At first glance this may appear to be a far cry from my usual postings here on the Daily Kos, but after some discussion on some of the patient news groups I participate in, I thought it was important to make the distinction.
Plus I still managed to subtly place a hint of my disdain for the US health care system in the post.
Manifestations and symptoms are two terms that get bandied about quite often, and I might add incorrectly for the most part. I even recently received an email telling me that according to dictionary.com, they are synonymous.
Well contrary to popular belief, not everything you read on the internet is true, especially when it comes to health care [and health care reform I would add]. Manifestations and symptoms, although related, are not the same thing.
Symptoms are something that alert you to a problem, i.e. night sweats, bleeding that won't stop, fatigue, bone fractures [in the case of Multiple Myeloma], and manifestations enable the doctor to reach a proper diagnosis. Even more simply put, manifestations can be measured, symptoms cannot.
For example,
Increased bone fractures are a symptom of Multiple Myeloma, resulting from decreased bone density, which is confirmed through additional blood tests looking for abnormal amounts of plasma cells, and certain particular antibodies of Multiple Myeloma.
Low platelets are a manifestation of many diseases, which can result in symptoms, such as internal bleeding from minor bumps, or bleeding from cuts that won't stop.
Low neutrophil counts are another manifestation, causing increased infections (a symptom) because of the body's lack of neutrophils to fight off the infections.
High lymphocytes, as in my case, are an indication of a lymphoproliferative disease, which can result in fatigue, night sweats, weight loss and other symptoms.
So why do I bring this up, you might ask yourself? I don't know for sure, except to say I think it's important to distinguish between the two. [Plus it's a rainy weekend, and I don't have much else to do.]
Just being diagnosed with a terminal illness, doesn't mean you're on your death bed, and it doesn't even mean treatment is immediately warranted. And despite being ingrained in our minds the earlier you can diagnose cancer and treat it, the better off you will be, that isn't always the case. There really is some truth to the statement,
sometimes the cure can be worse than the disease
In my case, I was diagnosed with Mantle Cell Lymphoma (MCL) in March of 2002. My MCL has manifested itself in many ways, high lymphocyte count, low hemoglobin, particular antibodies [CD markers], and several chromosomal aberations. But with the exception of an enlarged spleen [which I'm not sure is actually not a manifestation] I have no symptoms, and I feel mostly fine.
Had I been treated, when first diagnosed, I may have achieved a 5 year (or even longer) remission, but would I have been better off in the long run? What is the likelihood of a cure? What would have been the resultant side effects of the chemo? Would future treatment options be limited? [Does the doctor have an ulterior motive to encouraging treatment?]
Those are important questions to ask, and while I'm never going to know for sure, somehow I doubt I'd be better off today had I started treatment early.
There have been many lessons I've learned in my almost 8 years since diagnosis, but two have stuck with me the longest. The first being,
No one cares more about you than you do
and the second was from a hematologist in the UK, who said:
You treat the patient, not the disease
Just a little something to think about in the coming year!