Choosing between cancer or cancer treatments?

[thelabdude]

So have any of you, or know of any cases? I figure without treatment, I have few good years yet. Treatment will take away doing much of what I enjoy now. I am not sure I want 10-20 years of that. Nor 2 years of it and then die of a heart attack.

[Kobal2]

I'd disagree on the "good years" part. I've seen both of my grandfathers die of the crab. It was... not good. Your decision is not between 5 years of honey and 15 years of shit. It's between 5 years of shit and 15 years of it.
Most people will find the 15 years preferable, on account of the whole breathing thing.

[TriPolar]

I can understand how you feel. I don't know how to answer. Kobal2 makes a good point though. Will you have any good years left? If not, you might as well try a couple of years of treatment just in case it actually helps. I don't know what the treatment you are facing entails, but I'm not sure how I would handle the idea of having a major organ removed. A premature diagnosis put me in that position a couple of years ago, and I was leaning heavily towards taking advantage of the time I had left instead of getting gutted. It turned out to be a misdiagnosis, and I am very happy that doctor turned out to be an idiot.

[Marley23]

It depends on what the prognosis is, how bad the side effects of treatment are, how likely it is to work, and things like that. If the treatments don't work, the death part is the same regardless. Some chemotherapies are very bad, for instance, but the awfulness goes away after treatment is done. The damage from radiation can be more gradual and persistent, or surgeries could be disabling. Generally the only way I would refuse treatment is if the treatments were unlikely to help and I wouldn't have much time regardless.

[horsetech]

Depending on the cancer, some people can be cured. They go through shit for a while and go back to a normal lives with a normal lifespan (such as my mother, who was treated for non-Hodgkin's lymphoma over a decade ago and remains cancer-free, and a friend who was treated for breast cancer a few years later). Then there are people who aren't cured but achieve remission for some period of time, in which they manage to get a fair amount of living done, before the cancer returns or once again becomes bad enough to make them sick. Even those with virtually no chance of making it past their next birthday may find that palliative chemotherapy reduces the impact of the tumor on their life so that they can spend more time with family and less time being abjectly miserable, and palliative chemo is often lower doses/different drugs that are not as hard on your body. There's individual variation in response to chemo treatments and there are a zillion different protocols, so some people might get violently ill during treatment and others are able to keep working and doing their hobbies.

TLDR: cancers, and cancer treatments, are so heterogeneous that it's hard to come up with one logically consistent conclusion about what you'd do.

[SnakesCatLady]

How old are you? If you are relatively young, treatment might be worth it. It also depends on the type of cancer and how advanced it is.

[Chronos]

Another point: Suppose the currently-available treatments are enough to slow the cancer down for five or ten years. That might be enough time for better treatments to become available, with greater effectiveness, fewer side effects, or both. There are always a number of promising treatments in the pipeline-- Maybe one of them will turn out to be the magic bullet for what you've got. In which case, wouldn't it be foolish to have already given up when that happens?

[studmuffin]

A work colleague had cancer of the esophougus [?] and went through surgery, chemotherapy, the whole works, and was utterly miserable throughout, it killed him in a year.

I still wonder if he had refused treatment, he might have had a reasonable, happy, normal existance for a month or two.

I've decided [ depending on the type ] that I will refuse surgery, maybe refuse other treatments, and when life has become intolerable, will take the mans' way out rather than succumb to a slow painful demise.

I'll decide when I go.

[Lemur866]

When my 93 year old Grandmother was diagnosed with liver cancer, they decided that there was no point in treating the cancer. She died a year later. At 94.

If she had been even 70 years old, it's probable she would have made a different decision.

[Euphonious Polemic]

Originally Posted by horsetech

TLDR: cancers, and cancer treatments, are so heterogeneous that it's hard to come up with one logically consistent conclusion about what you'd do.

This. And also the age thing. Each individual must make a decision about treatment based on a very large amount of data points.

[tnetennba]

I have no answer but am truly sorry that you're faced with such a horrible dilemma.

[Mangetout]

Well, I did know one person who found chemotherapy so debilitating and undignified that she opted out of treatment. She had three months of fairly normal life followed by a couple of weeks of rapid decline and death.

Not going to work out that way for everyone, I'm sure, but in the case of this individual, it enabled her to set her affairs in.order and enjoy a few last moments with her family.

