rp1954 wrote: She wants a better offer, a means off the ledge taking fewer risks - a protocol, a treatment or even an analytical improvement, rather than that simple leap of faith based on some crude statistics with a lot of people not enough like her.
This speaks volumes.
Yes, it does. At best, you're not reading carefully. Often you're hot on the trigger, ready to blast and disparage anyone or anything "nonstandard".
My first post, at 4/17/19 835 am, above, I went out of my way to acknowledge Avastin's hazards and adjuvant (post-op stage 3) contraindications: ... in 2010, over their abuse... Avastin marketing (CRC stage 3s... jaded my views of their [onc's/pharmas'] ... analytical insight,... judgement and reliability.... some Faustian bargain aspects. We ... avoided Avastin...
...However, we know that Avastin carries its own risks and side effects that may overbalance its benefits.
What part of that did you not understand?
You suggest following evidence based medicine is too big of a “leap of faith” because...
Because, I re-stated Mattie's question and voiced it as any sentient, 3x recurrent
patient's doubts might be, call it the "Patient's de-escalation dilemma
Also, even your own reference suggested that there might be a potential window of exception for about 5% of patients, with MSI.
Further, Mattie's posts show that her oncologist arrived at this treatment through a process of elimination, over three recurs, somewhat beyond the scope of the trials.
In any case, a worried, cautious patient attempting to move forward on de-escalation, wants real reassurance that nothing
is overlooked, that a good
plan with extra chances is already
in place - that scrupulous attention with supercompetent, careful thought is guarding their life. Of course, this is far more consideration than most patients will get, without their own great effort and self-advocacy. Here, we try to help each other.
...the data isn’t “perfect”, but instead you suggest some other (undefined/unknown) protocol without ANY evidence of efficacy.
No, we haven't discussed ways and means, extra strategies yet. At this board, rejected, hopeless mCRC's have been known to grind the literature or their options finer, to seek out better answers, or the best experts in the world, or go to the other end of the f'g planet. Successfully in a number of cases, way beyond NCCN.
And whatever the outcomes, share them here, in a nonhostile environment.
I don’t have more to say [to, for or about?] you, people can be their own judge, adieu...
Well...bye, thank you for your participation. In fact, I acknowledge that amongst a number of PhD, MD, researchers, JD, medical, STEM, professors, and bright bodies doing mCRC-stage 4 posts here, that you have succinctly, most notably represented ASCO-NCCN's positions, of any poster in the last 14 years. With facility and ease.
So you're welcome, but puh-lease, lose the attitude.