Selling the Fantasy of Cancer Survival
Updated at the Bottom
I was so inspired by the New York Times’s article today about the “fertility industry” that I thought I’d apply that keen eye to other aspects of the medical world. So yes, cancer industry, I’m looking at you. I mean, aren’t ALL medical practices making money off our medical issues, churning us through protocols without any regard to how much the patient can take emotionally? If reproductive endocrinologists are selling us the fantasy of fertility, aren’t oncologists just selling us the fantasy of cancer survival?
I am being sarcastic, but it is frustrating that no other area of health care is labeled an industry and condemned. We don’t blame the medications or doctors when people die from cancer; we blame the cancer. In that situation, we understand that our bodies are not under our control as much as we’d like to believe, though we do hold out hope that what has worked for others will work for us. But yet when infertility treatments don’t go according to plan — and anyone who believes they’re a sure shot hasn’t done due diligence as a patient to explore success rates (and yes, exploring success rates applies to every area of the medical world as well along with second opinions) — we blame the “industry.”
We’ve been promised something that it hasn’t been able to deliver.
Except no one promised it. Or, if they did, they didn’t promise it any moreso than oncologists make similar claims when trying to assuage the feelings of very anxious patients. Have hope. Focus on the success rates not the failure rates. It’s worth a try.
Miriam Zoll writes,
Medical science has achieved great feats, improved and saved the lives of many. But when it comes to assisted reproductive technologies, science fails far more often than is generally believed.
But isn’t that true for ALL areas of medical science, at least the ones that have high emotional stakes? When it comes to cancer technologies, science fails far more often than is generally believed if you only focus on all the people wearing “survivor” shirts as they cross the finish line on a fundraising walk. But even knowing the failure rate, would anyone not try reproductive technologies or cancer technologies within reason, hoping they’ll become part of those success statistics?
Individual doctors who are treating individual patients need to do a better job at talking through the risks, success rates, and counseling patients out of treatments when they don’t make sense financially. And the good ones do. If your doctor isn’t doing those things, that is the fault of that doctor, not the fault of all doctors.
I am all for regulations. I do believe that patients need to be better informed, and the media needs to stop holding out IVF as a panacea for all fertility problems. I think it’s disgusting when I see the quarterly reports for a fertility clinic and see just how much money they’re making because I have a medical issue. Though the reality is that I’d probably say the same thing if I looked at the quarterly reports for medical practices focused on treating other diseases, AND I also know that I am looking at numbers without any understanding of how much of that money goes back into running the office so those doctors can keep providing treatment. I have no clue how much of my doctor’s annual salary goes into paying his insurance; how much of it is actual, usable take-home.
But above all of that, doctors need to do a better job educating AND supporting patients who choose to resolve their infertility by leaving treatments and pursuing another path including adoption and living child-free. I would be all for doctors being required to help patients explore those other options before starting any treatments; just mentally help them through the decision process. I think if there was more support for it, there would be people who would look at the success rates and say, “for me, it’s not worth the gamble.”
Because sometimes it isn’t. Though sometimes it is.
What I’m not for is skewing the story in the opposite direction. I don’t think that actually solves the problem with the way the general population understands infertility and the limits of treatments. Zoll quotes what she presents as eye-opening statistics such as the fact that “In the United States, the Centers for Disease Control and Prevention puts the overall failure rate at almost 70 percent.” And yes, that is true if we look at the number of IVFs performed yearly vs. the number of times it is successful. But Zoll’s number doesn’t tell us anything about the individual success rates of IVF. The percentage of people who get pregnant after two or three tries. When you look at it that way, the success rates of IVF mimic the success rates of an unassisted pregnancy. In other words, just as fertile people often take a few cycles to get pregnant, the same goes for treatment cycles, and a lot of that is dependent on the age and diagnosis of the patient.
To hold doctors or technologies to a standard that even the healthiest of bodies can’t achieve feels like it’s picking the wrong fight.
Oh, because there is a fight here to be had. But this isn’t it.
I don’t blame the author. I think she did a fine job presenting a facet of the infertility world, and she has a personal story that deserves to be heard and considered. I do blame the New York Times for that title and the lens it put on the article. Because they have a big agenda when it comes to infertility and we’ve seen it over and over again.
I own Pamela Jeanne an enormous apology. I missed until right now that she worked on the op-ed too.
As I said before, Zoll has a personal story that deserves to be heard and considered, and that goes for Pamela Jeanne too. I think both women have stories that are worthy of attention on their own, and I think it detracts from their personal stories to lay blame on the medical community or the media, both of whom didn’t create infertility.
I mean yes, we can argue that McDonald’s creates a product that creates a health crisis in people, but we can’t really argue that reproductive endocrinologist created infertility. Nor can they provide a perfect solution to a disease they didn’t create. If we want infertility to be defined as a disease, we need to treat it as a disease; one that has a wide range of severity within the diagnosis and one in which a single protocol or a single path doesn’t fit all. I’m glad that both women ultimately found a solution that worked for them and wish they had been given more support along the way.