Latest news with #kidneycancer
The Sun
6 days ago
- Health
- The Sun
Dying James Whale shares emotional update in terminal cancer battle as he reveals he is struggling to breathe and talk
PRESENTER James Whale MBE has broken hearts with a tear-jerking glimpse into his terminal health battle. Star James, 74 - who has been courageously battling stage 4 kidney cancer since 2020 - was told he has twelve weeks to live. 4 4 He is now up to week seven - but says, 'I'm not me anymore'. Speaking on his podcast Tales of the Whales alongside his co-host wife Nadine, they spoke about his conditions. The much-loved TV personality said he is struggling to breathe, talk and think - and can't hear very well. He also admitted his speech has become very slow and he is forgetful, while suffering with painful pressure sores. On the emotional recording, he said: "I can't breathe, I can't think, I can't talk. "Anyway. Good morning. Welcome to Tales of the Whales, our weekly podcast. I have terminal 5 cancer. Can you get 5?" A confused James continued: "Could I thank everybody for getting in touch and wanting to meet up. "I'm not being rude when I make it difficult to get touched up. I mean... in touch." Nadine explained: 'You're getting quite tired, so from next week, we're restricting visitors to just very close friends and family.' He added: 'The most tiring thing I found… I still can't hear very well, which is more frustrating than anything else. James Whale reveals he's got weeks to live in emotional update on cancer battle, saying 'I spend a lot of time crying' "I've become very slow in my speech and then forgetful and everything else." Talking about his pressure sores he said: 'I'm tootling along, which is all you can do really, trying to get my breathing sorted and the mark on my bum.' He humbly asked: "People have to go through a lot worse, don't they? Do they?" The poignant conversation concluded: "Anyway. I don't feel I can go on much more... "The other thing is, my energy levels have gone completely. "So I wish everybody well, and let us hope we go through these phases as quickly as we can." The star recently celebrated his 'last birthday' surrounded by loved ones after stopping his cancer treatment. Back in May, the TALK show host revealed his long-running programme could be coming to an end as he reached the final stage of his battle. One of the country's most revered radio personalities, James has been in the business for no less than 50 years and, in 2023, received the first ever TRIC Recognition Award for his outstanding work. He's helped countless others too, having launched the James Whale Fund for Kidney Cancer in 2006 - now known as Kidney Cancer UK - the nation's leading specialist charity of its kind. James, who first defeated kidney cancer 20 years ago, had been receiving the aggressive treatment since a second cancer detection in 2020. Nadine, who he affectionately calls Lady W, has cared for him throughout his health battle and meticulously keeps on top of his hospital appointments and prescriptions. 4
Health Line
15-07-2025
- Health
- Health Line
Kidney Removal
Key takeaways A kidney removal, also called a nephrectomy, may be considered when your kidney is damaged, not functioning correctly, or cancerous. A kidney may also be removed if you decide to donate it. Nephrectomies may involve simple (complete removal), partial (removal of part of the kidney), or laparoscopic (keyhole surgery) methods. After kidney removal, your remaining kidney's function may be monitored. The outlook is typically very good in cases where one kidney remains. A nephrectomy is a major surgery to remove all or part of your kidney. The kidneys are two small, bean-shaped organs in the abdomen. They filter water and waste products from your blood. They also produce certain hormones. A nephrectomy is done when: your kidney is damaged your kidney is no longer functioning properly you have kidney cancer you're donating your kidney Your doctor may remove your kidney through open surgery or laparoscopically. Laparoscopic surgery involves smaller incisions and has a faster recovery time. Recovering from a nephrectomy can take several weeks. It may be very painful. As with any surgery, complications such as infections are possible. However, the outlook is usually very good. What are the reasons for kidney removal? Removing part or all of a kidney is a very serious procedure, and doctors consider it a last resort to preserving your health. Damaged kidney You may need to have part or all of your kidney removed if isn't functioning properly. Reasons for removal include damage or scarring. These