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Quill

When a person “accepts” metastatic cancer and declines intervention

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5 hours ago, DesertBlossom said:

One thing that still upsets me about my mom's oncologist's optimism is that none of us were willing to be the Debbie Downer and ask, "well, what if you die?" Nobody wanted to be the one to say out loud that she might not get better, even though many of us were thinking it.   I wish we had spent those years helping her tell her life story or explaining to us the stories and sentiments behind jewelry and her ancestors' artifacts. There are so many things I wish I could have asked her, but I didn't have the heart to let on that I thought she would die. By the time my sister sat down with her with a tape recorder to ask her stories about her life, she was in a lot of pain and it was difficult for her to remember things. But I am so glad we have at least those few recordings. 

I just wish the doctor had been honest with her because I felt like he let her believe that every next treatment would be the one to cure her. She battled for years. And when he finally admitted that it was over, she only had a few pain-filled weeks to live.

This is part of what upsets me about my circumstance. The person is not saying or telling people death is on the near horizon. So we’re losing time to do or say things we might want to have done. This person is not a fact-facer under the best of circumstances. Part of me wants to level and ask directly. But I’m chicken. 

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Now I did know two people who had early stage very treatable cancers who treated them with crystals and herbs. Both went for “treatment “ in Mexico (nothing wrong with good treatment there but these were unregulated clinics). Both were convinced that they were utterly healed until they discovered that it had actually progressed to the point of being stage  IV and metastasized and there was absolutely nothing that could be done. This was heartbreaking for them and their family. The families had begged them not to go this route and it was very different from an informed approach because it was based on deception (I use a holistic approach to my own chronic illness so I am not against all herbal treatments etc).  

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49 minutes ago, Jean in Newcastle said:

Now I did know two people who had early stage very treatable cancers who treated them with crystals and herbs. Both went for “treatment “ in Mexico (nothing wrong with good treatment there but these were unregulated clinics). Both were convinced that they were utterly healed until they discovered that it had actually progressed to the point of being stage  IV and metastasized and there was absolutely nothing that could be done. This was heartbreaking for them and their family. The families had begged them not to go this route and it was very different from an informed approach because it was based on deception (I use a holistic approach to my own chronic illness so I am not against all herbal treatments etc).  

Yes, that’s tough.  We had a family friend who treated his cancer with diet and supplements, he was terrified of chemo and radiation.  It was a very survivable testicular cancer when he began - stage II I believe - and while he was treating it his way it got worse and metastasized and killed him after a few years.  I have vivid memories of how angry his wife was at him, after he died.  She loved him so much but I know she blamed him for his own death and going against medical advice on treatment because of fear of the side effects. 

That was my first big lesson, as an adult, about weighing when it’s a good idea or harmless to try something less invasive and when it’s foolish.  Even at the outset, once he got back a scan or two of progressing cancer with his treatment he refused to change course.  He left behind three high school and college aged daughters too 😞

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3 hours ago, Quill said:

 The person is not saying or telling people death is on the near horizon. So we’re losing time to do or say things we might want to have done. 

 

Can you or your siblings phrase some stuff as gathering family history and some stuff as normal old age planning? 

While some of my relatives died of terminal illness, some died of old age. My side of the family talks about estate planning when they are in their 60s. My brother and I know our parents wishes with regards to medical care and estate planning.

My husband’s grandma is nearly a hundred years old but she has dementia for two decades already. My FIL is 80 and hopefully he has made known his wishes by now because my husband has no idea what care he would prefer if he has dementia like his mom. 

My side of the family tends to die of old age around their 80s and thankfully are mentally sharp all the way. We are gathering family history and I hope we could do a short relaxing tour with my parents next year before my mom’s mobility further decrease (rheumatoid arthritis). My in-laws are physically stout so we have more time to do a trip with them if we can find somewhere with a casino (for them) and stuff my kids don’t mind doing. 

My maternal grandfather was my last grandparent to pass away. He was in ill health but mentally sharp. I had many great memories of him telling me stories of his times and he was very encouraging. He would sit in his favorite armchair and I would perch on the armchair’s arm rest when I come back from school (he stayed at my aunt’s home and my aunt “babysit” me). My paternal grandpa died before I was born, my maternal grandma died when I was a toddler, paternal grandma died when I was 6. I’m so glad I have that time with my maternal grandpa. He passed when I was 11.

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May I just say you guys are breaking my heart (and giving me a lot to consider)? I haven't dealt with the cancer issue, specifically, although we've had to deal with other terminal conditions. My deepest sympathy for all the heartache in these posts.

