What happens if you choose not to treat cancer?

[Anonymous]

Anonymous wrote:

Anonymous wrote:My mom is an doctor and had a patient who wouldn't take a life saving blood transfusion (she was jehovah's witness and had a DNR). As she died they made both her and her husband sign all sorts of papers acknowledging that they knew this would lead to death and absolving the doctor and hospital of liability. I'd assume if you didn't want to treat your cancer they'd have you sign something. You'd need to have a DNR signed too or else your DH could step in when you were incapacitated.

Thank you, this is sort of what I was looking for. I wasn’t sure if the doctor could require you to tell your spouse or get a mental competence certificate if you just opted against treatment.

I feel like there's a wide expanse here. The term "cancer" is essentially applied to different diseases at different stages with different prognoses. You could have DCIS, like a pp and I did, which may turn into something bad or may not, so a "watchful waiting" option of non-treatment is possibly not unreasonable. Or you could have a very advanced diagnosis, where the prognosis is poor and treatment is a trade-off between quality-of-remaining-life and quantity-of-remaining-life, and someone may reasonably choose a higher quality, but ultimately shorter remaining life without treatment.

Most of the time though, the diagnosis lies in the middle, especially with all the advancements that have been made in cancer treatment. Many diagnoses now have a reasonable chance at good outcomes, either eliminating the cancer entirely or extending life spans greatly.

If this is something you're facing, I would encourage you to talk to your doctor and really understand where you are and what is truly the range of possible outcomes. Whatever the situation is, hugs to you.

[Anonymous]

OP, no idea what stage of cancer you have or anything else, but when I was first diagnosed, this essay both made me laugh and helped me feel less alone. https://www.theatlantic.com/health/archive/2021/08/caitlin-flanagan-secret-of-surviving-cancer/619844/

[Anonymous]

I had a friend who was diagnosed with breast cancer when she was pregnant. She deferred treatment until after the baby was born. She died before the baby was two years old even though she started treatment after the baby was born. It was too late.

[Anonymous]

It doesn't sound to me like OP has cancer just FYI. She is just asking a question.

[Anonymous]

My dad asked me if he had to treat his stage 3 colon cancer. I said no. He was dead within the year. My mom and brother both died from cancer and both treated it. They were miserable. I completely understand his decision and I’m glad that we talked about it.

[Anonymous]

My mother had mouth and neck cancer in her mid 70s and chose not to have the operation or anything other than palliative care - pain killers basically. Originally she was told in August 2017 she would live through that winter Holiday season but wouldn't make it to the 2018 Holidays. She lived until the end of Dec. 2020.

[Anonymous]

There is a big difference in an elderly person declining treatment and a person that is 30.

[Anonymous]

My spouse had aggressive treatment and died 6 months after diagnosis. Every case is different.

[Anonymous]

Anonymous wrote:It doesn't sound to me like OP has cancer just FYI. She is just asking a question.

I agree. Another possibility is she has a mental health issue that needs to be addressed. I took the post as passive ideation.

[Anonymous]

OP, if this is your diagnosis, I’m truly sorry.

My grandmother had breast cancer at 52, in 1964. Her treatment was a “radical mastectomy” that apparently was the only treatment: surgical removal of her entire left breast, lymph nodes under her left arm and maybe even fat and muscle below her bicep area. She wore long sleeves and special weighted pads in her specially purchased bra. She was disfigured.

She lived well into her late 80s, although was perhaps the next to the last generation who kept her diagnosis a secret from everyone except her own daughter.

[Anonymous]

Here is a real story of a 34 year old who was diagnosed with stage 2 triple negative BC last year. Her doctors urged her to treat it aggressively because it was triple neg. If she did the prescribed chemo, surgery, and radiation, they gave her a 80% chance to live 5 years, and from there her survival odds could even improve depending on how she responded. But she was uncomfortable with “big pharma” and “the medical industrial complex” and decided to dedicate herself to natural healing. In truth, I think she was just terrified of it being real and she was in a protracted denial. For a year she did all the natural healing things: herbs, turkey tail, colonics, infrared sauna, acupuncture, IV vitamin C, vegan diet, on and on. She really worked at it. But she was getting dizzy and losing weight and so she went back for more scans. She is now stage 4 with Mets in her brain, lungs, and bones. She can’t take care of herself and she can’t afford a live-in caregiver (she’s a professional artist, basically on California’s version of Medicaid). She is in agonizing pain. She can’t sleep or eat. She is now begging her doctors to give her the toxol they offered her last year and to try to get her into clinical trials, but all they can tell offer her now is palliative care. She’s asking friends around the country if anyone can recommend a doc who can get her into a trial or offer her chemo at this point. She’s willing to travel and try anything and it’s heartbreaking to witness because she had a really good shot at survival last year. Not a guarantee, of course, but a good shot. I know she wishes she could go back in time.

[Anonymous]

Anonymous wrote:Breast cancer spreads to the bones, lungs, liver, and brain. Then you die. You might get 2-4 years but you'd get more and more painful and debilitating symptoms and it would be a miserable decline without any intervention. You don't just fall over one day after having lived life to the fullest up to that moment.

