Cancer? Maybe the best thing is to just do nothing
Posted by Jonathan Chamberlain on January 17, 2013
Cancer? Maybe the best thing is to just do nothing
by Jonathan Chamberlain
A couple of years back I was in a pub and I got talking to a man aged 89. He had just been told he had melanoma and was feeling a little shaken.
“I blame the sun in the Middle East where I worked for twenty years,” he told me.
I’m afraid I wasn’t sympathetic. The man did not look or act like an 89 year old. He had walked in and ordered his pint like anyone else. He was in good shape. Except, of course, he had this melanoma. And he was blaming the sun – that searing sun of the Middle East. Hmm?
“Maybe you should thank the sun for getting you to the good old age of 89 in otherwise pretty good condition. All that vitamin D must have done you some good,” I said, nodding in a friendly way to show I wasn’t taking the piss.
Thank the sun? Was I crazy? I could see his eyes retreat from mine. And anyway, what was he supposed to do now? I could see the concern and worry on his face.
Yes, that’s the question, what was he supposed to do now that the melanoma had spread? I could see the whole situation was new and a great shock to him. He was staring imminent death in the face. But, hang on here. He was 89 after all. Shouldn’t he have been staring imminent death in the face for at least ten years? I imagine when I’m 80 I’ll wake up every day wondering if it will be my last. I’m only a sprightly 63 and already I am wondering if this year will be my last – over sixty and you’re in the death zone. So what? We all die. Run from that truth as hard as you can but one day… Let’s be blunt. None of us are going to live forever.
I know of a man, the father of a friend of mine, who decided he needed some ‘necessary, life-extending’ surgery. He was 92 years old and he died on the operating table.
When you’re 80 plus you are not going to bounce back quickly from surgery. Surgery is something to be very cautious of. Yet doctors will recommend surgery and patients will go along with it. Like my 82 year old wheel-chair bound father who was suffering from Parkinson’s. He had hip surgery because he thought it would help him get out of the wheel chair. It didn’t. He had always been a very fit and healthy man – a Cambridge boxing blue, he was still playing field hockey well into his sixties. The operation only made things worse to his great frustration. There is nothing worse (certainly, I can’t think of anything worse) than to be very old, unable to be in control of the simplest aspects of your comfort, to be in pain and to feel the loss of all hope. So it is very easy to say: “I want an operation to just sort everything out and then I’ll be fine again.” If only.
Just yesterday there was the report of the 91 year old compiler of the Guardian crossword puzzle who announced that he was dying of cancer. The report quoted him as saying “Fortunately the doctors decided that I shouldn’t do chemotherapy.”
There was the strong suggestion that if the doctors had recommended chemo he would have gone along with it, even if he might have had misgivings about the pain.
Let us be very clear about this: It wasn’t the doctor’s decision to make. It was his own. Doctors can lay out the options but all treatment decisions are the responsibility of the patient. If he didn’t want chemo, then no-one could make him have it. That’s the truth whether you’re 17 or 70. You always have the right to refuse treatment. [Children under the age of 16 are another matter – here the State will intervene to enforce compliance with standard medical protocols, but that’s another issue altogether.]
Giving a talk to a Rotary club a few years ago, I made the point that anyone over 80 diagnosed with cancer might very well do best by doing nothing at all. Why? Because cancer grows slowly when we are old. Because we are more adversely affected by surgery, radiation and chemo when we are old. Because we have already had a good life and we should not fill the time remaining with unnecessary pain.
One of the members of that Rotary audience told me his mother’s story. At the age of 87 she had been told she had breast cancer and the doctors had then laid out the various options they proposed. She, however, waved them away, saying she was old enough and she had to die sometime and if it was to be because of breast cancer then so be it. She had then continued to live as she always had and did eventually die – aged 100.
So doing nothing for your cancer is one sensible strategy – one which becomes more and more sensible the older we become. I may have said something along these lines to the 89 year-old man with melanoma – but this was not a suggestion he really wanted to hear. He wanted to do something about it – probably the more radical the better.
But, it does pay to stop and think, long before cancer comes knocking on your door, what you – yes, you – would do. Ask this of yourself: What will I do when I get cancer? Doing nothing is one approach but it is certainly not the only one. The better prepared you are the longer you are likely to live and the less pain you are likely to suffer.
© Jonathan Chamberlain 2013, author of The Cancer Survivor’s Bible [ISBN: 978-1-908712-09-7] and Cancer: The Complete Recovery Guides – Books 1-8 (Kindle). http://www.fightingcancer.com