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I’m so sorry, Qull.

My mom chose this.  And she was adamant about not telling my siblings it was terminal even though she was living with me and on hospice care.  She was only in her 60s and she and my dad refused to discuss any type of arrangements for her either.  And since it was her death in question, I had to respect her choices not to plan and not to tell.  When asked, I just told my sibs they needed to talk to the parents about it.

it hurt my siblings a great deal to have been shut out.  And damaged my relationship with them at some level because they felt I should have told.  I still don’t know whether that was the right thing to have done, but I do wish I had argued with my parents more to be honest with my siblings.  But they “didn’t want any fuss”.

 

ETA- I did win the palliative care argument, but it took playing the “so you won’t be a burden” card on her, which was icky.  But that WAS the right thing to do as it made her final days comfortable and pain free.

Edited by AK_Mom4
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5 hours ago, Quill said:

This is part of what upsets me about my circumstance. The person is not saying or telling people death is on the near horizon. So we’re losing time to do or say things we might want to have done. This person is not a fact-facer under the best of circumstances. Part of me wants to level and ask directly. But I’m chicken. 

That's the part that's the hardest for me. I still feel some anger - that I know I need to let go of, and mostly have, but it's still there and definitely colors how I see things - toward my father and his wife that they refused to let us come and see him until the very, bitter end, because they felt they were handling it so well and he was going to be fine and even if he wasn't, then they didn't want to share that time. Deep breath. I had a sense that it was worse than they would admit. I wish I'd just gone. But it was the treatment that killed him and he died much faster than I think anyone could have predicted, so I didn't really have time to.

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A friend's mother just passed away this week and I ended up rehashing this conversation in various ways. The thing that was hardest for my friend was that his mother refused to do anything because of a fear of doctors - no treatments, but also no palliative care or pain management. In the end, they basically forced one chemo treatment on her and then she died almost immediately thereafter. He was convinced that if only she had done the treatment, that she would have definitely had years left. And I'm sitting there thinking, she died within three weeks of the diagnosis. She couldn't even endure one chemo treatment. She was not going to live for years. Maybe if she had lived her life incredibly differently and had screenings much, much earlier, but... come on. This is what I mean about people wanting to see what they want. Her starting treatment a couple of weeks earlier was not going to make a huge difference. In the moment, yes, it can be hard to know. But in retrospect, it should be super clear. But instead, he's left angry at her for robbing them of this time. And that really was hard to watch. I hope when the grief isn't as raw that they can all realize that.

It also makes me sad that there was apparently so little respect for her wishes. Like, she choose this path. And yes, maybe it was irrational (though with the way she died so quickly once treatment began, I don't know that that was true), but it was her decision. My friend said he wished he'd had medical power of attorney so they could have made the decisions for her, against her wishes, to try and prolong her life. 😥

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One of the hardest things to explain is that there is no guarantee that stage 1 or 2 which was treated with chemo & rads will not recur and kill patient as fast as the no treatment option or the catch it in stage 3 or 4 and treat it option.  Its a mutation, and its individual. Group odds don't apply in many cases.

 

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1 hour ago, Farrar said:

A friend's mother just passed away this week and I ended up rehashing this conversation in various ways. The thing that was hardest for my friend was that his mother refused to do anything because of a fear of doctors - no treatments, but also no palliative care or pain management. In the end, they basically forced one chemo treatment on her and then she died almost immediately thereafter. He was convinced that if only she had done the treatment, that she would have definitely had years left. And I'm sitting there thinking, she died within three weeks of the diagnosis. She couldn't even endure one chemo treatment. She was not going to live for years. Maybe if she had lived her life incredibly differently and had screenings much, much earlier, but... come on. This is what I mean about people wanting to see what they want. Her starting treatment a couple of weeks earlier was not going to make a huge difference. In the moment, yes, it can be hard to know. But in retrospect, it should be super clear. But instead, he's left angry at her for robbing them of this time. And that really was hard to watch. I hope when the grief isn't as raw that they can all realize that.

It also makes me sad that there was apparently so little respect for her wishes. Like, she choose this path. And yes, maybe it was irrational (though with the way she died so quickly once treatment began, I don't know that that was true), but it was her decision. My friend said he wished he'd had medical power of attorney so they could have made the decisions for her, against her wishes, to try and prolong her life. 😥

 

Anger, even anger at the deceased, is a normal stage of grief.  Try not to get too upset at him for being angry until he's had time to process all of the grief and move into acceptance.

