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Hope and Cure

Posted 2/24/2016

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  We all hope to be cured. If that is impossible, we hope to stay well for a very long time. If that is impossible, we hope to stay well for as long as possible with a high quality of life. Then it begins to get very tricky. Balancing hope and reality and QOL (quality of life) vs. symptoms and side effects and limitations becomes an extremely personal equation.

  There is a whole field of study in psychology called "response shift". It refers to changing attitudes about what is acceptable or even good. For example, someone might say: "I would rather die than have to use a wheelchair", and then that same person might later decide that,actually, a wheel chair is not so bad. When someone is very ill with cancer, this comes up a lot. It is so important to think and talk about what is most important for the individual. What the family thinks, what the doctor thinks, may not be accurate at all. I often have this conversation with patients, and hear all kinds of things like" I need to be able to talk with my grandchildren" or "I need to be able to read and enjoy food" or "I need to be pain free." We are all different, and those differences are never more important than when we are will. And I have surely learned that we never know how we will feel in those moments until we are there.

  This is a lovely essay from The New York Times. Here is the start and a link:

When Cancer Treatment Offers Hope More Than Cure

By Mikkael A. Sekeres, M.D
We joked that she had nine lives.
And like a cat, over the years, no matter the adversity — the extreme toxicities that resulted from her many
rounds of chemotherapy, the bowel perforation that left her with anostomy, the trips to the intensive care unit
— she always landed on her feet, the wattage of her personality undimmed.
With the most recent return of her leukemia in the fall, I asked her, not for the first time, if she had been
through enough, and would like to forgo any more treatment.
“I’m not ready to give up yet,” she told me. “I still got a whole lot of living yet to do.”

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