[gonzomax]

I knew a guy who had liver cancer. He did a chemo and felt horrible. He decided to take the 6 months that was allotted to him and enjoy life without chemo. He lasted 5 years. Then it took him out fast.
My brother died of brain cancer. They gave him 7 months. He did all the chemo and radiation and felt terrible. He died in the same 7 months. He said if he had to redo it, he would have eschewed the treatments.

[monstro]

It is a morbid thought, but sometimes I think about this question. If I were confronted with a cancer diagnosis, would I want to get treatment?

The variables I would have to consider:

1. How much time would it likely buy me? If the cancer has already spread and treatment would just extend my lifetime by a couple of years, then I might not see the point.

2. What are the downsides of treatment? Is it going to be constant pain and misery and expense?

3. What else do I have going on in my life at the time? If I don't have kids, and I'm just staying alive just to say that I gave it a good fight but I don't REALLY care if I die tomorrow or a year from now, then I don't see that being a good reason. I believe a person has a right to decide what they should do with their own life. If they want to live as long as humanly possible and they have the wherewithal to make it happen, let them at it. Conversely, if a person just wants to let nature take its course, then they have that right.

4. If I've given it a go in the past. If this is my first round with the cancer and the doctors are saying I have a really good chance of beating it, then I think that should be enough to motivate me to put up a fight. But if this is the third or fourth time I've had to duke it out and I'm simply tired of fighting, well, I think I don't think I should have to justify to anyone why I want to stop.

[Jackmannii]

I would emphasize that in many cases, there are complications of cancer that rival or exceed the complications of chemo/radiation/surgery.

Complete obstruction of your biliary or gastrointestinal tract, fistulas, intractable pain - these are some of the complications of untreated cancer that medical/surgical therapy can prevent or at least make more bearable.

The question of what if any treatment to get is so dependent on the individual, their disease, age, physical status and personal preferences that no one here could begin to pronounce on whether it's worthwhile.

[thelabdude]

Originally Posted by SnakesCatLady

How old are you? If you are relatively young, treatment might be worth it. It also depends on the type of cancer and how advanced it is.

I will be 68 next Saturday. I have had heart trouble and some other problems.

I have had the problems the tumors were causing for at least 3 years. It wasn't until a huge escalation in symptoms Labor Day weekend, that I got a doctor to pay any attention. Had a doctor done her job 1 1/2 years ago, a rather simple surgery may have fixed the problem. Yes I am bitter about that.

So is the world going to end 12 December 2012? Fat chance.

Originally Posted by Chronos

Another point: Suppose the currently-available treatments are enough to slow the cancer down for five or ten years. That might be enough time for better treatments to become available, with greater effectiveness, fewer side effects, or both. There are always a number of promising treatments in the pipeline-- Maybe one of them will turn out to be the magic bullet for what you've got. In which case, wouldn't it be foolish to have already given up when that happens?

I have already had the tumors removed. The problem is there are still cancer cells around. The current suggested treatment means chopping out an organ or 2 out. Not reversible. Better strategy, wait and hope research finds a to attack the cancer.

Cancer takes many paths. Some people are cured, or at least go many years without a problem. Some die quickly. Others go through horrors for years. I just hope when my time comes, I go quickly and with little pain and indignity.

[Marley23]

Originally Posted by thelabdude

So is the world going to end 12 December 2012? Fat chance.

That's a bunch of ridiculous mystic nonsense unfit to be posted on a board that prides itself on skeptical inquiry. The world is ending December 21.

Better strategy, wait and hope research finds a to attack the cancer.

That's not necessarily a better strategy. Depending on what kind of cancer you have and what your prognosis is, you may not have that kind of time unless some new treatments were developed a few years ago and the kinks are now being worked out. I can understand why you're hesitating to have organs removed, and if you haven't done this already, the best thing I can suggest is to talk to additional doctors and cancer treatment centers and patient groups to find out what the most up to date options are, and which ones might be the most helpful to you based on your situation. It sucks to see people who aren't getting the best treatment because their doctors don't know about it, but it happens. I met with someone today who had a tumor removed a year ago. Before she got her diagnosis, she had an open biopsy because her doctor was sure she couldn't possibly have cancer. He said a needle biopsy was unnecessary, and he was so sure of his opinion that he went in there and removed some of the tumor himself. She did have cancer, so now she has to worry about the effects of that. She was also very close to surgery with an inexperienced team before someone prevailed on her to go to a different hospital.

