Do You Really Fight or Battle Cancer?
A storm cell passes through Bayview, Idaho at sunset. Many cancer patients likely ponder what’s happening in the perceived “battle” within them. Are my immune system and the cancer treatments attacking now, and if so are they winning a “battle”? Or is the cancer sneakily spreading and invading elsewhere?
Carey -
We’ve read countless obituaries about folks who “lost” their “battle” with cancer, or well-intended comments on the patient’s social media to “Stay strong and fight.” And this makes sense for those with illnesses amenable to cures. From my perspective, the “fight” with terminal cancer is personal and psychological. Much of it is actually initially driven by the side effects of treatments, and only later by the cancer impact on the body itself. It’s a process of navigating, to the best of your abilities, the inevitable steps of decline that lay before you. Well meaning admonishments of miracle cures and “fights” simply may confuse and increase anxiety, or encourage prolonged suffering for fear of disappointing others along the journey to death. It may propagate guilt. It may retard progression through the stages of grief, anchoring them in denial. And for those with incurable illness, it may stymie the opportunity for self-exploration and the rewards of experiencing the journey as one’s life nears the end. Early on, Robin made me promise “no suffering.” So I choose to live with a terminal illness, enjoying what life provides to me, without setting up an expectation to “battle” or “fight”. My advice to well meaning friends and family is to avoid platitudes such as “stay strong” or “fight hard” and “you’ll win this battle.” You may inadvertently be forcing the patient to engage in further futile treatments that rob them of critical quality of life. This is not your body. It is not your disease. It is not your fight. Be supportive. But most of all be empathetic.
Bald eagle in Bayview, Idaho. A national symbol of strength and perseverance. Also one of America’s most successful environmental interventions on the part of our avian partners.
Nicole -
The admonition to “fight” hard things in our life undoubtedly has inspired our survival for centuries. Some patients need it to get through the hard steps of medical treatments and seem inspired by the “fight cancer” motto. It galvanizes them and gives their friends and family something to support. The dark side to “fighting cancer” is that not everyone is going to “win” if we only use survival as the goal. In fact, none of us will win if we use that as a goal. Sometimes I see people “fighting cancer” and it helps them get through the initial stages of the disease. When progression of illness occurs, I see in many people a gentle change and beginning acceptance their reality rather than projecting an impossible survival goal. Often families and friends don’t share this feeling because they aren’t living in a physical body which is in decline. They are desperately trying to prevent the inevitable. But desperation in wanting to avoid death doesn’t change the outcome and can cause the patient to feel worse. Families and friends who support their loved ones where they are without trying to change the situation provide true comfort. Be present, offer unconditional love and allow the person to be where they are in that moment.
Instead of bringing the latest “miracle cure that fixed my uncle” try listening and matching where the person is instead. It’s all right to say “I have an idea of something that may help, let me know if you want to know more.” This allows the person to choose it themselves when they feel ready rather than feeling burdened with something that may or may not be of interest to them. I prefer the goal of healing for my patients because this encompasses their entire journey. We can not “cure” everything but we can “heal” things. Healing means different things to different people and allows for them to succeed at whatever their journey is teaching them. It can include physical healing if the body eliminates their cancer or disease. And it allows for growth and love on whatever their journey is as the body follows it’s innate path towards death.
Carey didn’t fight cancer, he kept his eyes on his goals and accepted that treating the cancer was part of his journey. And he took it as an invitation to stay curious and continue to grow as a person, explorer, teacher and mentor.
Robin -
I have never been a fan of “fighting cancer.” There are treatments which prolong life and sometimes even cure some cancers. Fighting to me implies suffering in the hope that something will make it go away. Carey’s cancer is incurable and has a five-year survival rate of less than five percent. Treatment for him will increase the quantity of life sometimes at the cost of quality of life. Early on, Carey made the decision (fully supported by me) that quality was much more important than quantity. He started treatments which for the most part were pretty easy and didn’t impact quality of life much. He felt good most of the time and was able to continue activities he loved. I think of this as the “honeymoon” period with everything going well. Life returned to normal and cancer wasn’t an everyday thought for me. Then all of a sudden, the treatments weren’t working anymore and needed to be changed due to progressive disease. Even though we knew this was inevitable it was still a shock like getting the diagnosis all over again. He tried an experimental treatment which didn’t halt progression and had some nasty side effects. We decided to end all treatments as the only other alternatives had even nastier side effects. The shock came again when the rapid decline started seemingly overnight.
Many people view discontinuing treatment as giving up the fight but there are many horror stories of people “fighting” sometimes for years that have no quality of life. I think it is important to communicate to family and friends that it is not giving up but it is about having a good quality of life. This decision is harder for people with young children or others who are dependent. Our decision was made when Carey was still able to travel and do the things he enjoys doing.
Tyler -
Maybe it’s the ER doc in him, but my Dad has been clear about his treatment goals since the very beginning: quality of life over quantity. We can go back and forth over the definition of “fighting” or “battling” cancer, but I think this is an example of the bravest battle-strategy I can think of. To know when to say enough is enough. I couldn’t be prouder of my father.