A Get Well Card for Warren Buffet

photo: jparadisi

As an oncology nurse, if I listened to the family members of an affluent, elderly patient debating at his bedside his right to receive cancer treatment, insisting he is too old, I would suspect elder abuse, and call for a social service consultation. Yet, this very scenario is occurring throughout the media in response to Warren E. Buffet’s announcement last week that he has stage I prostate cancer and will undergo eight weeks of daily radiation treatment, beginning in July.

The hullabaloo is in regards to guidelines established by the U.S. Preventive Services Task Force (USPSTF) recommending that men over age 75 not receive prostate cancer screening, aka the simple PSA blood test. 81 year-old Buffet not only received the PSA test, but when the results came back raised, he under went a prostate biopsy, which is also a no-no for a man his age per USPSTF guidelines. This is how his prostate cancer was diagnosed.  USPSTF recommendations for treating slow-growing stage I prostate cancer consist of a digital rectal exam (DRE), and PSA test every 3-6 months, with annual prostate biopsy (see link above). Mr. Buffet’s choices for cancer treatment drives at least one oncology urologist batshit. By the way, the USPSTF is the same task force that presented new mammogram guidelines in 2009, sending women’s health groups to arms.

I’m no expert on prostate cancer, hell; I don’t even have a prostate. But if I did, I would consider it my right to choose how to treat it if it were diseased, assuming I am presented with appropriate choices. There are a few things I do know: Warren Buffet is one of the good guys. An outspoken advocate of fair play, he proposed The Buffet Rule a $47 billion tax increase on the nation’s richest households, which the House voted down earlier this month. He is also one of 81 billionaires pledging to give away more than half their personal wealth to philanthropy when they die.

Do I believe Warren Buffet deserves special health care privileges because he is powerful, wealthy, and generous? No. I believe everyone has the right to their informed health care choices, and have those choices respected by their providers, families, and friends, without scrutiny. A cancer diagnosis and treatment is difficult enough without this added burden, whether the patient is unemployed, homeless, or the third richest man in the world.

A man with the power and affluence of Mr. Buffet is most likely unconcerned about the opinions of the media, and even less with mine. But for what it’s worth, Mr. Buffet, from an oncology nurse in Portland, Oregon, I wish you the best throughout your cancer treatment, and send positive thoughts for a speedy recovery.

Oh, Did You Want Anti-Nausea Medications with Your Chemotherapy? You’ll Have to Pay Out of Pocket for That

   Note: If you are uninsured and diagnosed with cancer, you will probably find an oncologist and a hospital that will treat you. However, although your chemotherapy cost of tens of thousands of dollars is absorbed, no one will pay for the antiemetics (anti-nausea drugs) that your doctor will prescribe for you to take at home to manage the side effects of chemotherapy. (If you know something different, please post it in the comments.) So, if you don’t have any money, your oncologist will prescribe compazine (prochlorperazine), which is cheap, and used over 20 years ago, when people banged their heads against the toilet vomiting from chemo.  There are newer, more effective drugs, like Zofran (ondansetron) and Kytril (granisetron), that control nausea and vomiting. They are expensive. Uninsured patients usually can’t afford either. They don’t complain though, because they are getting their chemotherapy for free and they know they should be grateful. So they suffer. It’s the politics of health care.