My youngest brother died of a rare cancer almost a year ago. He had every treatment that was recommended: several operations done by expert surgeons, radiation, then after he had a recurrence, chemotherapy and more radiation. When he had another recurrence that was inoperable and was obviously going to kill him, he thought hard about palliative chemotherapy and decided against it because the chemo had been a really horrible experience and he wanted to try to enjoy things while he could. Even with the treatment he did have, he lived less than half as long as a typical patient with his diagnosis. Nobody wishes he'd let it go untreated because he would have just had the same awful death sooner, we just wish anything had worked. Most people are understandably willing to take a lot of chances in the hope they will be on the far end of the bell curve, but that's not possible.

I'm very sorry for what you're going through and it's hard to make decisions about these kinds of things. Whatever you decide to do, best of luck to you.

[Senegoid]

Originally Posted by Marley23

That's a bunch of ridiculous mystic nonsense unfit to be posted on a board that prides itself on skeptical inquiry. The world is ending December 21.

<snip>

My youngest brother died of a rare cancer almost a year ago. He had every treatment that was recommended: several operations done by expert surgeons, radiation, then after he had a recurrence, chemotherapy and more radiation. When he had another recurrence that was inoperable and was obviously going to kill him, he thought hard about palliative chemotherapy and decided against it because the chemo had been a really horrible experience and he wanted to try to enjoy things while he could. Even with the treatment he did have, he lived less than half as long as a typical patient with his diagnosis. Nobody wishes he'd let it go untreated because he would have just had the same awful death sooner, we just wish anything had worked. Most people are understandably willing to take a lot of chances in the hope they will be on the far end of the bell curve, but that's not possible.

I'm very sorry for what you're going through and it's hard to make decisions about these kinds of things. Whatever you decide to do, best of luck to you.

(emphasis added)

Sorry about your brother, Marley.

From earlier in this thread, this is the first time I've ever heard of "palliative chemotherapy". At first glance, that sounds totally oxymoronic. Is it? Would "palliative chemo" have been different than normal non-palliative chemo? Would it be, like, actually palliative???

Why do we hear such horror stories about the intractable suffering of end-stage patients? If all else fails, couldn't they just put the patient into a medically-induced coma or some other form of palliative terminal sedation?

That's what I think I would want. How can I arrange things to have the best chance of getting that if it ever comes to that? Are there some magic legal or medical phrases I should write into my AHCD to best assure myself of this? Just color me coward.

[Qadgop the Mercotan]

Originally Posted by Senegoid

From earlier in this thread, this is the first time I've ever heard of "palliative chemotherapy". At first glance, that sounds totally oxymoronic. Is it? Would "palliative chemo" have been different than normal non-palliative chemo? Would it be, like, actually palliative???

If the chemo or radiation shrinks a tumor enough to stop compression on a vital organ and reduce pain or restore the ability to eat and drink normally for another 6 months or more, I'd call that both palliative and worth it.

Why do we hear such horror stories about the intractable suffering of end-stage patients? If all else fails, couldn't they just put the patient into a medically-induced coma or some other form of palliative terminal sedation?

Palliative terminal sedation is also known as euthanasia, and carries a few associated problems.

That's what I think I would want. How can I arrange things to have the best chance of getting that if it ever comes to that? Are there some magic legal or medical phrases I should write into my AHCD to best assure myself of this? Just color me coward.

designate a specific person (plus a backup person or two) to be your medical Power of Attorney ahead of time, and make your wishes clear to them in no to uncertain terms, then get yourself plugged in with an accredited hospice in your area to discuss how you want your end-stage managed. Some pain is inevitable, but a good hospice can minimize it as much as possible with the meds and other measures available.

QtM, overseer of the care of too many terminal patients.

[Marley23]

Originally Posted by Senegoid

From earlier in this thread, this is the first time I've ever heard of "palliative chemotherapy". At first glance, that sounds totally oxymoronic. Is it? Would "palliative chemo" have been different than normal non-palliative chemo? Would it be, like, actually palliative???

