A bit “deep” this week, but for many, an important message. So you have been told you have terminal cancer. What can you do? The first thing is to sit down and take stock of your circumstances. All of us know that that piece of string called “life” eventually comes to an end, but we don’t know when. The only difference with you, is that your doctor has actually told you when your piece of “life” string is due to run out.
Now whilst the immediate thought is “How do I beat this?” there are many factors you have to consider in the time ahead, and one of the main ones is called ‘The Quality of Life’.
Now is the time to talk with family, friends and health care team. It is natural for a person with advanced cancer to feel many emotions including anger, fear, and sadness. Just as you may need time to adjust to this new phase of your illness, your family and friends may also need time. If you are having trouble talking with family and friends, ask your nurse, doctor, or counselor to gather everyone together to talk.
This talking phase should also include your getting to understand your cancer. This you do by talking with your treating doctors, and also from information from reliable internet sites. Note I say “reliable” sites. There are always plenty of sites ready to sell you snake oil.
Now is the time to manage your symptoms. Your quality of life is better if your symptoms are under control. Talk to your health care team about the best way for you and your caregivers to manage your symptoms.
Do not be afraid to ask your doctors about any proposed modalities of treatment. Getting an extra two months of life, but at the cost of the quality of life, may not be worth having. Always keep that in mind. Quality of (the remaining) life is everything.
Be as active as you can. When an illness progresses, it may be harder to do the things you have always done. Talk to your health care team about what, if any, limitations you may have. If your physical health allows, continue to exercise in some enjoyable way. Or, if you find it is too much for you, take up a new hobby or find things that you can still do and enjoy, such as reading, writing, creating a photo album, or making a video for family and friends.
Let friends and family know what they can do to help. What can you do for yourself? What is important to you? What can friends and family do for you? What can all of you do together? Where do you turn if you need extra help or care? If you are not up to being social, let people know this as well.
Make your wishes known. Making the decision to stop active cancer treatments can be a hard choice for a person with cancer and their family. These are personal choices. If you are faced with making these decisions, talk with your family and health care team about your wishes and explore all of your options. You are still able to make decisions about your life to the extent that you desire.
Maybe you want to give someone else some of the responsibilities or share decisions about what to do. You may want to create a health care proxy and/or power of attorney. This allows someone who you choose to make health care or other decisions for you. Whatever you choose, you are in control of your life and you know what will work best for you.
You should consider creating a ‘Living Will’ giving specific instructions on what your wishes are as the cancer progresses. This process makes your end-of-life wishes and desires known, and your health care team and can help ensure that your wishes are honored. These wishes may include funeral arrangements or decisions about hospice care. Discuss with your family, friends, and health care team your wishes regarding resuscitation.
Sorry if the column this week was a trifle dark, but it can give assistance to those who feel as if all their options have gone.
