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It sounds like your friend is choosing to die. Depending on what chemo can or can't do for him it may be a good choice or a big mistake.
I'd suggest that "mistake" is perception. Another person might think he's making a mistake simply because they wouldn't do the same thing in his circumstances. An oncologist might feel he's making a mistake because he knows there are all sorts of treatment regimens to try. Someone who happens to believe life and death is best left to a deity may feel he's making a mistake because he is taking that decision away from the deity. Another person may feel his decision is the right one because he is leaving his fate up to the universe instead of fighting it with medicine.
In the end, it's not a mistake if that's what he wants to do.
Can't agree. If he is not taking chemo because he fears nausea, and the chemo wouldn't give him nausea with anti-nausea meds, wouldn't that be a mistake? If he thinks chemo is a poison, but it could cure his cancer, wouldn't that be a mistake? Wouldn't making a life and death decision without knowing the facts be a mistake? It's not a matter of perception. It's a matter of reality vs. belief. Lots of people have believed suicide was their best option. Those lucky enough to survive a suicide attempt will usually admit they were mistaken.
Quote:
Originally Posted by Parnassia
I'd suggest that "mistake" is perception. Another person might think he's making a mistake simply because they wouldn't do the same thing in his circumstances. An oncologist might feel he's making a mistake because he knows there are all sorts of treatment regimens to try. Someone who happens to believe life and death is best left to a deity may feel he's making a mistake because he is taking that decision away from the deity. Another person may feel his decision is the right one because he is leaving his fate up to the universe instead of fighting it with medicine.
In the end, it's not a mistake if that's what he wants to do.
OP I meant to suggest another aspect that might help.
If your friend was diagnosed very recently, his own views may still be evolving. It's a big dose of news for anyone to swallow. He may going through a sort of knee-jerk reaction or even a sort of emotional numbness. Maybe not. Because he has other significant problems he may already know his own mind about such things, having had a long time to consider such life-altering realities. He might consider that his disease will bring closure to his life. Until he talks about it, no way to know. He may discuss it if he feels at peace with his decision as long as he doesn't feel he's being pressured to change his mind.
How do you handle it? By being supportive and respectful of his decision. Touch base, check in, remind him that you are ready to help (including just listening) if he asks. IMHO it could help you to learn more about why patients choose not to treat their own cancers. What palliative treatments can do and how well they work. Part of your anxiety is due to not knowing much about such things.
That is an excellent point. When I received the official news of my cancer diagnosis and the prognosis from the oncology-surgeon I took it so calmly that my brother, who had come to the appointment with me, thought that I was "in shock" and that I was just not hearing and understanding what the doctor was saying.
As I said in an earlier post, while the "official number" was 10% chance of survival the doctor did point out to me that day, that if the first rounds of chemo were ineffective there would be "no reason for me to have the surgery or to continue chemotherapy" (ie. the cancer would be terminal). My brother could not figure out why I did not seem upset or concerned and just asked a few questions about starting treatment. In fact, my brother got a little teary eyed when the doctor was explaining everything and I did not.
What my brother did not remember/realize/process was that my husband was currently in the hospital (yes, that very minute), in intensive care, and that he had been close to death just a few days early. Frankly, being told that I had Stage IV cancer was not my top priority that day, taking care of my husband was my top priority.
Parnassia is right. Your relative may be shock and may not of processed everything or no having chemo was a conclusion that he had arrived at after careful consideration. Listen to him and help him however he wants help.
I was actually hoping for some nausea & vomiting so I would lose weight (I'm was then and still am at least 50 pounds overweight) but nope, not a problem for me.
I had the same odd little "hope" when going through my own chemo for BC. I remember being surprised when my oncologist commented that statistically, more patients on many commonly-indicated chemo regimens end up gaining weight instead of losing it.
After each round, the side effects were very predictable. For the first couple of days when the primary effects of my particular regimen would most likely occur, the anti-nausea meds worked beautifully. I could have eaten anything on the planet no matter how bizarre. After that, the next couple of days I found it was best to eat things without a strong taste or smell. Some chemo meds distort both temporarily. I thought I might be able to get rid of my lifelong chocolate addiction by eating too much of it at the wrong moment and never crave it again. Didn't work at ALL!
A kind office coworker decided to make me her favorite chicken-turkey tetrazzini casserole one week. It was the biggest casserole I'd ever seen. Maybe chemo brain was distorting my vision too. Anyway, the thing sat in my refrigerator thawing for days. Something about the scent just repelled me and I couldn't touch it. Every time I opened the fridge it loomed into view, overwhelming, filling my tiny kitchen with that SMELL. Appetite totally disappeared. Finally, in desperation I called my next door neighbor from the bedroom begging them to let themselves in the back door, open the fridge and take that massive casserole home for dinner and not return the dish until it had been scoured clean. They loved it. I could finally open the fridge in peace. My coworker never found out thank goodness.
OTOH, due to another ill-advised experiment at that time, I've never been able to even sniff a block of Muenster cheese or drink 7-Up soda again.
Last edited by Parnassia; 07-16-2018 at 02:29 PM..
Can't agree. If he is not taking chemo because he fears nausea, and the chemo wouldn't give him nausea with anti-nausea meds, wouldn't that be a mistake? If he thinks chemo is a poison, but it could cure his cancer, wouldn't that be a mistake? Wouldn't making a life and death decision without knowing the facts be a mistake? It's not a matter of perception. It's a matter of reality vs. belief. Lots of people have believed suicide was their best option. Those lucky enough to survive a suicide attempt will usually admit they were mistaken.
I appreciate your point and your opinion. None of us knows the particulars for the OP's relative. Guess I'd suggest one other question. If someone makes this "mistake" about their care, who ends up regretting it? Their surviving relatives? Maybe. The patient? No, unless they find that there is an afterlife.
