Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

23 Tammuz 5760 - July 26, 2000 | Mordecai Plaut, director Published Weekly








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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Know your Enemy

I know many heroes in my business. One is Mrs. L., another is Mrs. C., and then there is Dr. O'Brien. They were involved in a life and death struggle against another of our sinister enemies--cancer. Let me tell you first about the enemy, so that you'll understand their heroism.

Cancer is a disease that can take twenty years to develop. Cells in the body are always dividing but once they reach a certain point they stop. This is programmed into the cell. In cancer, an abnormal cell develops that won't stop reproducing. These cells can be very similar to normal cells but they just reproduce aggressively, or they can be cells that are very abnormal (mutants) that spread without stopping. The latter are usually more dangerous. Since they are constantly reproducing, they crush and kill normal cells and put a great demand on the body to support their voracious appetites. Some spread via the blood stream and cause havoc in faraway places in the body. People weaken and become more susceptible to infections. Many literally waste away.

The cause of cancer isn't always clear. Pollution, many industrial chemicals, tobacco, and radiation are well-known causes of cancer. Some cancers are now known to be caused by viruses. There are some that are caused by heredity. Overexposure to the sun in light-skinned people can cause melanoma and other skin cancers. Most cancers have no known cause.

The most common killers of men are lung cancer (almost always caused by smoking) and colon cancer (it is thought that higher fat foods and the Western diet may have something to do with this). In women in the West it is lung cancer followed by breast cancer (we'll discuss risks for this in a future column).

The key is early detection of all cancers. Many have markers in the blood. Many can be detected on a yearly physical which includes a gynecological exam for females, a prostate and genital exam for men, and testing the stool. Sores that don't heal, swellings, prolonged weakness, easy bruisability, unexplained weight loss -- are all danger signs.

Treatments for cancer fall into four categories. Many need to be taken out with surgery, which must look for all the places where cancer may spread to once it is detected. Except for superficial cancers, surgery is rarely enough. Chemotherapy are drugs given in the blood that are designed to kill cells that reproduce rapidly. Since hair cells also reproduce rapidly, hair can often fall out. This can cure Hodgkin's Disease, a cancer of lymph nodes, but on the other end of the spectrum it fails terribly in cancer of the esophagus, the food pipe.

In most other cancers, it can put a cancer in remission but often the cancers recurs and is then resistant. Chemotherapy is very caustic, can require a special intravenous device, and can cause a lot of vomiting. Radiation is very effective for many cancers but it too has its side effects.

New therapies are the last category. These include killer cells or radiation directed to the cancer cells by immunological markers, which sniff out the cancer cells. There is always something new, as a lot of research is being done in this field.

Many cancers spread to bone and there can be intense pain. Adequate pain relief is essential. There is good research that those who turn to Hashem and those with a positive, determined attitude do better. Those who put things off or ignore signs are usually in bigger trouble.

I'll speak about individual cancers in future columns, but I just wanted to give an overview. And oh yes, I haven't forgotten my heroes. John O'Brien is a physician who is a few years younger than me. He was a superb physician, who became a chozer betshuva (his mother is Jewish) and developed into a warm and pure Jew. He taught me a lot abut what it is to respect and feel for his fellow Jew. John slipped into a coma two weeks ago after four years of battling a vicious cancer.

Mrs. C. lives in Israel and is holding on. She has been fighting cancer that has robbed her of many things, and has caused her much pain. The war is far from over, but she has taught me dignity in the face of adversity. She and her whole family have reinforced in me the value of using every precious moment for chesed.

Mrs. L. won. She, with Hashem's brocho beat a cancer that almost always kills, and then survived a more common but almost as lethal cancer. She has been free of all cancer now for 14 years. It wasn't always easy but she taught me courage and inner strength. This column is dedicated to her. I love you, Mom. Write me in care of the Yated.

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