I don't know what a doctor would do. If you're in your 30s and not stage IV they're going to try to persuade you as hard as they can that you're making a terrible decision. You might get referred for a psych eval to make sure you're not incompetent or mentally ill. If you're legally capable of making your own decisions then HIPAA would prevent them from telling your spouse, but it's not like you're going to be able to hide dying of stage IV cancer. It shows.

I hope this is a thought exercise and not something you or someone else is actively contemplating. I'm 34 and just finished radiation for stage 1 triple-positive IDC yesterday. I finished chemo in January. I don't know what my future holds but I'm giving it my best shot and treatment has been bearable and not what I feared.

Wishing you a speedy recovery, PP. Also, just for the record, Invasive Lobular Carcinoma (ILC), which makes up 10% of BCs, can also spread to the gastrointestinal and reproductive tracts, in addition the metastasis sites you listed above. Something to be aware of.

[Anonymous]

Anonymous wrote:Breast cancer spreads to the bones, lungs, liver, and brain. Then you die. You might get 2-4 years but you'd get more and more painful and debilitating symptoms and it would be a miserable decline without any intervention. You don't just fall over one day after having lived life to the fullest up to that moment.

I don't know what a doctor would do. If you're in your 30s and not stage IV they're going to try to persuade you as hard as they can that you're making a terrible decision. You might get referred for a psych eval to make sure you're not incompetent or mentally ill. If you're legally capable of making your own decisions then HIPAA would prevent them from telling your spouse, but it's not like you're going to be able to hide dying of stage IV cancer. It shows.

I hope this is a thought exercise and not something you or someone else is actively contemplating. I'm 34 and just finished radiation for stage 1 triple-positive IDC yesterday. I finished chemo in January. I don't know what my future holds but I'm giving it my best shot and treatment has been bearable and not what I feared.

Not the OP. Wow, extremely moved by this thoughtful post. Hoping for all the best in your life.

[Anonymous]

Anonymous wrote:Breast cancer spreads to the bones, lungs, liver, and brain. Then you die. You might get 2-4 years but you'd get more and more painful and debilitating symptoms and it would be a miserable decline without any intervention. You don't just fall over one day after having lived life to the fullest up to that moment.

I don't know what a doctor would do. If you're in your 30s and not stage IV they're going to try to persuade you as hard as they can that you're making a terrible decision. You might get referred for a psych eval to make sure you're not incompetent or mentally ill. If you're legally capable of making your own decisions then HIPAA would prevent them from telling your spouse, but it's not like you're going to be able to hide dying of stage IV cancer. It shows.

I hope this is a thought exercise and not something you or someone else is actively contemplating. I'm 34 and just finished radiation for stage 1 triple-positive IDC yesterday. I finished chemo in January. I don't know what my future holds but I'm giving it my best shot and treatment has been bearable and not what I feared.

what was your experience with radiation? did you have any bad side effects? How many weeks? where were you treated? was it on your left or right side? Mine is on my left side so they said I'd have to hold my breath during the radiation to protect my heart. I am still deciding whether to do radiation. In my case it is being recommended but not strongly recommended since my cancer is not that aggressive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Breast cancer spreads to the bones, lungs, liver, and brain. Then you die. You might get 2-4 years but you'd get more and more painful and debilitating symptoms and it would be a miserable decline without any intervention. You don't just fall over one day after having lived life to the fullest up to that moment.

I don't know what a doctor would do. If you're in your 30s and not stage IV they're going to try to persuade you as hard as they can that you're making a terrible decision. You might get referred for a psych eval to make sure you're not incompetent or mentally ill. If you're legally capable of making your own decisions then HIPAA would prevent them from telling your spouse, but it's not like you're going to be able to hide dying of stage IV cancer. It shows.

I hope this is a thought exercise and not something you or someone else is actively contemplating. I'm 34 and just finished radiation for stage 1 triple-positive IDC yesterday. I finished chemo in January. I don't know what my future holds but I'm giving it my best shot and treatment has been bearable and not what I feared.

what was your experience with radiation? did you have any bad side effects? How many weeks? where were you treated? was it on your left or right side? Mine is on my left side so they said I'd have to hold my breath during the radiation to protect my heart. I am still deciding whether to do radiation. In my case it is being recommended but not strongly recommended since my cancer is not that aggressive.

Not PP, but you will get better information from a radiation oncologist because it depends on your breast size and where in the breast your cancer is (and tumor size). I met with one before I had surgery to help me decide which kind of surgery to do. I was worried about the left side issue too. She made me feel a lot better about it. She said they can often do prone positioning (depending on where the cancer is in your breast) to decrease heart and lung exposure. She also said that the technology they have now really reduces the non-breast exposure and most of the studies were conducted using older technologies. I still decided on a bigger surgery to avoid radiation, but it helped to talk to an RO about my specific case. She was in Bethesda.