may be due to disease, injury, or infection. Cancer is another reason to remove a kidney. If a kidney tumor is small and you catch it early, only part of your kidney may need to be removed. Donating a kidney Sometimes, a person will donate their healthy kidney to someone who needs a new kidney. Kidney transplants are more successful with kidneys from living donors than deceased donors. You can be healthy with only one kidney. What are the types of kidney removal surgery? There are several different types of nephrectomy. Simple nephrectomy A simple nephrectomy involves removing the entire kidney. Your surgeon will make a cut up to 12 inches long in your side. The surgeon will cut away your kidney's blood vessels and its connections to your bladder. Your surgeon will then remove the entire organ. They may need to remove a rib to access your kidney. Partial nephrectomy This procedure involves removing only part of your kidney. The procedure is very similar to a simple nephrectomy. However, your surgeon may be able to use a smaller incision. Laparoscopic surgery This technique, also called a keyhole surgery, can be used for either a simple or partial nephrectomy. Instead of one long incision, your surgeon will make a series of smaller incisions in your abdomen. They will insert a camera and other small instruments through the incisions. This will allow the surgeon to see inside you and remove your kidney. This type of surgery is usually less painful than open surgery. Recovery time is reduced as well. What are the risks of kidney removal? There are risks associated with any major surgery. Complications are rare, but they include: loss of blood heart attack stroke allergic reaction to anesthesia or other medications the formation of a blood clot in your legs that moves into your lungs, which is called a pulmonary embolism breathing difficulties infection at the surgical incision site Other risks are specific to a nephrectomy. They include: an injury to other organs or tissues around your kidney a hernia in which organs might bulge out of your surgical incision You may experience problems with the remaining kidney after surgery. This is partly because people who need kidney surgery may have an increased risk of other kidney diseases. These problems are less common in kidney donors. How do I prepare for kidney removal? Be sure to tell your doctor and surgeon if you might be pregnant. Also, inform them about all medications you're taking, including those that are over the counter. You may need to stop taking certain medications before the surgery, especially blood thinners. Several days before the surgery, your doctor will draw blood. This will determine your blood type in case you need a transfusion during the procedure. You will also need to fast and stop drinking liquids for a period before surgery.
Health Line
15-07-2025
- Health
- Health Line
How to Identify Symptoms of Kidney Cancer and What to Do Next
Key takeaways Kidney cancer often doesn't cause noticeable symptoms in its early stages. Symptoms like blood in your urine or lower back pain tend to appear as the tumor grows. Risk factors such as age, smoking, obesity, high blood pressure, and certain genetic conditions can increase your likelihood of developing kidney cancer. If you experience potential symptoms, early diagnosis with a medical professional may improve treatment outcomes. What are the symptoms of kidney cancer? Kidney cancer, also known as renal cell carcinoma (RCC), is one of the 10 most common cancers in people. Doctors most commonly diagnose this cancer in people over 60 years old, often after finding it by accident during routine imaging tests. The kidneys are two bean-shaped, fist-sized organs under the back of your rib cage. They help: filter waste from your blood create urine control blood pressure create red blood cells Your body can function normally with only one kidney. But a tumor growing in one of your kidneys can disrupt its normal functions. Most symptoms of kidney cancer have to do with kidney function and tumor growth, but these symptoms often don't appear in the early stages. When symptoms do appear, they tend to show up in places like your urine or lower back. Blood in the urine Hematuria, or blood in the urine, is the most common symptom of kidney cancer. Even a small amount of blood can cause a color change. Your urine might appear: pink brownish red The presence of blood can be inconsistent, appearing about every other day. Sometimes the amount of blood is so small that only a urinalysis can detect it. Other possible reasons you might notice blood in your urine include: bladder