Regarding Plan A and cancer

A dear friend’s cancer is back, in a leg bone. She’s sick of chemo so she’s treating it nutritionally. In the one lecture I’m allowing myself (I promised) I said that was the same as giving up. My usual prayer when I hear a prognosis like this is, “May the end come quickly and painlessly,” but I’m not ready to say it, nor does bone cancer play like that. Can someone better at praying say one for her?

I pray that she will come to her senses! Bone cancer is usually treated with surgery and radiation, not chemo, anyway. I’ve lost too many this year to not try, but I promised her that it would be my only lecture.

I objected, as a husband or other interested party should, when Wife said she was going into hospice. She yelled at me, saying that it was my duty as her husband to support whatever she chose. I’m gun-shy about having an opinion, but I’m not married to Plan A, leaving me at a loss regarding my responsibilities. Help?

Giving up what, exactly? Months, year of discomfort, sickness and general poor quality of life?

Nobody is going to live forever. What the hell does a couple of shitty years tacked on at the end amount to? You can “fight” all you want. You’re still going to die.

But your friend will dictate the when and where. Support them.

I know all that. It was a sucky choice in May. It’s a sucky choice now. But it is not yet her only choice. She’s not yet in pain. When the end is in sight I will kiss her goodbye, but it’s not there.

And, however it turned out, I went into this aware of the possible outcome. Mike, her boyfriend, is a mensch and will do his job. A Marine. I wish I could depend on everyone like I do Marine Lifers.

Going through cancer treatment is exhausting, painful, scary and dehumanizing. I think you said she’s had cancer more than once? She’s had enough of ALL of it. Having been there, I understand. There are worse things than being dead. I’m sorry it’s so hard for you, though.

Yeah. My own NDE was ten years ago, or so. “No, you weren’t dying, just your blood pressure approached zero,” Wife said. She refused to describe exactly where one stopped and death occurred. It was probably not much later.

I cannot ask her to go through Hell again, and will not, but I kinda love her, despite it all, and want the best.

My brother died of bone cancer, specifically osteosarcoma. But that was after several rounds of treatment which was rough and very aggressive chemo. And an amputation. And more chemo. And another surgery. And so on. But never radiation. Go figure.

And when he decided no more I could only support his decision. May the end be painless and peaceful is a reasonable sentiment in support of a loved one who has reached the decision to end treatment. No arguing or pleading needed.

Letting go is a bitch, and I think like an engineer, with an alphabet of Plans. I will smile and be supportive with her, but I hope y’all can accept that I’m gritting my teeth to pretend.

Which means that I will be lying, and that’s no way to maintain a friendship.

I hate Real Life.

Oh, I understand the teeth-gritting. I had several months of it not too long ago.

Not sure why you think it’s the duty of a loved one to object to someone going into hospice. I don’t think it should be done lightly, but but sometimes it really is the lesser evil.

No, it’s not easy to watch someone you care about die. I speak from multiple experiences with this.

You can’t always stave off death. Actually, eventually we all die. If you can’t “fix” this problem then perhaps your engineer mind could work on plan to make the time remaining as comfortable and meaningful as possible for the person you car about?

With big decisions someone must always ask, “Are you really sure?” We’re monkeys: impulsive and stupid. We need that angel on our shoulder questioning everything. Once. One of my many problems is that I question everything over and over. I try to not do that to others.

As for that plan, I’m working on it. When I first asked her out I knew that this was a possibility, and worked it into my calculations. I just didn’t plan for it to be so soon, given how healthy and alive she seems. And I hoped I’d be in a better position. As it is, I’m on the sidelines.

All too often, people think of the battle against cancer as some sort of test that can be won if the patient just tries hard enough. This attitude is especially prevalent among people that are high achievers in general - because when they hear 10% chance ( or 5% or 20% ), they think “No problem, I can do that”. And if they FAIL in the first line treatment, they are determined to TRY harder and they frequently embark on a series of increasingly uncomfortable and expensive treatments with increasingly lower statistical success rates.

The results can be devastating. Back in my cancer support group days, I saw way too many people chasing non-existent cures - there’s I reason the doctors use the word “treatment”, most treatments will never be curative, and way too many patients don’t know this. But I saw people throw away their life savings and leave their families only to spend their last days alone in some crappy motel near some crappy clinic in a foreign country - only to die alone and financially depleted. Then someone else would come along and fall for the same empty promises.

My SO, who never lost his intelligence or sense of humor, refused to participate in the support groups. When I asked him why, he said “THOSE PEOPLE are all going to die”. It was his way of letting me know that he understood his prognosis.

(Although actually the support groups propagated lots of hope, most of it false. Because a very very small handful of long term survivors formed an outsized presence and they tended to cheerlead.)

And I think the patient knows better then anyone when it’s time to stop treatment. I admire your friend.
Although I’m not sure about her idea to treat it nutritionally. This was often the subject of intense debate in the support groups - people that felt like the dietary treatments had value vs the people that felt that this was the time to eat whatever and whenever you wanted - both to fight off the wasting effects of the cancer and to get pleasure from the foods you loved. I tended to weigh in with the latter position.

But it can be important psychologically to feel like you’re doing SOMETHING , and if a diet of veggies and brown rice does that, I’m all for it.

Hey, some people like veggies and brown rice.

I get what you’re saying. Both of you.

My husband very much wanted to live, right up until the end. Just days before he died he asked the doctor again if she was sure there wasn’t something else that could be done to give him more time. And, sadly, she told him again that no, there wasn’t, and attempting to do so would likely make him even more miserable than he was.

