We do not the future and that is why every newspaper and many magazines have weekly or monthly horoscope. We also have psychic readers and Taro card readers.People make lots of money telling people as to what is going to happen love life and job market and so on. But we in medicine have the firm but wrong belief that we can predict as to what is going to happen , the so called prognosis. But I have come to a firm conclusion that what we are doing is more of a statistics and a chance and probability and we could be wrong . But then I wish we could have some more TESTS that could bring us to 100% prediction of future. When I used to go for a movie in my earlier years like 10 or 12 years of age,when hero was being followed by villon, my cousin used to shout warning the her that the villon was right behind him . But if hero knew that then the story would end right there , but in life we have similar situations. I guess then there won't be FREE WILL or Law of Karma.That brings me to the story for today .
I saw this patient for a short time . He was life long nonsmoker and he had some cough and was admitted 3 months ago and had abnormal chest x- ray. The X- ray was abnormal and so had a CT scan and has a small nodule less than 2 cm . The work up was done and had needle biopsy and he had cancer of the lung. He had never smoked and he still had lung cancer. So he had further work up with PET SCAN and there was no spread of the cancer and so he has surgery done in November . The cancer was operated and there was no suggestion of spread to lymph nodes and the borders were clean and nothing to suggest need for any additional treatment.He did well and recovered from the surgery and was doing good . Then he had some vague pain in the belly and he came tp hospital. He had CT scan of belly and also chest X- ray . The CT scan of belly was abnormal and had a mass that was pressing on the duct that drains the bile and so he also had CT scan of chest and that showed a cavity. This was near the suture line of the previous operated cancer. So it looked like he had recurrence of the cancer that was taken out. The further work was started .
So 3 months ago or less he had no evidence of spread of cancer and so had surgery and no test could have shown that in short period of 2 or 3 months he has now a cancer that has spread to a point that it is not possible to do much surgery. WOULD IT NOT BE NICE IF WE HAD SOME TEST THAT COULD PREDICT THIS OUTCOME ?