Thank you, and I hadn't heard of the concept either until we got to that point. I see I previewed so many times that Qadgop the Mercotan beat me to it. Drat him. We were told that some chemo might alleviate the symptoms my brother was having at that point by shrinking the tumor a bit or slowing its growth, and maybe it would extend his life by a few months. At that point we'd been told he had "weeks, maybe months," which turned out to be accurate. Things were bad at that point, but he was still able to hang out with his friends and listen to music or watch movies and he could keep some food down, and we wondered if he could do those things if he was feeling sick and exhausted from chemo. The doctors advised the side effects, if there were any, would be mild. To my thinking, the chemo might work or not, but he could have side effects whether or not it helped. Like I said, his previous round of chemo was pretty terrible and there was not a lot of evidence supporting the proposal because his cancer was very rare. In the end he decided against it.

Why do we hear such horror stories about the intractable suffering of end-stage patients? If all else fails, couldn't they just put the patient into a medically-induced coma or some other form of palliative terminal sedation?

There are laws in most states against that kind of thing and I disagree with those laws, but what should matter is what the patients want - "they" shouldn't do anything against the patient's wishes, and not everybody is going to want something like that.

That's what I think I would want. How can I arrange things to have the best chance of getting that if it ever comes to that? Are there some magic legal or medical phrases I should write into my AHCD to best assure myself of this?

Not if you want something that isn't legal, no. Patients who are at the end of a terminal illness are heavily medicated anyway, so the difference might not be as much as you think. Talk to your spouse or whoever ahead of time in case anything incapacitating happens.

[Chronos]

On thinking about this some more, if I were in the OP's shoes, with the best-available treatment being something that still doesn't have very good prospects, I would ask around about experimental treatments. Not just because they'd offer some hope of a good outcome (though, of course, I wouldn't turn away that hope), but because someone has to volunteer for those trials. I've lived in the service of science; why shouldn't I die so, too? And this way, at least I'd be helping others who are or will be struggling with cancer.

[Marley23]

I do wish people were better informed about trials. It's another area where patients tend not to find out what's going on unless their doctors are directly involved, although that's another thing that has to be a difficult choice.

[TriPolar]

My mother's in a trial now. She's a scientist, and motivated in the manner Chronos described. She's had her dosage scaled back because it was too hard on her (she's in her 80s). But there are no placebos involved. These choices are very personal, but they are choices. She has no treatment options that are known to have good results. I don't have her permission to discuss the details yet, but I think she would want to share her motivations. labdude, whatever your choice, you are entitled to be selfish in these circumstances if you want, it's your life. I hope you things turn out as well as possible for you.

[Senegoid]

Originally Posted by Qadgop the Mercotan

If the chemo or radiation shrinks a tumor enough to stop compression on a vital organ and reduce pain or restore the ability to eat and drink normally for another 6 months or more, I'd call that both palliative and worth it.

Palliative terminal sedation is also known as euthanasia, and carries a few associated problems.

designate a specific person (plus a backup person or two) to be your medical Power of Attorney ahead of time, and make your wishes clear to them in no to uncertain terms, then get yourself plugged in with an accredited hospice in your area to discuss how you want your end-stage managed. Some pain is inevitable, but a good hospice can minimize it as much as possible with the meds and other measures available.

QtM, overseer of the care of too many terminal patients.

(emphasis added)

Likewise, Marley mentions that it's illegal.

This is controversial, to say the least. Google "palliative sedation" and you'll find umpteen articles on the subject, pro and con. I would assume the laws vary from state to state on this evolving subject. I am especially bothered at the arguments involving the "double cause" rationale, or the "existential considerations", or whether the patient is "depressed" and other such philosophical talk, as they seem aimed primarily at narrowing down the patient's "legitimate" reasons to be allowed to ask for euthanasia, or assisted suicide, or terminal sedation, or any kind of sedation, to the point where the patient is simply forced to rot in torment until dead. They debate abstract ethics while terminal patients seethe in agony and beg to die.

(I'm not sure if maybe this is a hijack away from the original OP. I have been thinking of starting a thread on this question, but I haven't searched yet to find what threads are already around. I'll bet this has been thrashed around before on this board. I did, however, just yesterday discover blinkie's lengthy thread about locked-in syndrome, which dealt with related issues.)

Oops, sorry, thelabdude. I can see that my expressions may be hurtfully dysphemistic and tone-deaf, in light of your original OP. Ultimately, I hope you will be allowed to make whatever choice you choose to make, and be allowed to have it carried through.

