BBC.地平线.2022.认识癌症（2022）

Yes, so… In a… This would be a relatively low-risk case.
例如有一百位女性 其中八十人
Let’s say you have 100 women. 80 of them,
如果此刻什么都不做
if they do nothing at this point,
可能会幸福的生活十年
would live ten years very happily
而且不受癌症再次侵扰
with their cancer not coming back.
或许她们中的十五人 癌症复发
And maybe 15 of them, the cancer comes back.
化疗将是最好的方法
Chemotherapy will be the thing that means
确保这十五人中有五人不复发
the cancer doesn’t come back for five out of the 15.
所以一百位女性接受治疗
So you have treated 100 women,
其中五位受益
and five women have been benefited.
这一点值得强调 在一百位女性中
That point is worth repeating. In 100 women,
其中五位会死于其他因素
five of them are going to die of other causes –
可能是心脏病发作或是车祸
perhaps heart attacks or car crashes,
之类的事情
that kind of thing.
在剩下的女性中
Of all of the women that are left,
百分之八十癌症不会复发
80 of them, the cancer is not going to come back.
不管她们是否接受化疗
It doesn’t matter whether they have chemotherapy or not,
她们都已经痊愈了
they are already cured.
剩下十五名女性癌症会复发
That leaves 15 women where the cancer is going to return.
但是 在她们中有五个人
However, for five of these women,
如果现在接受化疗
if they have chemotherapy now,
就能预防癌症复发
they can prevent the cancer from coming back.
然而当你开始化疗后
But when you start off,
你根本不知道谁是那五名女性
you have no idea who these five women are,
因此这些女性中的每一个人
and so every single one of these women
都不得不经历化疗 就为了拯救五个人
has to go through chemotherapy just to save five lives.
而且对于剩下的每一个人
And for everybody else,
化疗与否并没有差别
chemotherapy made no difference whatsoever.
她们承受所有的副作用 脱发
They had all of the side-effects – hair loss,
呕吐 失业
vomiting, giving up work,
不能见人
not being able to see people –
九十五名女性承受这一切 但事实上
all of that for 95 women, and actually,
毫无区别是吗
it made no difference?
是的 这就是争议点
So, yes, that would be the case,
而且这些是非常困难的讨论点 因为
and these are the difficult conversations because
一个病人 她们也在思考
a patient, they could also be thinking, you know,
“这真的值得吗”
“Is it really worth it?”
但我想从另一个角度来说
But then I guess on the flip side of that,
你不知道你是在九十五人中还是在五人中
you don’t know whether you’re in the 95 or you’re in the five.
而且或许 事实上 化疗将会是
And maybe, actually, chemo will be
-你的救命稻草 -没错
– the thing that saves your life. – Exactly.
当一切都说了做了之后
When all is said and done,
大部分人会认同一个观念
the majority of people would put quite a lot of value
“我不想癌症复发”
on the concept of, “I don’t want this cancer to come back.” Mm.
就因为另一个选择恐怖到难以想象
Just because the alternative is so horrible to imagine.
药房♥N化疗区
停下思考
你正在进入清洁区
朱迪邀我去观摩一次她的门诊
Judy has invited me to observe one of her appointments.
-安 现在可以进来吗 -谢谢
– Anne, do you want to come down? – Thank you.
安是来自巴尼特区的六十七岁游泳教练
Anne is a 67-year-old swimming coach from Barnet.
你好 请进 我的名字是朱迪·金
Hello, come in, my name is Judy King.
我是这里的医师一
I am one of the consultants.
三个月前 她做了一场手术
She had surgery to remove
切除了一个直径两厘米的乳腺肿瘤
a two-centimetre breast tumour, three weeks ago.
在化疗过程中会造成损伤
..which is going to wreak havoc with scheduling…
我将要说明什么是化疗
I’m going to talk about what the chemo is,
以及为什么我们推荐你做化疗
and why we would recommend it.
然后你可以思考
And then you can have a think about
化疗究竟是不是
whether that’s something that you
-你想要的 -好的
– want to do or not. – OK.
所以如果我们进行化疗
So if we take,
某种程度上 处于你这种情况的女性
sort of, women in your situation
患有这种程度的肿瘤 我们关注的是
with this kind of cancer, we’re looking at,
“患者之后存活并”
“What is the chance of people being alive and well,
“无癌生存十年的可能性有多大”
“cancer-free ten years down the line?”
-是的 -所以这是一切都好的概率
– Yes. – So, this is the chance that everything is fine.
这是很不错的一个概率
There’s a pretty good chance,
肿瘤被切除 任务完成
cancer has been cut out, job done. Mm-hm.
这里 是肿瘤复发的风险
This, here, is the risk of the cancer coming back.
