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.
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.
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.
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.
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.
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.
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?
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.
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.
This. And also the age thing. Each individual must make a decision about treatment based on a very large amount of data points.
I have no answer but am truly sorry that you’re faced with such a horrible dilemma.
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.
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.
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:
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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.
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What are the downsides of treatment? Is it going to be constant pain and misery and expense?
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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.
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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.
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.
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.
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.
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.
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.
(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.
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.
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.
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.
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.