[PandaBear77]

Genuinely curious here:

Originally Posted by thelabdude

So have any of you, or know of any cases? I figure without treatment, I have few good years yet.

What kind of cancer is it? If you can have a few good years WITHOUT treatment (if I'm reading this correctly), it sounds as though it's a pretty survivable kind - in which case, why NOT try to beat it?

Originally Posted by thelabdude

Treatment will take away doing much of what I enjoy now.

What will it take away? And will it take it away forever, or for a couple of years?


FWIW, I'm in the "go down swinging" camp. But I do see where sometimes the cure is worse than the disease. I had a lady at work go through chemo to beat cancer and the chemo trashed her heart

Regardless -- I'm sorry this is something you're facing. Cancer fucking sucks

[not what you'd expect]

I'm so sorry that this is something you are facing.

My mom was about 65 when she was diagnosed with lung cancer. She was given a few months to live. She already had heart disease, so she did not want to do the chemo. She was tired.
She was convinced to try by another family member, so she had three treatments and then stopped. The doctors were very surprised when her cancer stopped growing. She died of heart failure a couple of years later.

I doubt any of that helps you. Just sharing how one person handled it. Again, I'm so sorry.

[thelabdude]

Originally Posted by Chronos

On thinking about this some more, if I were in the OP's shoes, with the best-available treatment being something that still doesn't have very good prospects, I would ask around about experimental treatments. Not just because they'd offer some hope of a good outcome (though, of course, I wouldn't turn away that hope), but because someone has to volunteer for those trials. I've lived in the service of science; why shouldn't I die so, too? And this way, at least I'd be helping others who are or will be struggling with cancer.

While I was out raking leaves today, I was kicking around what to put into a search engine to find a trial. An inlaw died of cancer a couple of years ago. No know cure for that type. He desperately searched for a trial, but didn't qualify for any. That was horrible, he was 40 with 4 kids at home. I will be missed, but won't leave as big of a hole.

I have been referred to one of the top surgeons in the field. ''To the man with a hammer....''

I am thinking it is like the diabetic who has his leg cut off to save his life. The doctor sees it a success.

[Qadgop the Mercotan]

Originally Posted by thelabdude

I am thinking it is like the diabetic who has his leg cut off to save his life. The doctor sees it a success.

What do you love more? Your leg or your life?

To decide that your life without your leg is not worth the pain is not necessarily an unreasonable choice. But you need to have a clear idea of what you are comparing when you consider your options.

[Marley23]

Originally Posted by thelabdude

While I was out raking leaves today, I was kicking around what to put into a search engine to find a trial.

Start with www.clinicaltrials.gov.

I have been referred to one of the top surgeons in the field. ''To the man with a hammer....''

The doctors are almost always going to think they can do something to help at least a little bit. That's a good thing. Since it's your life, you get to set the priorities and direct their treatment based on what matters to you. That could mean making you comfortable, pulling out all the stops to extend your life as much as possible, or something in between.

I am thinking it is like the diabetic who has his leg cut off to save his life. The doctor sees it a success.

If that's what the patient wants and it works, it is a success. It's not a situation anybody wants to be in so I wouldn't call it cause for celebration, but if somebody loses a leg and gets years of extra life, that could very well be a success.

[thelabdude]

Originally Posted by Chronos

On thinking about this some more, if I were in the OP's shoes, with the best-available treatment being something that still doesn't have very good prospects, I would ask around about experimental treatments. Not just because they'd offer some hope of a good outcome (though, of course, I wouldn't turn away that hope), but because someone has to volunteer for those trials. I've lived in the service of science; why shouldn't I die so, too? And this way, at least I'd be helping others who are or will be struggling with cancer.

Well I have poked around and found one trial I am trying to get my doctor to refer me to.

I have long said ''If you don't want to do it, any excuse will do''. In this case, I am looking for an excuse to do something and that taking part in a trial could help others is all I need. It really fits with me. I figure I am dead already. Why not take a chance on doing something useful in whatever time I have left? I have also said that nothing you learn enough to know what will work is a complete failure.

One more thought. I have been scanned and found free of tumors in my lymph nodes and other organs. But how do I know there aren't some cancer cells scattered around where they will get me in a few years? My mother in law was treated for cancer 3 times. Yet it came back a fourth time and killed her.