or kidney infection kidney stones cysts kidney injury It's always best to make an appointment with a doctor or other healthcare professional (HCP) as soon as you notice blood in your urine. Lower back pain Many people over 40 years old experience back pain, usually due to musculoskeletal injury or disc degeneration. Back pain can also be a symptom of kidney cancer, but most people don't experience back pain until the cancer has reached the later stages. This pain can vary from person to person. You might notice: a dull ache below the back of your ribs or on one side of your flank (the area between your lower back and the bottom back of your ribs) a sharper stabbing pain in the same location pain on one side only pressure rather than an ache or sharp pain You'll usually want to connect with a doctor or other HCP if you have any sudden, persistent pain that lasts more than a few days. Mentioning any other symptoms during your visit can help them determine the most likely cause. A mass or lump around your abdomen A mass or lump in the abdomen, side, or back can also be a sign of kidney cancer. You might feel a hard thickening or bulging bump under your skin. But kidney lumps are hard to feel, especially in the early stages. That's because the kidneys sit deep in the abdomen. You may not even see or feel the lump as the tumor grows. If you do discover a lump, a doctor or other HCP will likely order diagnostic tests, such as an ultrasound or a CT scan. These tests may help determine the cause of the lump. You'll typically need a biopsy to confirm the diagnosis. Keep in mind that not all lumps are cancer. If you're concerned about a lump around your abdomen, a doctor or other HCP can offer guidance and information about next steps. Fatigue Fatigue happens commonly with any type of cancer. According to a 2020 research review, nearly half of people with cancer experience fatigue. Fatigue is especially common during cancer treatment, too. Fatigue from cancer is different than just feeling tired from lack of sleep. Cancer-related fatigue is persistent and interferes with daily activities. It can also intensify as time goes on. Anemia Anemia, or low red blood cell count, can also happen as a symptom of kidney cancer. Healthy kidneys signal your body to make red blood cells, but cancer can interfere with that signaling. Anemia can also cause: worsening fatigue shortness of breath dizziness skin that appears paler than usual If you feel unusually tired, a good next step involves making an appointment with a doctor or other HCP. They can run tests to help diagnose the cause and find the right treatment. Appetite loss While appetite loss can have a range of causes, it can occur as a symptom of cancer. Appetite loss might happen when growing tumors affect typical digestive processes or the production of hormones in your body. If you suddenly lose interest in eating and nothing seems appetizing, you may want to consider connecting with a doctor or other HCP to explore possible causes of appetite loss. Unexpected weight loss People with kidney cancer commonly report weight loss when not trying to lose weight. Weight loss, which can happen in part due to appetite loss, may happen quickly as the tumor spreads to other organs. Fever A fever on its own doesn't usually suggest kidney cancer. That said, unexplained and recurring fevers can happen as a symptom. These fevers aren't usually caused by an infection. You might notice your fever comes and goes, or simply won't go away. Swelling in your legs and ankles Edema, or swelling in your feet, ankles, legs, and hands, can also occur as a symptom of kidney cancer. This swelling happens when fluid builds up in your body's tissues. Your kidneys typically help remove this fluid, but the growing cancer can prevent them from working as they should. Are there early warning signs of kidney cancer? Many people with kidney cancer don't notice any early signs or symptoms until the cancer's later stages, or until the tumor is large. Research suggests, in fact, that over half of all people diagnosed with RCC have no symptoms at the time of diagnosis. Some of the earliest symptoms you might notice include: blood in your urine anemia and related fatigue loss of appetite unexplained weight loss It's always a good idea to make an appointment with a doctor or other HCP if you feel generally unwell and: your feelings of illness or fatigue last for more than 2 weeks your symptoms get worse over time Who's at risk of kidney cancer and how can it be prevented? Some people have a greater chance of developing kidney cancer than others. Risk factors include: age (as you get older, your chance of kidney cancer increases) smoking obesity high blood pressure treatment for kidney failure certain genetic or hereditary factors male gender Experts have also linked certain health conditions to increased kidney cancer risk. These include: hereditary papillary renal cell carcinoma von Hippel-Lindau disease Birt-Hogg-Dube (BHD) syndrome hereditary leiomyoma-renal cell carcinoma tuberous sclerosis Cowden syndrome You can take certain steps to prevent or lower your risk for kidney cancer, including: managing high blood pressure with lifestyle changes and medication eating a balanced diet getting regular physical activity, if you're able to exercise avoiding cigarettes and other tobacco products taking acetaminophen only as directed, without exceeding the recommended dose avoiding frequent exposure to harmful carcinogenic substances, like trichloroethylene Letting your physician know if you have a personal or family history of cancer can help them better determine your specific risk factors for developing RCC. What happens next? If you've noticed any of the symptoms mentioned above, you'll want to make an appointment with a doctor or other HCP as soon as possible. Connecting with a doctor promptly becomes even more important when certain factors raise your risk of developing kidney cancer. If you have any symptoms of kidney cancer, a doctor or other HCP will typically: Order tests to help determine the cause. Possible tests include a urinalysis, urine culture, and blood tests to check for anemia, along with an analysis of liver, kidney, and other metabolic functions. Perform a physical exam. They may try to feel a lump or mass by examining your abdominal area. Kidney cancer often can't be detected through a physical exam, though, so they'll usually only feel larger masses. Recommend imaging tests. If they find a lump, they'll likely recommend imaging tests, such as ultrasound, CT scan, or MRI to get more information. Recommend a biopsy. When imaging tests reveal a lump or mass, you'll generally need a biopsy to determine whether or not it is cancerous. Symptoms of kidney cancer can develop with other, less serious health conditions. But because they can suggest kidney cancer, especially when they occur together, ignoring them can have serious health consequences. Getting a diagnosis sooner rather than later can improve chances of treatment success, not to mention your long-term outlook with the condition.
Daily Mail
05-07-2025
- Health
- Daily Mail
Royal chef Richard Corrigan reveals his secret battle with kidney cancer
A celebrity chef who has cooked for the Queen has revealed his secret battle with kidney cancer. Richard Corrigan, 61, runs multiple high-end eateries in London and most recently opened The Portrait Restaurant atop The National Portrait Gallery. The three-time winner of the BBC 's hit show Great British Menu told The Times about the train of events that led to his diagnosis. Corrigan said his wife forced him to go for a check-up after noticing changes in his physical and mental state and that sleep patterns were out-of-whack. A private scan subsequently revealed a giant cancerous tumour on one of his kidneys. Fearing that he did not having long left, the larger than-than-life Irish chef responded in characteristically outlandish fashion - by treating himself to several crates of the finest bubbly. He said: 'I decided I'm not going to drink s*** if this is my last six f***ing months, so I phoned up David Motion in the Winery in Little Venice and said, "David, I'm only going to drink Grand Cru for the next few months", so he sent round five grand's worth. 'I said to Maria, "If it's my final countdown, I'm doing it with f***ing great champagne." Corrigan endured a seven-hour operation at the Royal Free Hospital in London, where surgeons discovered that the tumour had spread into the main vein for the kidney. Doctors were also concerned after seeing black spots on his lungs, fearing the cancer may have metastasized - but they turned out to be small clots related to his kidney issues. For four months the superstar chef required a daily visit from an NHS nurse and he is now receiving state-of-the-art gene therapy from cancer specialists at St Barts. The chef is full of nothing but praise for the NHS, which he describes as 'one of the greatest healthcare services in the world' - and says he does not begrudge paying tax to fund it. Corrigan, whose own mother died age 66 of cancer, even invited his entire surgical team to his upmarket resturant in Mayfair, lavishing them with magnums of champagne and spoonfuls of caviar. He