Tuesday, December 6, 2005

"I don't believe in God. I believe in Schering-Plough."

Lancet Oncology has published an article on quality of life for those with glioblastoma.  Specifically, the authors present data from a previously published randomized controlled trial showing that adding temozolomide to radiation therapy prolonged life by ~2.5 months for those with gliobastomas.  During the same trial the authors gathered health-related quality of life data for ~570 patients receiving either radiation or radiation plus temozolomide.  Essentially, they found that except for a bit more GI and appetite disturbance during the treatment phase, the groups didn't differ much--that is, temozolamide didn't do much harm, & clearly did some good.  All of this is fine.  I was a little curious as to why they published the quality of life data as a separate paper, and a little confused as to whether I thought this was a good thing.  One could argue that publishing the QOL data separately gives special attention to the importance of QOL as an outcome, especially for a uniformly and rapidly mortal disease like glioblastoma.  Conversely, keeping the QOL data from the "major" article--in the New England Journal of Medicine no less--relegates it to a secondary status behind the all-powerful Mortality Outcome.  I really don't know, but am inclined to think that publishing it separately is best, not least because it flashing "quality of life" in the title made me pay particular attention to the piece. 

Both of the studies were, of course, funded by Schering-Plough.

Which brings me to the first mention of morbid palliative care related humor on this blog.  A non-palliative care colleauge of mine was telling me about a patient which she eventually referred to the pall care service at my institution.  She was trying to be a good, thorough physician, and tried to explore spirituality with the patient who was transitioning to the "dying phase" of her cancer.  The patient's response was "I don't believe in God.  I believe in Schering-Plough." 

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