[pendgwen]

Originally Posted by Qadgop the Mercotan

Palliative terminal sedation is also known as euthanasia, and carries a few associated problems.

Euthanasia is obviously illegal but palliative sedation can be done. I had a geriatrics rotation in med school that included a lot of hospice care. On of our patients had intractable pain from his terminal cancer. He had tried just about every possible combination of pain meds without adequate symptom relief and in the end asked to be just knocked out. He spent the last couple days of his life on a ketamine drip.

[thelabdude]

The end often isn't pretty. Even if I elect life saving treatment, I could still eventually go through a ghastly death.

[Marley23]

Right, that could happen regardless. So the important thing is what your life in between now and then looks like.

[gonzomax]

Originally Posted by thelabdude

Well I have poked around and found one trial I am trying to get my doctor to refer me to.

I have long said ''If you don't want to do it, any excuse will do''. In this case, I am looking for an excuse to do something and that taking part in a trial could help others is all I need. It really fits with me. I figure I am dead already. Why not take a chance on doing something useful in whatever time I have left? I have also said that nothing you learn enough to know what will work is a complete failure.

One more thought. I have been scanned and found free of tumors in my lymph nodes and other organs. But how do I know there aren't some cancer cells scattered around where they will get me in a few years? My mother in law was treated for cancer 3 times. Yet it came back a fourth time and killed her.

Do you have lymphoma?

[cerberus]

ACOR

This a great resource for patient and caregiver cancer support.

[Dangerosa]

Originally Posted by thelabdude

Well I have poked around and found one trial I am trying to get my doctor to refer me to.

I have long said ''If you don't want to do it, any excuse will do''. In this case, I am looking for an excuse to do something and that taking part in a trial could help others is all I need. It really fits with me. I figure I am dead already. Why not take a chance on doing something useful in whatever time I have left? I have also said that nothing you learn enough to know what will work is a complete failure.

One more thought. I have been scanned and found free of tumors in my lymph nodes and other organs. But how do I know there aren't some cancer cells scattered around where they will get me in a few years? My mother in law was treated for cancer 3 times. Yet it came back a fourth time and killed her.

Its possible that they are, and you won't know. But I don't know either (I've never had a cancer diagnosis).

My sister was diagnosed with breast cancer at 38. She's a nurse and had two young kids at home. She went after it aggressively - double mastectomy, radiation, chemo (a clinical trial that had good results). She is now "as cancer free as I am" - which either gives her comfort or makes me nervous - depending on your point of view. She has reconstructed and rather scarred breasts, but she has a really good chance of seeing two boys graduate from high school - and while she'll never be her pre-chemo self (early menopause, less energy) she is pretty close to it now.

My brother in law was diagnosed with bladder cancer a little over a year ago. He made the minimal decisions - the shortest chemo regimen, the smallest amount of surgery For him, it was quality of life - having no bladder at 40 is a big deal - and aggressive surgery was going to mean an altered sex life. He's back in chemo with stage IV and a 5% two year survival rate and fighting it.

I think my sister made good decision then to go after it aggressively early. And, at the same time, I don't know that my brother in law is making a good decision now to fight it - although palliative chemo may be where its at for him (and to date he's tolerating the chemo well and it does seem to be reducing pain).

It sounds like you are early enough that a an aggressive few rounds of chemo and surgery may mean you die 15 years from now of "old age." Maybe not, but ask your oncologist about your odds (and oncologists are notoriously unforthcoming on these discussions), the side effects of treatment, etc. On the other hand, sometimes you are just ready....

[tomndebb]

While a serious and valuable topic, this really has not turned into a debate.

I think it will have a productive life in IMHO.

[vivalostwages]

It is the sort of topic that demands attention, at the very least.
My neighbor had lymphona, went through 9 mos. of chemo, got better, now running his own business and doing great. This is not the case for everyone.

My mom was diagnosed with breast cancer when nearly 83 years old, opted for a mastectomy instead of chemo and radiation, is now 85+ and doing just fine. Everyone was pretty sure that the other treatments would have been much too hard on her because of her age.

