Commentary: Quality vs. Quantity
“Before my diagnosis, I, like most people, would probably have said that living longer is the top priority. No question. Easy answer. But now I'm not so sure... another few months of feeling bad -- is that really the way I want to live? Is it worth it?”
The following essay is from the NPR My Cancer weekly podcast:
It's probably the toughest decision a cancer patient has to make. It's a question that most people don't ever expect to face — I know I didn't. And it really cuts to the heart of who we are and how we want to live. The question is: Quality vs. quantity... of life?
The treatments for cancer are not pleasant, to put it mildly. Surgery? That may be the easiest — you have it done, you heal, you move on. Not a lot of fun, but at least you can sort of see an end to the discomfort.
Radiation? I haven't had it, but it doesn't sound like much fun either.
And chemo? Definitely not fun. Debilitating, depressing, exhausting? and more. But you go through it because you hope that, if it doesn't destroy the cancer, then at least it will hold it at bay and buy you more time. And that's really what doctors are trying to do — buy you more time. There's usually very little talk of curing you of cancer — at least there wasn't for me. The only time it really came up was when my doctors told me not to expect a cure.
Instead, they want to do everything they can to prolong your life. Increasingly, cancer is treated as a chronic disease, like diabetes. Something you have, but that you can also live with. And that all sounds fine the first time you hear it. Even if there is no cure, this approach holds out the promise of longer life — maybe a much longer life. The hope is that cancer does not have to be a death sentence.
But after you've taken the drugs, or had the radiation, it may not be so attractive.
So it comes down to that one basic question: Would you rather have quality of life, or quantity? Is it worth it to live longer, even if the treatments that make that possible also make you miserable? Or would you rather have a better quality of life, even if that means a shorter life? I never expected to face a dilemma like that.
It's actually pretty simple though. There are two choices. Undergo treatment, feel miserable, but live another six months. (Is that time so precious that it's worth any amount of discomfort?) Or don't take the treatment, feel pretty good for a few months, but know that untreated, the cancer will probably kill you sooner.
If you had given me those choices before my diagnosis, I, like most people, would probably have said that living longer is the top priority. No question. Easy answer. But now I'm not so sure. I'm in no rush to die, believe me. But another few months of feeling bad — is that really the way I want to live? Is it worth it?
I don't know. And it's more complicated than just what I want. Is it fair to my friends and loved ones? Do I owe it to them to try to live as long as possible, no matter what the quality of that life is? Or is it more cruel to make them suffer through those painful treatments along with me? Is it selfish? Or is it my decision alone?
I go back and forth on this. Stopping treatment seems like a slow form of suicide. At the same time, having just taken a short break from chemo, the idea of not feeling sick is very appealing. But even if it means a shorter life?
I don't know how to answer this one. I hope that I won't actually have to make that decision any time soon, but I know that I will have to make it at some point. I wonder, when that time comes, if I will be wise enough to make the right choice.
6:31 AM ET | 07- 3-2006 | permalink