Also in my nursing work, having watched many families make decisions to prolong the suffering of their parents because they weren't ready to let go of someone who was dying, it's typical.  It's so common and so upsetting to medical personnel that's why hospitals push you to complete living wills any time you are admitted.

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6 hours ago, Quill said:

This is part of what upsets me about my circumstance. The person is not saying or telling people death is on the near horizon. So we’re losing time to do or say things we might want to have done. This person is not a fact-facer under the best of circumstances. Part of me wants to level and ask directly. But I’m chicken. 

 

I think if this were happening in my family I would share with all of the family that you're worried about this as a possibility.  But then again my family doesn't have a bunch of drama and narcissism, really just one mentally ill person who doesn't live within 500 miles of the rest of us, so only you know if discussing this with everyone would help or hurt the situation.

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8 hours ago, Quill said:

This is part of what upsets me about my circumstance. The person is not saying or telling people death is on the near horizon. So we’re losing time to do or say things we might want to have done. This person is not a fact-facer under the best of circumstances. Part of me wants to level and ask directly. But I’m chicken. 

My grandmother (a"h) never told us she had received a terminal diagnosis (we learned from her oncologist in the days before strict HIPPA regulations).  We never told her we knew and never pushed her to share anything.  It was so clear that she needed her rosy-tinted glasses and her denial and, despite my sadness at the conversations we never got to have, I have never regretted letting her handle her imminent death in the ways she needed to.  It was hard, but it was also the only thing I could do for her. 

...but here, 19 years later, I can still remember how hard it was, and I wish it were different for you. ((((Danielle))))

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On 6/24/2019 at 3:32 PM, happysmileylady said:

I know 2 people who "gave up." 

The first had no one specific diagnosis, but a whole bunch of little ones.  All were chronic and she had been treating for years, and I think she just got tired.  She had a doc appointment or two each week (on average) and she wasn't undergoing multiple heavy duty treatments or anything.  She had been living with relatives for years, who were helping her keep track of her appointments and pills, driving her around, but generally she was pretty mobile, active at the senior center etc.  And then she suddenly decided no more meds, moved into an assisted living facility several hours away and passed away a few months later.  I know she hadn't received any sort of life threatening diagnosis, but the effect of not treating the chronic little ones caused the very swift declined.  Her entire family felt totally abandoned....once she reached that point of passing, they couldn't get to her fast enough because she was so far away.  I think she thought she was doing something beneficial because the facility was very near the burial plot she shared with her husband who had passed many years before.  But between leaving them to move away and then deciding to leave the earth, they felt very abandoned.  I don't know that one of her sons ever got over it.

The second also didn't have a diagnosis but looking back, he *knew*.  He had lost his wife years before, she was his first and only real love and I can see now that he was tired of living without her.  I believe he knew what was going on with his health, but deliberately chose not to pursue anything specifically so that he wouldn't have to undergo any treatments.  And as above, I am not sure his son will ever actually resolve his feelings surrounding the circumstances.  

 

I suggest that whoever might be the people left behind, they gather their courage up and try to discuss their feelings ahead of time.  It is so much harder to accept a person's decision in this sort of thing when that person is no longer around to discuss and explain.  It still may not resolve anything, but I think it's harder to resolve once the person is gone.  

This is me before the decline.  I can totally understand why the son can't get over it.  It is because often the parent decides they are too much of a burden.  The kids may not think so-but the patient feels guilty.

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There are so many factors that come into this that it is hard to give a blanket answer.  Age of the patient, the costs, the benefits and life extension vs the quality of life in that extension...

My aunt was in her late 80s.  She and her husband (whom she married at 78! and was the love of her life) came back from a 3 week golfing trip on Monday, didn't feel good on Tuesday, went to the doctor on Wednesday, diagnosed with cancer on Thursday, started chemo against her wishes but to please her family on Friday. Chemo was horrible.  She asked how long she had with and without chemo.  With it? 6 months, most of that being sick and in treatment.  Without it, 4 months.  She quit it.  And she was gone on Friday.  

It was so fast that we couldn't catch our breath, really.  But I totally get what she did, because of the surrounding factors.  Age, benefit, costs, pain, and so on.  It's not a formula applicable to all but an equation for each person to work out.  