said: 'We had the lot of them — Ravi, the head theatre nurse, the whole lot of them — and Ravi wrote me a lovely letter saying how everything was amazing and the best part was watching me in the kitchen doing what I'm supposed to do, as he said, "to see you back at work".' Passionate in his beliefs and never one to shy away from controversy, Corrigan - a farmer's son from Co Meath in Ireland, who was raised Catholic - recently attended the protest in support of singer Liam O'Hanna from the Irish punk band Kneecap. O'Hanna, who performs under the name Mo Chara, was charged with terror offences in May for waving a Hezbollah flag at a UK concert in November 2024. He said: 'A policeman sees me,' he says, 'and he says, "You're that chef off the telly, aren't you? I'll escort you through the crowd, sir." So I say, "No, I'm joining the protest." The celebrated chef has never been afraid of airing his opinions in public, admitting earlier this year that he found Meghan Markle's Netflix series 'pretentious'. 'I admit I watched With Love, Meghan – it's a bit pretentious,' the Irishman told the Mail's Richard Eden. 'I don't like the pretence. California is all very Hollywood, it's all very samey – Britain is not like that.' The chef compared Harry and Meghan to Edward VIII and Wallis Simpson, another American divorcee. Edward abdicated in 1936 so he and Mrs Simpson could be married. Corrigan said: 'I don't think anyone likes people doing cheap TV. If you're gonna leave [royal life], buy yourself a nice pad and entertain and enjoy yourself, but don't become a burden.' The remarks were not the first time Corrigan had expressed his disappointment with the former actress's behaviour. 'I cooked for the Queen free of charge, of course. And I'll cook for anyone, but let me just say, some people will have to pay. I'd let [Meghan] in the restaurant, for sure, but the Queen had the red carpet rolled out. Would Meghan? I don't think so.' Meghan's eight-episode series, released on Netflix as part of the Sussexes' reported £85million deal with the US streaming giant, has now been renewed for a second season While Corrigan holds the Queen in the highest regard, it is clear that he has less affectionate feelings to some other members of the Royal Family besides Harry and Meghan. In 2021 he revealed that he had a 'minor member' of the royals escorted out of one of his restaurants after they used the word 'Paddy' - which can be an anti-Irish slur. He has to this day refused to name the royal, but confirmed only that it was a woman. 'I have witnessed very little racism, or racist kind of remarks, to me in over 33 years of living and working in London,' Corrigan said. 'I mean, [there were] the odd times that they did pass comments. There's been a few [times a] minor member of the Royal Family called me 'Paddy'.' Referring to the incident, he said: 'I made her pay her bill and kicked her out on the street, so that word goes around very quickly.' He added: 'I've always associated racism and comments like that with the bullies, so if you give it straight back into their eyes, they tend to shut up and go away, and stay quiet around you.' But he says that the prejudice he faced was nothing compared with that endured by Irish immigrants in the past. 'It has happened in the previous generation going there [to London], the Irish people that went there in the Fifties and Sixties, they got it between their two eyes.' Corrigan has also courted controversy by lashing out at health and safety culture in British restaurants. Speaking in 2018 to Mail Online, he said: 'The nanny state has taken all the fun out of dining. Enough is enough. 'Every day there's another public health scare. 'The relentless cries of a fearful few tell chefs that we can't serve bacon, we mustn't offer red meat, and if we do it must be well done or we risk cursing our customers with a death sentence. 'I'm increasingly being told how to prepare my meals by health and safety executives. 'The finest game our country can offer is to suffer the indignity of being served with all traces of pink removed. 'We may as well bin the lot. No one with any taste wants to eat the way these zealots would have us eat.' Corrigan's restaurant portfolio includes Bentley's Oyster Bar & Grill and Corrigan's, both in London's swanky Mayfair district. The TV chef also runs Daffodil Mulligan near Old Street, as well as Virginia Park Lodge in Co. Cavan, Ireland, with the most recent addition to his portfolio being the much-lauded The Portrait Restaurant - branded 'one of those rare restaurants that can match the splendour of its surroundings' by the Mail.
