." the idea with tumor excision is usually to prevent there from being so many potentially-metastatic stems.
Making a decision vs having one made for you are very different things, even if the outcome of the decision is the same.
Having said that, I just wanted to add a small message of hope for those in similar situations. Atleast in the case of lung cancer, the situation is vastly improved now. The variants of lung cancer that are most prevalent now can be managed with oral medication alone and the patients can recover to go on and lead normal lives. This is from experience seeing another close relative suffer terribly from lung cancer (mainly because diagnosis of lung cancer itself is very hard as the symptoms show up very late and can be mistaken for other issues) and has now miraculously recovered and is back onto his normal routine.
When I was an undergraduate I worked in the lab of Dr. Robert Bast to pad my resume - he went on to head cancer research at MD Anderson. He's the doctor that discovered the CA-125 ovarian tumor marker. Anyway, 26 years ago he told me he thought we'd have a cure for cancer in the next 10 years. I think he's off by 40-50, but we are making strides
I work with software and we gotta give estimates in hours (because the managers didn't like complexity numbers), you know, like add a dropown to the search page or whatnot and I say yeah sure, it's simple, one hour... and then I end up in prehistoric spaghetti land for two days.
Cardiac surgeons in the US have had their own database for >20 years, and vascular surgeons do too. General surgeons have gotten into it the last 10 years or so
https://www.facs.org/quality-programs/acs-nsqip
I'm the NSQIP champion for my hospital system and go to monthly meetings to review our system's data. There's a lot of controversy with the data. We show individuals their data as compared to their anonymized peer data. Recently, the credentialling committee wanted access to the data, and that is being discussed, but I'm against it because the data only samples your outcomes, not every case, so it can be biased (although as you get more cases sampled, hopefully, the pattern established becomes more relevant). Anyway, it can be humbling.
Moreover, all deaths / OR take backs / readmissions get reviewed by a hospital committee and in the 15 years I've been in practice, there have been 4 surgeons in town that have lost their privileges to operate at the hospital.
It's irresponsible for the doctor to not give a reasonable prognosis!
[1]http://www.lung.org/lung-health-and-diseases/lung-disease-lo...
I'm not. That's been my experience with pretty much every surgeon, and even a fair amount of the non-surgical doctors. Letting patients see uncertainty and indecision is not part of the medical school culture, as near as I can tell.
It behooves anyone with serious medical issues to do independent research. (God help you if you don't already know how to deep learn on literature not in your field.)
It was 20 years ago, so my memory is fuzzy, but I don't remember ever being presented with anything but certainty from the surgeon that he could cure her. I think that patients and surgeons need to have a better idea of the realistic chance of success from a major surgery in order to make an informed decision. Perhaps if surgeons at least have to worry about their own numbers, they might hesitate before attempting cases like my mother's.