My other relative had a longer path, and there were other factors in it.  He was 90, down to doing personal care, eating and sleeping and that was ALL, and on an experimental drug that cost something like $5,000 a month, cash.  He believed he was getting better because the label on the drug said that it was for treating cancer and by gum, that's all he needed to know.  But he wasn't getting better--and it was beggaring the family, which was not born with a money-tree orchard.  It put stress on the family, for what are *they* supposed to live on when all the money is gone?  Events intervened, and in a 6-week steep decline, he was gone.  It was only in the last 3 weeks that alllll the treatments stopped, however, and it was mostly because he himself had made an end-of-life plan that gave some teeth to decisions that had to be made.  Once he knew that the pain of it all would be managed, he was OK.  He said he wasn't afraid of death but of pain.  

Another younger friend did everything she could, traveling across the country to a specialized treatment center, where she ultimately died.  Almost alone.  She had only a few family members and they could not stay for the entire weeks-and-weeks of treatment.  They got there as quick as they could, but ...  So she pursued the treatment to the end, but that turned out to be far away from home.  And I can't fault HER for that.  She was only 53, and she loved life and had all kinds of things she wanted to do in it.  So that's what she went for--whatever gave her hope for more life.

IDK.  I don't think it is right to accelerate natural death, but I don't think there is something wrong with accepting one's life as it comes to one, and not prolonging the inevitable.  

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On 6/24/2019 at 4:40 PM, Quill said:

Living in a place where health care makes sense. Jealous! 

UUUH- unless you have conditions that are treatable with medications in this country and not available in places like UK and NZ.

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On 6/24/2019 at 4:42 PM, Murphy101 said:

I don't think it is "giving up" to acknowledge that the limits of current medical/financial options for finding healing as been reached and that energy is better spent loving than fighting.

Some people want to "go down fighting" either out of fear or obligation or hope or just because that's their personality.

But I hate the entire "fighting" mentality wrt illnesses of any kind.

As  a person who does live the life of never ending medical visits and lots of medical problems, I do like the phrase fighting the illness. I am fighting my own immune system.  It is a fight----it takes lots of effort.  It is one that I have been fighting for over 35 years.  It is one that I hope to keep fighting for many more years. 

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3 minutes ago, TravelingChris said:

UUUH- unless you have conditions that are treatable with medications in this country and not available in places like UK and NZ.

Sorry; I hope that didn’t sound flippant. I’m just so frustrated about our health insurance and medical care circumstances in this country. It’s something I so much want to see improved. 

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On 6/24/2019 at 3:51 PM, Pawz4me said:

DH has metastatic cancer, so this is close to me.

There is no cure for any cancer that has metastasized. Doctors may refer to remission, or getting to "NVED" (no visible evidence of disease), but at this point the word "cure" is not one that is used by medical professionals in relation to stage IV cancer.

I strongly dislike the terms "gave up" or "giving up." Ugh. it sounds like the person is just passively fading away. Sure, some choose never to pursue treatment. But some stop after realizing that staying in treatment to keep the disease under control is too costly in terms of quality of life. Not only from side effects of medication, but the never ending doctor appointments, scans, surgeries, blood work, managing prescriptions and insurance, and on and on.

And just about everyone, unfortunately, has to consider finances. Even with good insurance cancer (and many other chronic illnesses) is incredibly expensive. A very high percentage of people with stage IV cancer declare bankruptcy within a couple of years. There are a few people on the cancer board I belong to (same type of cancer that DH has) who have made the decision to stop treatment, or to never pursue treatment, because of the toll it takes on the family.

Long way of saying -- there is much to consider, and unless one has walked in the shoes I wouldn't judge.  Unless it's you or someone you are very, very close to then it's not up to you to decide.

But plenty of people are surviving long, long term after metastatis.  LIke 20 years long and still alive.  Think of Lance Armstrong- who had stage 3 testicular cancer in 1996 that had spread to his brain and liver and elsewhere.  He is still alive  and doing well physically, at least.

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10 minutes ago, TravelingChris said:

But plenty of people are surviving long, long term after metastatis.  LIke 20 years long and still alive.  Think of Lance Armstrong- who had stage 3 testicular cancer in 1996 that had spread to his brain and liver and elsewhere.  He is still alive  and doing well physically, at least.

A lady in my parish lived 15 plus years...into her mid-70s.  

 

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16 minutes ago, TravelingChris said:

But plenty of people are surviving long, long term after metastatis.  LIke 20 years long and still alive.  Think of Lance Armstrong- who had stage 3 testicular cancer in 1996 that had spread to his brain and liver and elsewhere.  He is still alive  and doing well physically, at least.

