It’s not the easiest thing in the world to come to grips with, but not all cancer cases can be cured. Sometimes, cancer progresses to a point where it can’t be treated, and sometimes treatment simply stops working. Even when treatment may extend a person’s life, some people find that the side effects of that treatment makes life unbearable. That’s why it’s important to recognize that refusing cancer treatment is not only a medical decision, but a personal decision, as well.
Approaching age 60, Mark was diagnosed with widespread brain cancer. Doctors predicted his 5-year survival rate was about 50% — but only if he underwent intensive treatment consisting of six weeks of chemotherapy and radiation. After therapy, Mark lost the ability to walk. Dizzy spells would send him spiraling to the floor, and he became unresponsive.
Doctors suggested staying the course, but Mark and his wife decided to stop treatment and turn to hospice care. Free from the disorienting effects of his treatment, Mark became lucid again, and spent his remaining days enjoying quality time with his family. It’s clear that for cases like Mark’s, treatment isn’t always the answer.
Understanding the Decision
There are many reasons why a person might decline treatment. In the 1960s, film actress Joan Crawford refused treatment for her pancreatic cancer because of her faith as a Christian Scientist. Countless others have declined treatment because it was ineffective for them, or the benefits simply didn’t outweigh the drawbacks. In fact, knowing the risks and benefits, a number of physicians would decline aggressive treatment when facing their own end-of-life disease. One Stanford study found as many as 88% of surveyed doctors said they would use a DNR order if facing their own end-of-life decision.
And most physicians agree, just like you shouldn’t stop chemotherapy early, you shouldn’t stop it late, either. In some circumstances, enduring chemotherapy won’t just make you sick — it can actually shorten your lifespan. It is never easy to make these kinds of decisions, which is why Griswold strongly encourages patients to make their own informed decisions after having detailed conversations with their physician and care providers.
Care After Non-Treatment
Just because you’re discontinuing treatment for cancer doesn’t mean you’re giving up. Some people with advanced cancer survive for years. These patients can turn to palliative, hospice, and home care designed to help maximize quality of life and minimize symptoms. Some people may also be eligible for clinical trials that are exploring new types of cancer treatments.
Preparing for the end is a dour subject, but when your life is drawing to a close, it’s important to set your affairs in order. That means getting important documents together, and storing them with a lawyer or in a safe deposit box. That might include insurance records, bank statements, trusts, and a will.
Many people also find it useful to create an advanced directive to outline the type of care you want to have going forward, or to select a healthcare proxy to assist making medical decisions. This can help ensure your wishes are known and respected, which can be a welcome relief for you and your loved ones.
Refusing treatment is a personal decision that involves not just the medical facts of the case, but the values of the person afflicted with cancer. Although it can be hard to accept, sometimes refusing treatment is the right decision to make. Given the option, many people would prefer spending their final days enjoying favorite activities with loved ones.
How do you feel about this issue? Do you know someone who refused treatment for cancer? What, if anything, changed their minds? We’d like to hear from you in the comments below.