[lavenderviolet]

I'll echo those who say that it depends on the kind of cancer and depends on the treatments.
With some cancers, conventional treatment is futile. With others, treatment allows people to have a remission and decent quality of life for an extended period of time even if the cancer can't be cured.
"Chemo" is not just one kind of treatment. There are a lot of different chemotherapy drugs and each one has different side effects. Not all of them are as hard to tolerate as others are.
Not everyone who has "chemo" becomes terribly sick from it.
I would suggest talking honestly with your doctor about your concerns about the side effects of treatment and ask what their advice would be taking into consideration that you are most concerned with quality of life.

[StGermain]

thelabdude - My sister had surgery, chemo and radiation for breast cancer and found the chemo and rad no big deal. Fatigue on the day or two after chemo was administered was about it. Surgery was painful, but managable. My grandmother was diagnosed with pancreatic cancer. Because of her advanced age, the doctors basically wanted to set her up in hospice care and gave her 3 months. She fought to get chemo and radiation and lived 21 months, and had no real cancer pain until the week of her death. (She did, however, slip on the ice outside the doctor's office and broke her hip. She recovered from the broken hip while undergoing chemo and still managed to enjoy the extra time it afforded). And honestly, she looked better with the wig than with her curly-perm-fried hair.

Don't assume that cancer treatment is going to be horrifying. Many times these days they can minimize side effects and target treatment to the individual. My mother was one of 11. Of the 11, 6 had cancer, my mother twice. And only one died from cancer, a brother who was diagnosed with a brain tumor at the age of 4 in the late 1930's.

StG

[thelabdude]

I am continuing to appreciate the posts, just haven't felt any need to comment. My file has been foreworded to the doctor recruiting for the trial. Biggest problem now is the uncertainty the trial adds preventing me from moving on with whatever time I have left now I have rejected the mutilation of the conventional treatment.

Edit, why couldn't it have been thryoid cancer? http://boards.straightdope.com/sdmb/...d.php?t=628320

[CarnalK]

I am not sure I understand. You said that you've had scans and that you don't have any cancer in your lymph nodes or organs, but you said earlier that there are "still cancer cells around". Are you actually cancer free right now and removing organs is a precautionary step? I can see how you would balk at that regardless of how high recurrence rates may be. Wouldn't some sort of monthly exam be an alternative if that's the case?

My mother, who is about your age, has an intestinal cancer that is being held at bay by an experimental drug. She'll probably be on it for the rest of her life. Mostly she lives her life just fine nowadays.

[thelabdude]

It is confirmed I have cancer cells in the organ where the tumors were. So chop out the whole thing.

[PandaBear77]

Which organ IS it?

[Hari Seldon]

You are even assuming the treatments are effective. My MIL was diagnosed with breast cancer in 1966. She underwent a full radical mastectomy (the only treatment they used then), followed by a couple months of radiation therapy. She died just 3 years later, having spent the whole time in misery. Now they know that radical mastectomy is no better than lumpectomy (since the aggressive forms of breast cancer have always metastasized through the body by the time they are diagnosed and the non-aggressive kinds are generally not a problem) and women who undergo radiation treatment do worse than if they hadn't. She might have had 3 years of decent life and then gotten sick and died.

Nearly 7 years ago, my PSA suddenly shot up over 8, which is very high (it had been just over 2). My doctor said to wait a month and then repeated it. Still over 5. So he sent me to a urologist. He said he "had to" advise me to get a biopsy. It was clear he would have preferred to advise me to forget it (I was just 68 at the time), but, since I saw him, he felt an obligation to advise me thus. So I did the biopsy. It felt like taking 8 bullets in the nuts. No cancer. Great. After that experience, I told my GP, "No more PSA tests" and he was happy with that. In fact, his standard practice to advise against it for men over 70 and I was close. If I die of prostate cancer, so be it, but knowing how my quality of life would likely decline after prostate surgery, that is my decision and I will live or die with it.

This book: http://www.jameslindlibrary.org/tt-downloads.html available for free download (also available in several other languages) covers a couple of the things I have discussed here, including breast and prostate cancer. The preface is written by Ben Goldacre, MD, one of the most prominent anti-quack writers around, especially on medical subjects.

[thelabdude]

Maybe I will check out that book. I think she was trying to encourage me, but yesterday a lady was telling me about how well her first husband did for 4 years after his surgery. 4 Years! That's all? I might get that without the surgery.