Yes, that's kind of what I've been attempting to express. Stage IV cancer isn't necessarily a quick death sentence, nor does it absolutely mean living with little/no quality of life. Every single cancer is different and IMO treatment decisions (or not) should be considered on a case by case basis. There are so many people here saying they know, or at least feel certain, that they wouldn't undergo treatment. But to me making a decision like that w/o evaluating all the data and the pros and cons is just as bad as doctors who don't make all the data and facts plain before urging a patient to pursue treatment. One way or another, I'd want ALL the info before making a decision. Walking this walk with DH and knowing what I know there's no way I could make a blanket statement that I would or wouldn't pursue treatment until I knew it all. I can't help but wonder if some of the people saying they wouldn't pursue treatment have any experience beyond traditional chemo? Like with the newer treatments like targeted drugs and immunotherapy.

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52 minutes ago, Pawz4me said:

I can't help but wonder if some of the people saying they wouldn't pursue treatment have any experience beyond traditional chemo? Like with the newer treatments like targeted drugs and immunotherapy.

I never say never- because I don't think you can really do that until you're there staring it in the face- but I think I am one of the ones who would be very reluctant to have any treatment. And I'm definitely well versed in the newer treatments. But ironically, being versed is what shifted me on all of it to hink it's not the choice for me. I don't judge other people at all- even if they want extension cords and every treatment known to man- I mean have at it. I'm not trying to dissuade or convert anyone. My parents are like that- keep me alive no matter what types-,but for me, seeing what I've seen and working on what I did, I decided it's not a likely path I'd take. 

ETA- I think for me it's sort of what Katy describes upthread as far as observations at the hospital.  Where when you see people really put family through the wringer, it causes a sort of visceral reaction against it. As does sitting on a study call and waiting for enough "deaths" to occur so you can get your data in on your drug trial. It was sort of soul sucking, although I do know that good came out of it for other people down the road. But you just don't bounce back from those things very easily. Or at least I didn't. 

Edited by Æthelthryth the Texan
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My husband does palliative care and works with patients and families through the death process.  It has helped me too as we've walked our own family members through some of these decisions.  I think that good providers (and there are those out there as well as the bad) take a very individualized approach that looks at all angles.  Those families or even patients who are rigid (in any direction) are the ones who have the most trouble and often are the ones who leave heartache in their wake because they often run roughshod over others.  I don't blame them for that, we've seen it over and over again and understand how often these decisions are rooted in things going way back long before the illness ever took hold, but it also makes me sad to see.  I think this is why I have had a hard time filling out my own Living Will documents when asked to do so.  There are so many "it depends" situations. 

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1 hour ago, Jean in Newcastle said:

My husband does palliative care and works with patients and families through the death process.  It has helped me too as we've walked our own family members through some of these decisions.  I think that good providers (and there are those out there as well as the bad) take a very individualized approach that looks at all angles.  Those families or even patients who are rigid (in any direction) are the ones who have the most trouble and often are the ones who leave heartache in their wake because they often run roughshod over others.  I don't blame them for that, we've seen it over and over again and understand how often these decisions are rooted in things going way back long before the illness ever took hold, but it also makes me sad to see.  I think this is why I have had a hard time filling out my own Living Will documents when asked to do so.  There are so many "it depends" situations. 

 

The words "rigidity" and "roughshod" stand out to me.  I'm not talking about being weak on principled stands, but about being able to flex within the principled stand based on the reality of the situation.  (I could say the same thing about math curriculum:  "I would NEVER use THAT program...." until I had THAT child. The point is, the PRINCIPLE is that my kid has to know math.  The reality is that Program A ("THAT program") met the principle--and the kid.  Dumb example about a much more serious issue...but it is how I learned not to be rigid and to run roughshod...and keep principles intact.)

Yup.  

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22 hours ago, Arcadia said:

My relatives gave up when there was negligible chance of remission. For them it’s a case of 

1) not wanting their last months to be endless rounds of hospital stays and doctors visits

2) needing their children to help with care because home aide is costly and feeling bad about burdening their children 

3) wanting to leave some life savings for their surviving spouse or children instead of depleting all life savings on medical bills

My late younger cousin (Roman catholic) was suffering during the last months of leukemia. It’s heartbreaking but we have to make peace that God has other plans.

