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Sunday, August 5, 2007

I’d be dead if I’d stayed with the first provider: A cancer survivor

Karen Pasqualetto, age 36, is slight and dark-haired, with a soft voice. She has a law degree and a Type A personality, and worked for several technology start-ups. She made enough money to quit that career and do something she loved, teaching sixth grade at a Catholic school in Seattle.

After giving birth to Isabel by Cesaerean section last July, she noticed a lump under her ribs, the size and shape of a banana. Doctors noticed it but did nothing. Calling it a bruise, they sent her home.

Within a week she was back in the hospital, terribly sick – swollen with fluid, vomiting, so anemic she needed a transfusion, with severe abdominal pain. Tests found tht advanced Stage 4 colon cancer had already spread to her liver.

Crying, her doctor told her she had six months to live. Surgery was not recommended because the liver tumors were too extensive. Her doctor referred her to an oncologist for palliative chemotherapy to ease her symptoms rather than try to cure her.

Her health plan would only cover palliative care. But she had read enough about her disease to know that the proposed treatment plan did not include the full program of drugs typically recommended for Stage 4.

Her family urged her to look for other options. Her husband had a new job that provided better health coverage, and they switched to a different insurer.

"I’d be dead if I’d stayed with the first provider," she said.

She rejected the first oncologist after one visit and consulted the Seattle Cancer Care Alliance and Swedish Cancer Institute. Both recommended aggressive chemotherapy.

Her new oncologist, Dr. Philip Gold, told her "I have a lot of tricks up my sleeve. This is what we start with, and if it doesn’t work I have this, and then I have a clinical study." Karen said, "The feeling I got was, there was hope, and a plan of attack."

Karen recently celebrated her daughter’s first birthday.

Advice to cancer patients and their families: Aggressively seek second medical opinions from doctors who have extensive experience in treating patients with your disease.
Read the source story in Denise Grady’s July 29 article in the New York Times.

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