Since we all die anyway maybe none of it matters. I just regret when someone throws away their life for no good reason. To me it's precious and shouldn't be squandered. To answer your question with a question, I just watched a documentary on Jonestown. Jim Jones and his followers made a big mistake. Who wound up regretting it? I'd say almost everyone. I'd say if a person or a doctor or anyone makes a misjudgement about care that has a bad outcome, then anyone who cared for the person would regret it. And quite possibly the person would regret it too, but it would be too late to do anything about it. I feel like a sick person has an obligation to those who care for them to do the best they can to survive if they can, and if the pain of doing that is something they can live with.
Quote:
Originally Posted by Parnassia
I appreciate your point and your opinion. None of us knows the particulars for the OP's relative. Guess I'd suggest one other question. If someone makes this "mistake" about their care, who ends up regretting it? Their surviving relatives? Maybe. The patient? No, unless they find that there is an afterlife.
My doctor found cancer in 2014. I got in to a specialist right away, he did the scans and biopsy, so we knew exactly what it was, ect. Then to a surgeon who used the DaVinci robot to remove it. Post-surgery pathology said it was stage-3. From start to finish was like 5 weeks and my insurance co-pay was $32.
I go back for blood testing every year. This year [2018] we found that cancer came back. So now I am doing radiation treatments with hormone therapy. At my last sit down visit with the oncologist, he said that at the very worst at least they bought me another 4 years of life.
If it comes back now it will be stage-4.
I am doing the best that I know I can do. I have met a lot of fellow cancer patients. Encourage them and support them. Most of all support their decisions.
Doing our best is the best we can do. Living in the present one day at a time. When I graduated 8th grade my godfather / uncle wrote in my book. "Yesterday is dead, forget it. Tomorrow is not here yet, don't worry about it. Today is here, live it."
Quote:
Originally Posted by Submariner
My doctor found cancer in 2014. I got in to a specialist right away, he did the scans and biopsy, so we knew exactly what it was, ect. Then to a surgeon who used the DaVinci robot to remove it. Post-surgery pathology said it was stage-3. From start to finish was like 5 weeks and my insurance co-pay was $32.
I go back for blood testing every year. This year [2018] we found that cancer came back. So now I am doing radiation treatments with hormone therapy. At my last sit down visit with the oncologist, he said that at the very worst at least they bought me another 4 years of life.
If it comes back now it will be stage-4.
I am doing the best that I know I can do. I have met a lot of fellow cancer patients. Encourage them and support them. Most of all support their decisions.
A friend of the family was diagnosed with cancer. He doesn't want to go through chemotherapy. He said that he would rather "go" than subject his body to chemo. (He is physically handicapped and cannot walk without the aid of crutches... I don't know if this is what contributes to this perspective?)
How do we deal with this?
My family went through this with my mom.
Throughout her life, she had contended that she would never “do anything” about a cancer diagnosis. No surgery, no chemo, nothing. She had a terrible distrust of doctors and the medical community in general due to the handling of her lifelong depression/anxiety.
When she was 73, she had abdominal pain that revealed masses on an ovary. She basically took her care into her own hands, as she was accustomed to doing. Refused a colonoscopy and various other tests. Six months later the pain eventually led her to surgery to remove the mass. Biopsy revealed it was a benign cyst.
A year later, she had pneumonia that took a long time to resolve. Shortly afterward, she coughed up blood. She had a chest CT that revealed a mass in the lung. She immediately suspected lung cancer, as that’s what she watched her dad die of 40 years earlier.
The family convinced her to see a pulmonologist, as we thought it might be related to the pneumonia, and we wanted to ease her fear of cancer. The pulmonologist recommended a PET scan, which she eventually agreed to.
A day before the PET scan, she had extreme abdominal pain and went to the ER with my dad.
They did abdominal imaging and determined there were masses on the stomach, liver and intestine. Coupled with the knowledge of the lung mass and impending PET scan, they “diagnosed” her condition as metastatic cancer, sent her home with pain killers and referred her to her primary care doc.
The primary doc suggested biopsy. My mom decided there was going to be no more medical intervention, just comfort care. Much to my family’s surprise, the primary care doc signed the necessary documents to make her hospice eligible, even with no definitive diagnosis.
I don’t know whether this is normal or not.
For the next nine days, the family tried to manage her at home on powerful painkillers. She kept wanting more and more pain meds, so eventually she decided that hospice care was what she wanted. She went into the hospice facility, where she was able to essentially expedite her death by not eating or drinking and taking more pain meds than she had been prescribed at home.
She died 11 days later. The death certificate indicated cardiac arrest and metastatic cancer as causes of death. She was 75.
A year later, many in the family struggle with how everything went down. Some were angry at her, and at the primary care doc. Some are disappointed she didn’t fight it, and actually kind of expedited her death with her decisions.
For me, I had known for a few years that she suspected an abdominal cancer, but clearly preferred to live in ignorance since she was so opposed to cancer treatment. She just didn’t want to know. It wasn’t what I would have done, but it was her choice and I respected it. I knew she wouldn’t fight any cancer if diagnosed. Just comfort care. I suppose I might be the same if I were 75 and in fear of so many things, including dementia.
What I have a hard time accepting though, is there was no biopsy, but yet she was still accepted into hospice. I would have felt a lot better with a biopsy.
But it was her decision. She controlled the ending as best she could. She had enough pain meds to keep her comfortable. It didn’t drag on. She also decided no services, no obit, nothing. Just pick up the ashes and bring them home.
In retrospect, I realize how easy she made it on everyone, and for that I am grateful.
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