I said I like the fight term. BUt in my mind, fighting a disease does not have to mean medical treatment.  I think what your relatives have done and others on this thread described is fighting.   What really bothers me is with Autoimmune diseases are people who decide to just give up on living a life because of fear of medicines and/or belief in one of the crazy beliefs out there=  lose weight and you will be cured, acai berries, pyramids, exercise (as a cure), essential oils, etc.etc.

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On 6/25/2019 at 11:19 AM, Pawz4me said:

What everyone should remember, though (IMO of course) is that not all cancers are alike, even the aggressive ones. There are different treatments for different cancers, some of which have pretty much zero impact on quality of life other than the time it takes to get the treatment. Also, to treat or not treat is not a one time decision. It's not as if a patient can't try treatment and see how it goes. You can stop at any time. At every single appointment DH has the doctor asks about quality of life.

 

I completely agree with this! Some cancers, even aggressive ones, can be treated successfully with  surgery and require only vigilance in the following years. Others forms you know are going to require drastic measures and have lower rates of positive long term outcome. We’ve experienced both types in the family, with one choosing treatment and the other choosing palliative care. Each person made a wise and reasonable decision based on individual circumstances. 

And pawz, what a blessing your dh has in you, his advocate. 

Adding to the chorus, read Being Mortal. I found it most helpful for having conversations around what one desires for their life, and end of life. 

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The Atlantic June 25th, 2019 article https://www.theatlantic.com/health/archive/2019/06/immunotherapies-make-cancer-treatment-less-brutal/592378/

“Many researchers and doctors are looking to immunotherapies to wipe out cancers without putting patients through the suffering often associated with surviving the disease. These treatments harness the power of the body’s existing immune defenses, which aren’t very good at attacking cancer cells without medical intervention.

The cancer immunotherapies most widely available now are checkpoint inhibitors such as Keytruda, which take the brakes off the body’s immune responses in order to more effectively unleash them on tumors. Merad said that these drugs have shown particular promise in cancers that are notoriously unresponsive to chemotherapy or radiation. “What was dramatic is that metastatic lung cancer—which doesn’t respond to any therapy—could be cured. The cancer would completely disappear,” she said. “We believe that in the years to come, more than 50 percent of cancer patients are going to receive checkpoint inhibitors.”

The CBS News chief medical correspondent Jonathan LaPook, who moderated the panel, said the most famous recipient of checkpoint inhibitors is probably Jimmy Carter, who was diagnosed with metastatic melanoma in 2015, which had spread to his brain. Normally, survival periods for patients with that type of cancer are less than a year, but Carter is still alive and cancer-free almost four years later.

A second immune system–based cancer treatment, this one in earlier developmental stages, is CAR T-cell therapy. “I think about it as pregaming,” Wayne said. “You’re pregaming your T-cells to be ready to party when they’re back in your body.” T-cells are on the front lines of the body’s immune response, and engineers like Wayne are developing ways to extract them from patients and optimize them to find and fight cancer cells.

“Just like you would give a scent to a bloodhound and say ‘Go get it,’ you’re giving the scent of the cancer to these T-cells and then multiplying them a billionfold and putting them back in,” LaPook explained.

The downside of this treatment is that it’s expensive and time-consuming. T-cells have to be harvested, adjusted, and proliferated from individual patients, which takes four to six weeks. That’s more time than some people have, and T-cells from previous patients can’t be used to treat future tumors in others, although Wayne said that she and other researchers are working on that technology.

Despite the current cost, Merad said there’s still immense cause for optimism for the future of immunotherapies in cancer treatment. “This is just the beginning,” she said. “There are two molecules on the market, but there are hundreds of them we can exploit.””

Edited by Arcadia
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On 6/26/2019 at 10:19 AM, Katy said:

Part of me wants to level and ask directly. But I’m chicken.

 

@Quill I think you said this not Katy?

 

If it was you, I think it’s okay to go ahead and ask directly.  You could preface with it’s okay if person doesn’t want to answer, or needs time to answer, but you’re concerned and wondering about _____.

 

 

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24 minutes ago, Pen said:

 

@Quill I think you said this not Katy?

 

If it was you, I think it’s okay to go ahead and ask directly.  You could preface with it’s okay if person doesn’t want to answer, or needs time to answer, but you’re concerned and wondering about _____.

 

 

Yes, I said it. 

I do have a bit more information today after discussing it with another i,portant person who cares about the ill person. I actually have a better understanding now as to why certain procedures and appointments were not complied with. 

I do not think the person has told doctors there is a deliberate choice to not pursue certain treatments, even if that means cancer advances. I don’t agree with this aspect, but I do see the logic in the choices being made. 

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