Forbes
26-06-2025
- Health
- Forbes
My Kidney Cancer Taught Me That Patients Aren't Consumers
concept - kidney tumor. Most normal people, when told they have kidney cancer, worry about what that means for their long-term health. I'm not normal. When I discovered I had a 1cm tumor growing on my left kidney, I wondered: 'How much is this going to cost me?' My lack of normality results in part from my profession – I'm a physician and behavioral scientist who believes that every experience is an excuse to conduct research. I'm also a famously discerning consumer (my euphemism for being a cheapskate). So when I realized I had a kidney mass that needed medical attention, I made sure to figure out how much every test and treatment would cost me. I found myself trying to live up to what free market enthusiasts say we need in this country – patients who bring consumer savviness to the medical marketplace. I was going to scrutinize my medical alternatives like a five-star chef at an organic farmer's market, squeezing the metaphorical offerings to determine which goods are worth which prices. But I quickly discovered that no patient is a decision- making island, and therefore healthcare consumerism will never work as well as its enthusiasts hope. My cancer journey began when I went to the bathroom and noticed bright red urine. I remember feeling simultaneously shocked because my urine was full of blood and disappointed that I hadn't felt pain that would signal a benign problem like kidney stones. 'Shit,' I thought to myself, 'could I have cancer?' A few days later, a CT scan revealed a 1cm mass hanging off the lower pole of my left kidney. My urologist explained that the kidney mass had nothing to do with my bloody urine: 'It's too small and too far away from the center of your kidney to account for hematuria.' 'Then what could have caused me to bleed?' I asked. 'Probably a vein in your prostate,' he answered. 'As you can see,' he said, pointing to the CT image which he pulled up on his computer screen, 'your prostate is quite large.' As for the kidney mass, the urologist confirmed that it was probably cancerous: 'But it's such a small size, we have a 98% chance of curing it. We just have to decide what treatment approach you like best.' One treatment alternative was cryotherapy. With this procedure, an interventional radiologist would stick a needle in my back and inject the tumor with freezing liquid. 'The main advantage of cryotherapy is its gentility,' he told me. 'You'll be playing tennis in a week', no small consideration for an avid exerciser like me. The disadvantages? 'Well, they will biopsy the mass before freezing it, but there is no guarantee the biopsy will yield diagnosable tissue, so we might never know whether the lesion they zap is cancerous or benign.' There was also a chance the freezing wouldn't kill all the tumor cells, an 8-10% likelihood, in fact, that the tumor would grow back over the next five years and require further treatment. Finally, to monitor for such a recurrence, I would need CT or MRI scans of my kidney 3, 6, 9, and 12 months after the treatment, plus annually for the next five years. Determined to be a savvy shopper, I did some quick math. I had already paid $45 to see my primary care doctor, another $45 to see the urologist, and another $150 for the CT scan. (These payments are what insurance companies call co-pays. Although they usually cover only a small portion of overall healthcare expenses, studies have nevertheless shown that even modest co-pays are enough to make many patients think twice about seeking out medical interventions.) Now the urologist was recommending 8 more scans, each costing $150; plus 8 follow-up appointments at $45 a pop, plus parking; plus the $450 cost of the kidney freezing procedure, . . . I could see this adding up to a decent chunk of change. But I had a second alternative – robotic, laparoscopic surgery. The urologist would make four incisions in my belly, and through a series of cameras and instruments, remove the mass. 'The advantage of surgery,' he told me 'is that we will remove the entire mass with clean margins. It will be gone, with only a 2% chance of recurrence over the next 5 years.' Because the procedure was more definitive, I would only need follow-up at one and five years. Two scans instead of eight, saving me close to $1200. But the surgery had a major downside because the urologist would cut open my belly, and I'd have to go six weeks without vigorous exercise while my tissues healed. I decided to get surgery, to avoid all the additional imaging tests, tests that would cost not only money but time. So far, my decision-making was a textbook example of how patients as consumers should make decisions. I learned about my treatment alternatives, their medical risks and benefits, as well as their financial costs, and made the choice that fit my values. It was only after returning to the urologist's office, two weeks after surgery, that I realized that this textbook was missing a chapter on the powerful role that physicians play in patients' medical decisions. After appropriate pleasantries, the urologist showed me the pathology report confirming that my mass was a renal cell cancer, a small one 'with clean margins,' meaning that he had cut out enough healthy tissue surrounding the tumor to be confident that no cancer cells remained. He then went over the follow-up plan, which I was surprised to discover had changed significantly since we last discussed it. 