A strange question perhaps, but a recent event gave me pause:
I briefly had some symptoms that superficially resembled one form of cancer, and being the hypochondriac I am I imagined the worst for a while. This led to a startling revelation: If I knew I had a form of cancer with only a mediocre chance of long-term survival, I’d just throw in the towel. I’m 51, have pretty much led a dysfunctional life, and don’t really have anyone but my wife. I wouldn’t go through the expense and suffering of chemo just to have a five-year survival chance of 50%. Or as this XKCD cartoon shows, the chances are always iffier than the statistics.
What say you?
There are so many variables (different kinds of cancers grow faster than others, different kinds of cancers vary in how responsive they are to treatment,different chemo drugs vary in how likely they are to have nasty side effects) that it’s impossible to give a blanket answer.
For example, thanks to recent advances, Stage IV breast cancer is fairly “treatable” as advanced cancers go (not curable - you’ll still die from it sooner or later - but you can survive with a decent quality of life for at least a few years and there are a few long term survivors out there who have made it even 10 years with bone mets from breast cancer even though sooner or later the cancer will probably still kill them). Under most circumstances, I’d want to pursue treatment with that diagnosis. There are a number of different chemo drugs that are active against breast cancer, so even if one kind of chemo caused bad side effects then there are other options.
Stage IV pancreatic cancer, on the other hand, is a pretty grim disease that most people die from within a year of diagnosis even with treatment. I could definitely picture deciding that it’s not worth it to pursue surgery and chemo in that situation, though since I’m pretty young if I did get such terrible news at this stage of life I think I’d probably still want to try something. I might try to get into a clinical trial if there were an experimental treatment that sounded promising.
I would fight it up to the point when they try to put me in an ICU. Then I would just go home with as much morphine as they will give me. I watched my wife die of an incurable disease, and the ICU doctors were monsters. Completely untrained in palliative pain relief, they seemed angry she didn’t want to go on a ventilator, so they punished her with a prolonged, agonizing death. Bastards.
My mother was diagnosed with stage IV pancreatic cancer about 6 weeks ago. It is grim. She’s going ahead with the treatment, but if the side effects get too much she’s going to stop. Not worth it for the extra 3 months or so it’ll probably buy her.
Same thing killed her father (my grandpa) and my great uncle. Now I get to wonder if it’ll kill me in a couple decades (I already beat lymphoma once). Fun times ahead.
I know my limitations. It takes courage, determination, a kind of fierceness, a “fire in the belly” to fight and win. I don’t have those qualities. That’s just the way it is.
Given how many variables that could come into play I can certainly imagine conditions for me where “meh, its time to go” and conditions where “its fight, fight fight!”. But as a general rule “if it looks bad and I am just buying a little time and will suffer like hell for it” I am just going to give up.
Something’s gonna kill me sooner or later. I’d take treatment if it would help me amass a lethal collection of drugs, then I would stop treatment, and end it all when things became too uncomfortable.
It all depends on my quality of life. Up to a certain point I’d be willing to fight, but past that I want to enter hospice, go home, and die in my own bed (if possible)
Even if things were very grim I’d like a few weeks, at least, to get my affairs in order.
Quality over quantity. If the available treatments offer only a short extension to life at the cost of a great amount of quality then it’s better to embrace the time that’s left to you and enjoy it as best you can.
I don’t think I’d fight red tooth and nail. But this question is easy to answer when you aren’t in the situation. I can easily imagine feeling guilty about foregoing intensive treatments if my family flipped out about it after learning of my decision. So I probably wouldn’t tell them anything…which would also make me feel guilty. Guilt over hurting people would no doubt make do stuff I wouldn’t want to do.
I’d prefer quality of life too. But if that’s taken off the table, I settle for quantity. My belief is that a miserable life in a hospital is still better than death. I fight any disease even if it’s only for a few extra weeks.
I can’t think of a bigger waste of resources than keeping me alive. I can’t even be bothered to eat a decent meal or have a checkup. I doubt I’d be motivated enough to do chemotherapy or any of the other hellish treatments I’ve seen others undergo.