Wanted...A Crystal Ball
I was recently reading an article on the internet that was written by a physician who's specialty was palliative care. The main thrust of his article was this: If you knew how much pain and agony you were going to have to go through to stay alive for a limited amount of time, would you choose to subject yourself to that struggle, or choose to forgo treatment and try to live the best life you could before succumbing to the Grim Reaper?
Hindsight is 20/20
The author talked to people that were family members or friends of people that had recently passed, and most of them opted for the choice of stopping any kind of treatment that would adversely affect their quality of life, since it would prove unsuccessful anyway, and try to live life to the fullest over the last few months. They had watched their loved ones go through the heartbreaking process of trying to stay alive at all costs, and it was horrifying.
But here's the thing. They were looking at this situation with the benefit of hindsight. When looking back at someone suffering the effects of chemotherapy, or radiation, or hormone therapy, or any kind of therapy that totally changes a persons life for the worse, with no change in the result, it's kind of a no brainer to say no to all of it.
What's the value of more time?
As cancer patients, we don't get the benefit of hindsight when looking at treatment choices. As a metastatic prostate cancer survivor, I try to choose the treatment that best meets both my need to stay alive and my need to live a meaningful life.
If you told me that the pain and agony of the hormone treatments I'm going through right now were going to extend my life for only one year, as opposed to choosing not to have treatments at all, I would definitely think about stopping treatments. An extra year of life isn't worth the pain and expense of the treatments.
Or is it? What if in the extra year of life, a cure is discovered? Now, I know cancer cures have been talked about forever. I remember writing in college about how interferon was the magic cancer cure and we should be excited about it. It wasn't. That was in 1981. 38 years later, we are still waiting for the big discovery that will save our lives from this dreaded disease.
But, besides a miraculous cancer cure, what if other things happened in that year? What if a grandchild was born? What if my son got married? What if the Detroit Tigers won the World Series? (I know, I know, slim chance of that.)
Let me know if it's all worth it
What I really need, in making these agonizingly difficult decisions on when to treat and when not to treat is...a crystal ball. I need a crystal ball to tell me if the treatments are going to work, and if they work, how much time are they gonna give me. I need concrete facts on this looking into the future stuff, not probabilities and best guesses.
If I'm going to be puking over the next 6 months, let me know if I'm going to at least be pouring champagne on somebodies head in a World Series celebration. Let me know if it's all worth it.
Working with best guesses and what if's
The problem is, crystal balls really can't tell the future. So, the cancer patient is left with best guesses and what if's. Hindsight may be 20/20, but in Cancerland, foresight is very fuzzy vision. So we have to do the best we can.
Maybe tarot cards are the answer.
Thanks for reading.
Have you experienced side effects from androgen deprivation therapy (ADT)?