'Now the NCCN guidelines,' he told me, 'say that we don't need to do any follow-up imaging for someone with a tumor as small as yours.' The NCCN is the National Cancer Center Network, a professional organization whose clinical practice guidelines hold a lot of weight with physicians, because they represent a thorough assessment of the scientific evidence. 'But in your case,' he went on, 'you are so much younger and healthier than average, I would want to get a follow-up scan in three months, then annually after that for the next five years.' Huh? Before the surgery he told me that I would only need follow-up scans at 1 and 5 years, a factor that had influenced my choice of the procedure. Now he was telling me that I should receive six more scans. Surprised by this new course of action, I pushed back: 'How fast do renal cell cancers grow?' 'Usually about 0.6cm per year,' he answered. 'Then why do we need annual scans?' 'Recurrent tumors usually grow faster than primary cancers,' he answered, meaning that the 0.6cm figure he had given me five seconds earlier hadn't been an answer to the question I had asked. 'Look,' he said gently, 'we can have fewer scans if you want, but I hate to take the chance of missing a treatable recurrence in a young guy like you.' I was 51 at time, whereas the average age of someone diagnosed with renal cell cancer is 64. 'If you were older, with a bunch of competing health problems, I wouldn't be so worried. Most of my older patients with tumors like yours end up dying of other diseases, like heart problems, so getting frequent scans in them doesn't make sense.' Earlier in the visit, he had remarked upon how little fat he'd seen around my kidneys during the operation, and had commented on how quickly I was recovering from the procedure. My relative youth and healthiness were seemingly causing him to push for a more aggressive follow-up. He reiterated his recommendation that I receive an MRI in 3 months. I flashed a skeptical look in his direction, so he quickly elaborated: 'I just saw a patient at the three month follow-up today who already had a recurrence. Now he had a different tumor than yours,' (which seems like a pretty relevant fact to me), 'but I have seen too many bad cases in my career, patients whose tumors we discovered too late. Better safe than sorry.' Hard to argue against the logic of 'better safe than sorry.' But in my case that logic led down a path of potentially unnecessary tests and procedures, all of which cost money—not only to me, the patient forking over a co-pay, but also to the rest of the healthcare system. And of course, just two weeks earlier I had chosen to have my cancer removed surgically to avoid all those follow-up tests. In most consumer markets, individual consumers decide what products they want to buy at which prices. My experience with kidney cancer reminded me that in medical markets, physicians often play a large role in deciding what tests or procedures individual patients will receive, with little regard for the price of such services. In such settings, it defies logic to expect patients to make the kind of discerning choices that maximize market efficiency. We are undergoing a silent revolution in medical care in this country, with insurers and employers encouraging an increasing percent of Americans to enroll in high out-of-pocket health insurance plans. This move fhas been built on the assumption that giving patients a larger financial responsibility for the cost for their healthcare will turn them into more discerning healthcare consumers. My experience belies that assumption. Even savvy healthcare consumers – aka patients – will have a hard time reining in healthcare spending in the face of physicians preaching an ethic of better safe than sorry. In the end, the urologist and I compromised. I skipped the three month follow-up that he recommended but agreed to receive a scan at twelve months. I doubt that many patients would have been able to resist the recommendation for the earlier scan. Even I left the office that day wondering, worrying really, whether I had made a mistake, fretting about whether a small nexus of undetected cancer cells was silently rejoicing, knowing they had an extra window of time to draw strength from my blood. I had won a victory for medical markets and for common sense. But it left me wondering: would that victory cause me to lose the war?