-所以 我的工作就是降低风险 -好的
– Yeah? So, my job is to reduce that risk. – Right.
十年生存期
肿瘤复发风险
就绝对数字来说
In terms of absolute numbers,
我们会把肿瘤复发风险降至约百分之四
we reduce the chance of it coming back again by about 4%.
问题在于我不知道你究竟是
So, the thing is that I don’t know if you’re one
这些人之一
of these people over here…
-对 -仅靠手术就能痊愈
– No. – ..who the surgery is enough,
还是剩下的这些人之一
and I don’t know if you’re one of these people over here.
不得不说我推荐每一个人
So, what I have to say is that I recommend that everybody
服用药物进行化疗
has the tablets and the chemo just to reduce
-从而尽可能降低风险 -为了不复发
– the risk as much as possible. – Just to get to that, yeah.
我将要说的是一些有关化疗的
So, I’m going to talk a little bit about how the chemo works
作用和副作用的事 然后我想我们应该
and the side-effects, and then I think we should have
讨论一下你是否想做化疗
a talk about whether that’s something that you want to do.
好的
OK.
-行吗 -行
– Is that all right? – Yeah.
副作用 常见的是感到疲倦
So, side-effects, common things – feeling tired,
人会在一段时间内感到极度疲惫
people do feel pretty washed out for a couple of days. Mm-hm.
化疗会降低你的免疫力
Chemotherapy can drop your immune system.
那意味着 如果你发热或感染
That means that, if you get a fever or if you get
你不能 你的身体不能合理地抵抗它
an infection, you can’t… Your body can’t fight it properly.
如果你发热
If you get a fever,
你必须拨♥打♥急救电♥话♥
you must phone the emergency numbers.
如果你撑不下去
If you can’t get through,
-你不得不进入急救室 -好的
– you have to go to A&E. – All right.
化疗会影响你的头发
It does affect your hair.
-可以吗 -那可能是我的
– All right? – That’s probably my…
抛开一切不谈 脱发这个问题会是
Out of everything, it’s the hair loss that’s going to be…
它确实是大部分人在意的事
It’s actually the thing that most people…
毕竟我有这么好看的头发 所以
Because I’ve got such fine hair anyway, so…
-总是要用围巾或假发之类的东西 -是的
– Always worth having a scarf or a wig or what have you. – Yeah.
另一个问题 感到恶心或呕吐
Other things, feeling sick or being sick,
反酸 肠道会有两种结果 可能是腹泻
acidy, bowels can go either way – can be diarrhoea,
也可能是便秘
can be constipation.
隐痛或剧痛 种种问题
Aches and pains, those kinds of things.
你怎么看
What are you thinking?
-我要接受化疗 -你要接受化疗
– I’m going for it. – You’re going for it.
-是的 -好的 那我们接受化疗
– Yeah. – All right, we’re going for it.
你想要现在签知情同意书 还是再
Do you want to sign consent now, or do you want some time
-思考一段时间 -不 不用 我已经
– to think it over? – No, no, I’ve
-下定决心了 我要接受化疗 -好的
– made up my mind, that’s what I’m going to do. – Okey-doke.
你感觉如何
How are you feeling?
还好 接受一件事需要点时间
OK, OK. It’s a lot to take in
一点点 一会儿
in one, sort of, short space of time.
有一点你有没有想过
Was there a point where you thought,
“可能我不会复发呢”
“Oh, maybe I won’t?”
总有案例表明
It’s always been the case of,
“存在你必须接受化疗的可能性”
“There’s a possibility you might have to have chemo.”
所以我想这是一种引导 接受它 承受它
So, I think that’s been a lead into it, with it.
它不是很震撼地出现说
It’s not come as a big shock to say,
“没错 你要去做这件事”
“Yeah, you’ve got to do it.”
我想如果我不去做化疗相关的事 我的
I think if I don’t go along those lines, you know, my…
结果可能是癌症复发
The chances are it’s going to return,
我不想要那样
and I don’t want that.
我不知道 就想了这么多 很多了不是吗
I don’t know, it’s just all so much. It’s a lot, isn’t it?
化疗只是预防复发的措施之一 不是吗
It is a lot. It’s one of those things, isn’t it?
我懂 尽管化疗仍然很糟
I know. It still sucks, though.
是的 它仍然很糟糕
Yeah. It still sucks.
我在外面跟她聊天的时候
When I was talking to her outside,
她的话有点像 “如果我不做化疗
she was sort of saying, “If I don’t have the chemo,
“极其有可能癌症会复发”
“it’s overwhelmingly likely that the cancer will come back.”
我没有纠正她
And I didn’t, sort of, correct her.