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Sometimes the best cancer treatment is no treatment

Brand new Buffett rule

I recently read an article about how to respond when someone tells you he has cancer.

The gist of the article was simple. Be a good listener. Be supportive. Don’t give advice.

I’ve been on both sides of the “I have cancer” conversation. And I would agree with all three of those guidelines.

But that third one can be tough. You want to help. And you may actually have good advice. But new cancer patients are overwhelmed with advice. So it’s usually best to hold off.

And yet, today I’m going to offer some advice to Warren Buffett.

Warren, you really need to get a second opinion. And don’t worry about the money. Your insurance company should cover it.

Billion–dollar advice

You may have heard that multi-billionaire Warren Buffett has prostate cancer. That’s the bad news.

As for good news, there’s a lot, actually.

Buffett’s cancer is stage one — the two words you most want to hear when diagnosed with cancer.

His doctors have also determined that his cancer hasn’t spread, and he’s otherwise in very good health. In addition, most prostate cancers are slow growing. So Buffett, who’s 81, is very unlikely to die of this disease.

In a public statement, Buffett said his “condition is not remotely life-threatening or even debilitating in any meaningful way.”

Clearly, his cancer will probably have very little impact on his wellbeing (or on his ability to run Berkshire Hathaway…which is the underlying question no reporters are really asking).

I wish I could say the same about his treatment. In mid-July, Buffett plans to begin two months of radiation therapy, five days each week.

Now, every cancer case is different. And only Buffett’s doctors know the complete details about his condition. But given what we do know, it strikes me as sheer madness for him to undergo any radiation at all. Much less two months of it!

The day Buffett announced he had cancer, I saw a CNN report that included several commentators chatting about Buffett’s options. One of them described “watchful waiting” as the “crazy” option.

Watchful waiting is the opposite of crazy. It’s prudent and protects patients. It requires regular testing, so it’s not a walk in the park. But watchful waiting is almost always the best option for a man of Buffett’s age with stage one prostate cancer.

The truly crazy option is a long round of radiation. It’s like hunting a housefly with a cannon.

Potential side effects of prostate radiation include fatigue, with a risk of urinary and bowel problems. And you never know how radiation will affect a patient. Those “problems” could easily become severe.

One radiation oncologist told the Associated Press that undergoing radiation is like kindergarten — “The hardest part is showing up.”

That’s outrageous! Showing up is the EASIEST part. Coping with urinary and bowel problems is unquestionably the hardest part — especially for a man in his 80s.

I hope someone will get through to Buffett and explain the wisdom of watching and waiting. But more importantly, if he does choose radiation, I hope other men his age will not follow his lead.

Let’s call it the Brand New Buffett Rule: Watch. Wait. Don’t radiate.

“Warren Buffett Says He Has Early Prostate Cancer” Josh Funk, Associated Press, 4/18/12,

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