What's the Latest Development?

An increasingly coveted cancer treatment has Mary Mulcahy, MD, Northwestern University, asking when the harms of tough medicines outweigh the benefits they can realistically deliver. The treatment in question is called HIPEC. It requires surgery to remove metastatic cancer before bathing the abdominal cavity in heated chemotherapy. "Given the intensity of the procedure and the likely need to travel to one of the 27 states that boast of an expert," says Mulcahy, "those who pursue such treatment tend to be highly motivated, younger, healthier, and wealthier." 

What's the Big Idea?

The medical profession's enthusiasm for advancing the scientific flagpole must be tempered with clearer explanations for patients and a better understanding of what procedures actually offer. "If the goal is curative," says Mulcahy, "I encourage [patients] to ask their surgeon, 'What are the chances that this is going to cure me?' If cure is not the goal, I want to ensure they have a clear understanding of this surgery's benefits. Will undergoing HIPEC prolong life? Will HIPEC improve quality of life? These are simple, pertinent questions that, unfortunately, often go unasked."

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