Follow the data when the conclusions don't make sense. As an aerospace engineer with Hamilton Standard, Dick Leahy learned to make decisions when conclusions were suspect and the stakes were high. Today, as a cancer patient and reluctant student of the disease which threatens his life, he applies lessons learned during a 34-year engineering career. "I have only one guinea pig, so I need to keep him alive", Leahy explained to CR4's Steve Melito. "I've been lucky so far. I'm in my ninth year of testing my own hypotheses, but my list of options is getting pretty short".
DES and an Early Success
Leahy's first round of post-prostatectomy cancer treatment was at the University of Massachusetts (UMass). There, he found an oncologist who was willing to prescribe diethylstilbestrol (DES), a synthetic non-steroid with estrogen-like properties. During the 1960s, the United States Veterans Administration (VA) had commissioned a DES study with over 2000 patients at 14 hospitals. Although the study was, as Leahy writes in Prostate Cancer Survival Decisions, "well planned and carefully executed", researchers muddied the conclusion by combining lives saved and lives lost. Thirty years later, doctors still regarded this "most senior of studies" as proof that there is "no proven survival benefit" to the early treatment of prostate cancer. With help from his UMass oncologist, however, Leahy used DES to reduce his prostate-specific antigen (PSA) level, an important medical marker for prostate cancer.
Struggles at Southampton
Not all of Dick Leahy's doctors have been as willing to question medical orthodoxy. While receiving cancer treatment at Southampton Hospital on Long Island, Leahy was unable to convince his oncologist to prescribe keetoconosol, a potent chemotherapy drug. After Leahy visited two gastroenterologists, however, a primary care physician (PCP) who had lost several family members to cancer agreed to write a prescription. Unfortunately, the side effects were painful and life-threatening. First, Leahy was forced to visit an emergency room (ER) with a bleeding ulcer that required staples. He then abandoned keetoconosol for DES, but wound up with a blood clot in his left leg that traveled to his lungs.
Although Dick Leahy has struggled to find doctors "with enough courage and understanding to write the prescriptions that I need", he does not advise cancer patients to go alone. "There is some danger in this", he explains, emphasizing his trips to the ER. Still, the retired aerospace engineer keeps "trying for time", extending his life while testing a "double philosophy" - even as his list of remaining options grows short.
Editor's Note: This is the second in a three-part series. Part 1 and Part 3 are also here on CR4.
Additional Resources:
www.stjude.org/glossary
wordnet.princeton.edu/perl/webwn
Steve Melito - The Y Files
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Re: Prostate Cancer and the Engineer (Part 2)
