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two hands surround a crystal ball

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.

Probably not.

Thanks for reading.


This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Will Jones moderator
    1 week ago

    Thanks so much, Dan, for your honest reflection. There are days when I think I was premature in deciding to have surgery. Then I remember the turmoil my mind was in just before making that decision. And my wife reminds me as well. Foresight was more than fuzzy. It was scary. I’d rather be where I am now. I’m sorry for your pain, but I agree with you: a meaningful life, and the unexpected, are good reasons to continue treatment.

  • Dan Cole moderator author
    7 days ago

    Thanks Will, for the comment and kind words. Most of the decisions we make as cancer patients are life changing. Whether to treat or not to treat can be an excruciatingly difficult decision to make. But looking back at it with the benefit of hindsight is a bit unfair. I can look at my decision to have chemo in order to shrink or eliminate my tumors as a bad one, because my tumors stayed pretty much the same. One actually got a little bigger! Would I do it again? Of course not. But if I didn’t try chemo, would people say, “Oh, he’s not fighting hard enough.” That’s not fair, either.

  • johnp
    1 week ago

    All living things die. Not all livings things suffer before death. Cancer can produce suffering. I have had metastatic prostate cancer for 17 years. Initially, I was told I could expect to live 3 years. I began hormone therapy. It did take a toll of my strength and certainly ruined my sex life. However, I was pain free and could still live a quality life. When Lipton failed me, a new drig became available, Zytiga. It held my cancer for another 2 1/2 years with additional weakening but no pain. Now I am on docetaxel chemotherapy. Yes, more side effects, weakness and fatigue. I have been able to avoid the peripheral neuropathy by placing my hands and feet on blocks of ice during infusion. I have had to resign myself to a sedentary lifestyle. I still have no pain despite multiple site of metastatic disease. The chemo has kept my cancer from progressing about one year so far. Is it worth it? Absolutely. Chemotherapy can prolong the period of time that you remain pain free. Pain may be the turning point. If I was suffering from intense pain I would probably throw in the towel. The treatments to date have allowed me to avoid pain. Yes, I am waiting for the next best treatment. I keep track of the current clinical trials available and try to remain optimistic. I could have decided 16 years ago to forgo hormone therapy because I didn’t like the side effects and was likely to live such a short time anyway. Wow, would that have been a mistake!

  • Dan Cole moderator author
    1 week ago

    Wow. You are an inspiration, John. Thanks for sharing your story!

  • jnickulas
    1 week ago

    Thank you for sharing your thoughts & insights.

  • Sam Collins
    1 week ago

    Thanks Dan Cole, this is a subject that all of us with a terminal disease have to face. Everyone’s journey is different. I recently learned that with my good friend of mine. He just couldn’t see any light at the end of tunnel. He was in lots of pain. He called me and told me that he was going on hospice. Inside me was screaming fight buddy fight, but I knew in my heart that it was important for me to support him in what ever he decided. It is his life not mine. I spent time with him the night before he passed. Then again I keep fighting myself with my prostate cancer. God and my doctor has given me 14 years and I’m hoping for many more. There may be a day when I’ve had enough of the fight and then I will talk to God. Just like we have to make our own decisions on what treatments to do we may face the time when we say that I’m just too tired and sick to fight anymore. This is a really good subject to talk about. Thank you Dan for bringing this up.

  • Dan Cole moderator author
    1 week ago

    You’re welcome. Thanks for sharing your story. These things aren’t always easy to talk about, but they need to be talked about.

  • Baldybell
    1 week ago

    Hi, I was diagnosed 2 years ago, Gleason scores of 4+3, 4+4, & 4+5. Ouch! I did 8 weeks of radiation & just finished 2 years of hormone therapy (lupron). Never got sick & even though I would get tired quicker than usual none of it has been a big deal at all. PSA has been undetectable while on therapy. But now we wait & see if it comes back. If it does I will do the same & look to see what treatments are left. I will not take any treatments that makes me miserable but let’s me live longer. I not afraid of dying but I’m afraid of being a burden to myself or my family. But if anyone were to ask me if radiation & lupron are worth doing I would say absolutely!

  • sarah.wallin moderator
    6 days ago

    Hi @baldybell, I’m glad to hear of your therapy experience and results. Thanks for posting this encouraging message. You expressed a very real fear of being a burden to yourself or your family. I can assure you that you aren’t alone in feeling that way. You can always talk about that here if you wish. Do keep in touch with how you are. -Sarah ( Team Member)

  • j600
    1 week ago

    I understand! I have a question. Are you ‘puking your guts out’ currently or have you been doing it much while on hormone therapy? Or are you thinking you might? How long have you been on it? All info helps. I do appreciate it, especially from those who’ve been there/are there.

  • Dan Cole moderator author
    1 week ago

    I was puking last year during chemo treatments. Chemo is a weird thing. I would get sick at the drop of a hat, even when I was feeling ok. I have been on hormone treatments off and on since 2014. I have experienced a number of side effects with ADT, but getting sick is not one of them.

  • Baldybell
    1 week ago

    I hope you read my above post.

  • fhall4au
    2 weeks ago

    Nicely expressed.

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