That was his emotional side. Rationally - and he retained his intelligence and rational mind until the end - he knew it was the end. For him, stopping eating seemed to be a comfort, he had spent weeks forcing himself to eat when he didn’t feel like doing so. His way of “doing something” was trying to tie up his affairs and making sure there would be someone there for me after he was gone, asking friends to check in on me and make sure I was alright. For other people - sure, I could see them opting for nutritional gambits, and whether it would help medically or not psychologically it could be a boost for them. If it’s not hurting them let them do it. In the final lap it’s as much or more about the mental and emotional care as the physical.

Thanks, Ann. I’m probably in the “Do SOMETHING” camp, as shown by all of my Plans, but I draw the line at brown rice. That shit’s nasty. :wink:

In my FB discussion of this, one person linked to a guy whose re-alignment of his chakras, or something, made his cancer go away, allowing him to give uplifting lectures and sell tee-shirts. My response was, “Thanks, though I tend to be too science-based to think that is anything but a spontaneous remission, which does happen. For every ‘success’ how many Andy Kaufman failures are there? You usually don’t hear about them and they seldom result in a tee shirt.” And never result in a lecture tour.

I can’t say anything that Broomstick and Ann Hedonia haven’t already said better and more clearly. Bravo to you both; it’s a great sadness that your wisdom was earned so expensively.

Yes, dropzone, we v2.0 chimps can be impulsive. But usually not about something as important as living or dying. The end is going to suck and as much as hospice is about avoiding unpleasant treatments, it’s also about knowingly hastening the arrival of that very sucky end. So choosing hospice is very far from a one-way all-upside decision.

Asking someone you respect “Are you sure?” after a hospice announcement feels to me an awful lot like disrespect of their decision-making ability.

IMO one of the bad reasons people often delay hospice far past the point they should have switched is a fear of disappointing or leaving behind their friends and family. Every friend or family member who counsels “more fighting!” or asks “are you sure you’re sure you’re sure?” is another vote, as seen by the patient, to consider your wishes over their own. IMO that’s deeply unhelpful.

Dying is one of the few acts of life we do utterly alone. We may be surrounded by spectators, helpers, and well-wishers. But we’re the sole participant. Given its importance IMO we each owe it to ourselves to do this our way; the way that seems most beneficial to our interests, and our interests alone. As we see them at the time.

The immediate corollary being that everyone else owes the dying unconditional support, not second-guessing. Make it easy for them to make whatever decision they choose to make. IOW, be part of their solution, not part of their problem.

The fact we each find it hard to do this is almost proof that it’s the right thing to do. That pain you (any you) feel is the pain of not satisfying yourself. Which satisfaction for you would come at their expense.
On top of everything else you’ve experienced, this is just one more turd on a gigantic shit sandwich. I’m sorry life is going as badly as it is for right now you and the people near you. Good luck on having the strength to do the right thing at least most of the time. And the courage to put one foot in front of the other over and over until you trudge to the other side of this mound of obstacles.

But…but…but, my point is that SHE’S NOT DYING! Except for the part where she’s withholding “proper” treatment for reasons I can understand and respect. She’s sick of fighting. I get that, and I know that my own reaction is selfish.

We’re all dying every day. She’s just closer to the end than you or I are. A major failing of both modern western society and traditional mainstream western religion is to ignore this simple truth and pitch some other supposedly more comforting nonsense instead.

Getting one’s mind right about this stuff isn’t easy. Nor fun. But it makes the actual reality of the human condition more bearable and more understandable. Most of our angst at the end (ours or others’) is the pain of being disabused of our fantasy notions about how life really works. IMO.

My dad opted not to treat his lung cancer at all. Period. And it did shorten his life, but on the other hand, he didn’t have to deal with chemo or radiation or surgery. Most of those final months weren’t too bad, he was still able to sit at the dinner table with family a couple weeks before the end, he had no pain most of that time and when the pain did start it was very controllable. Sure, he could have (maybe) bought a few months but they would most likely have been bedridden and not at all enjoyable.

Do you want a long, miserable span of time or a short and painless one?

Your lady friend has been on this roller coaster ride more than once from what you say. No one is better qualified than she is to say whether or not one more trip around is worth it or not. And, to be blunt, third time around on bone cancer is pretty dismal odds. Yes, 45 is too soon to go. 90 is too soon to go for that matter. But her life belongs to her, and she is the one who gets final say in how that life should be lived whether she has 50 years left or 50 months or 50 weeks or 50 days. The only difference is the length of that time, and that she knows her time is shorter rather than longer.

My sister, who is a hospice director, says that often her job is more about taking care of the family and friends of the dying than the dying person him/herself. That is probably true more often than we’d like to know. Sometimes the hardest thing to do is to do nothing at all, but sometimes that is the best thing as well, hard as it is.

Thanks, folks. I needed to vent somewhere not in front of her. I will be the supportive friend she needs, but dear God, I’m sick of death and illness.

Kudos to Broomstick, Ann Hedonia, LSLGuy and others here for delivering thoughtful, on the money information and reflections.

As a physician, I’ve seen a lot of cancer diagnoses, and dealt with people going thru chemo/radiation/etc. I’ve seen good outcomes and bad outcomes and lots of stuff in between. I’ve recommended and delivered hospice care too. And as an administrator, I’ve sat through hundreds of mortality reviews where each case is looked at individually to see what went right/wrong/other. I’ve learned a few things in the process.

I do know that for myself, if I ever received certain types of cancer diagnoses, I would NOT undergo treatment to try to cure or prolong life, but rather I’d seek palliative interventions only. Too many treatments offer only to maybe delay death for a trivial amount of time while inducing hideous side-effects and making what time is left a real hell on earth. I want quality in my last days/hours, not quantity.

However, being close to someone in such a situation is very, very hard. I definitely wanted my dad to “rage, rage against the dying of the light” even though he was sick and tired and ready to go. And had to vent to others in order to let go in front of him, like you are doing, dropzone.