Question about time left to live

Dear Jeff

When I first read your letter, and I see that several others have as well, I said to myself, “None of us can give this fella a definitive answer."  So sometimes we read a letter and we just don’t know what to say, so we say “nothing.”  And sometimes that’s a good thing too.

First of all, you didn’t give us a lot of information about the age and health condition of your aunt at the time of diagnosis.  Do the doctor’s feel the spread is so invasive that it would be an added “weight” on the shoulders of your aunt to subject her to chemo treatments?  Perhaps her condition is so fragile that it isn’t worth the risk of making her suffer more?  Just asking?

Now other questions need to be asked?  What does your aunt think?  Is she happy with the doctor’s diagnosis and content to forego chemotherapy?  If so, she will not be the first one to be diagnosed with cancer, and elected not to choose the chemo route!  Has she had a 2^nd opinion? 

Now Jeff, I don’t know if you’ve ever had cancer yourself, but speaking as a Stage IV Ovarian Cancer patient, I’ve had more than one series of chemo treatments, and mine have not been easy.  It has afforded me with some quality of life in between, but not without pain and suffering too.  So then as family members, I would suggest that if the Aunt is content with the first diagnosis—if she is sure she is in the best place for treatment—and if she doesn’t want to go through the ordeal—then other family members will have to “live with it?”

How long can she live without chemo?  Actually her oncologists who deal with her condition every day are a better judge of a time frame than any of us cancer patients.  So none of us would dare give you an answer because we’re simply not God.  As for myself, I am a Christian, and I believe the words of the Psalmist in Psalm 139.  If you choose to read that, you will see that David said, “You saw me when I was being knit together in my mother’s womb, and in Your Book, all the days of my life were written, when as yet there was none of them.”  But of course, that doesn’t mean that He doesn’t want us to take the best care of ourselves while we live on this earth, and that does include having the best doctors you can have to diagnose your condition.

As for myself, my condition was Stage IV from the time I was diagnosed in November of 2012.  It has been anything but easy!  And this particular week, has me questioning if I want to subject my body to any more poisons?  I firmly believe that there is a time when chemo does the body more harm than good, and that is a decision that the patient will have to make.  When the chemo is making you sicker than the quality of life you are enjoying in between, I believe it is defeating the purpose of the chemo. 

Then there’s the question of just what kind of chemo is being considered?  Is it something to which the patient will respond positively?  Not always.  Sometimes the patient goes through a series of chemo with side effect and the CT scans show NO improvement!  And sometimes it will slow down growth in one area, while it crops up in a new place.  Such is my case.  So I will have to be the one to make that final assessment.  Of course, my doctor is fine with whatever course I choose.  He will abide by my decisions.  But as for a time frame, only God knows how long any of us will live, and He hasn’t provided me with a date certain.  I’m sure you love your aunt or you wouldn’t even be writing, but when you say “Stage IV”, short of a miracle chemo is not a cure, only a deterrent.  The most I can hope for as a Stage IV patient is to have a period of “progression free survival” in between treatments.  And with the passing of time, those periods of time are getting shorter and shorter.

Lastly, I think you will find this article I have saved in my files since the Mayo Clinic first published it in 2006 helpful.  The version at their site today is much more condensed.  I believe some of the questions you asked are covered in this article.  You might want to print it out and share it with the family.  Mayo Clinic article dated 2006.

http://csn.cancer.org/node/299199

My heart goes out to you and your family, Jeff.  I’m sorry I can’t be more definitive, just wanted to give you an answer from my heart to yours.

Loretta Marshall

Stage IV Peritoneal Carcinomatosis/Ovarian Cancer Stage IV (Nov. 2012)

Jeff, I would suggest if you really want to see your aunt than go and see her as soon as you can.  That way you can have a good conversation with her and tell her how much she means to you - which it sounds like she does.  I wouldn't wait until she is gone - but as Miss Lorretta says - no one really knows.  I would only add that cancer is an ugly disease and I pray they find something to stop it.  

My dear Jeff:

There is no one on earth with a definite time table on life.   There is no one here who can tell you how long your aunt will live without chemo treatment.  Just had a gentleman diagnosed with Stage IV Esophageal Cancer with spread to his Liver and Lungs.  He was diagnosed about 3 weeks ago.  Doctors have given him 3 to 5 days maximum time to live.  Naturally, his family is devastated.  He had no prior symptoms to give him a clue.  Life can be gone at a moment’s notice.  Cancer doesn’t always come with a “time table”.   There are no guaranteed outcomes.   

You seem agonized on which trip to make to see your aunt.  Allow me to pose two questions.

No. 1 – “If you were the one diagnosed with a terminal cancer and you had a loving family, would you want them to come and give you one last hug, and hear one last “I love you” while you’re alive?  Or would you rather not have family visit you  now and just have them read about you in the obituary page?

No. 2 – “If I were your aunt, and you were my nephew Jeff”, (and I am a terminal cancer patient), I would want to feel the warmth of your embrace while I can still “feel it”.  My grandkids gave me a musical globe that plays music and inside the globe is a big flower.  On it is written:  “A GRANDMA’s Hug lasts long after they let go!”  And just two days ago my oldest grandson, age 32, came by “just to see me”.  He gave me a big hug and with tears in his eyes he said, “Grandma you’ll never know how much I love you.  You’re so special.”  And with that tears rolled down my cheeks as well.  Those words mean more than any nice thing that may be written about me in an obituary or sympathy card, or flowers after I’m gone.  Life is so uncertain.  If you can either come to see your aunt now, while she is alive, or wait until she dies, I can tell you which would mean the most to ME!

So if I were your aunt, I would say,

 “If you can only make one trip, make it now.  Come see me while I can still see your handsome face--feel the warmth of your embrace—hear your voice and give you a big hug that will “last long after I “let go”.

 I want to see you NOW, while I can still see and smell the beautiful flowers that bloom—while I can still hear the birds sing—while I can still tell you how much I love you.

 What more can I say?  I wish that we lived closer to each other, but I fully understand your inability to make two trips.  Looking forward to seeing you soon!”

"Aunt Loretta"

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Hope this helps. 

Loretta Marshall

Jeff. I can sense your urgency especially because you're out of the country and cannot afford to see your aunt multiple times. I would check in with your aunt directly if possible. Honestly, as a cancer patient myself, I'm very understanding of people's capacities (as most if not all of us here are) to be there for me. Some simply can't because of the distance and financial burden to visit me. But there are phone calls, text messages and video calls that can be easily had. I've made it very clear to my support family that they should only commit to something that is realistic and quality is more important than quantity. Some of my friends and family simply text me from time to time. Some visit often. Some I see for dinner every week. Others I've seen once in the last 6 months. I appreciate them all.