I was thinking about your blog today and where as I don't think cancer patients should stand as judge and jury I think what my husband (the cancer warrior as I call him) and I (his wife) have discovered is that life has become even more precious than before and is very short. Since we have no idea how much time he or for that matter, any of us have, we no longer find ourselves wanting to "waste" our time on what we consider unimportant matters or people who cant or wont deal with Jacks disease. I know that this may sound selfish, but quite honestly, we are ok with that. Because of the chemo and the disease he doesn't have a tremendous amount of time when he feels "good" so we don't want to spend it telling other people how to live. He wants to enjoy it. Our family and friends have happily risen to the occasion. They, like us, are far from perfect. We accept them and they accept us. We have come to see that things that used to be important, no longer are and things that never really mattered do so much more now. It is change in priorities. Cancer is, as I call it, a "life altering experience." Nothing is ever the same again... even if you survive. He needs all his energy focused on fighting this disease so how ever anyone else chooses to live their life is their choice not ours. Nor do we want anyone telling him how to live his.

Sent by Amy Wile | 12:22 PM ET | 09-25-2006

Leroy, I think that youve gotten to a point about our being "moral authorities" or not, and also one of the reasons why some of the people that we know, dear friends or family members even, fade into the woodwork after were diagnosed with cancer. In addition to the possibility of their feeling guilty practicing poor health habits such as smoking around us, just the very fact of our having to deal with our mortality well before when most others do makes some very uncomfortably project themselves into our situations. "What if that were me? How would I cope with that illness, and maybe dying so young?" For some, avoidance is much easier than looking at that issue too closely, and perhaps, making any changes in their lives.

Sent by Nancy K. Clark | 12:25 PM ET | 09-25-2006

For me, its not so much judgment of my friends (often poor) choices as it is envy of their still-good health. I could be angry as hell about that: the chain-smokers, the junk food junkies, the TV addicts, the too, too heavy drinkers who have nothing wrong with them! Talk about a "why me?" moment... I'm the cyclist, the runner, the cruciferous veggie eater, the one who quit smoking years ago, who's carefully moderated my drinking habits over the past few years, who goes to bed at 9:30 most nights... and *I'm* the one with cancer! Whatever... that still doesn't give me the right to judge anyone else's behavior. What I do have is the knowledge that my own conscious efforts towards good health gave me the strength to survive a myriad of extreme treatments. And anyway, what would I do with superior moral standing? Wish this hell on someone else? Not likely. If people try to grant us with moral authority, what they've done is off-loaded their guilt onto us. Your smoking in front of me makes you feel bad? That's not my problem, bub... I've got plenty of problems, but you're not one of them!

Thanks, Leroy!

Sent by Joan Jones | 12:28 PM ET | 09-25-2006

There are two behaviors that have been clearly linked to cancer — smoking and sunbathing. Everything else, such as diet, is still in the realm of theory. Lung cancer is so overwhelmingly deadly that it is difficult not to see the foolishness in smoking.

I would never lecture a friend but I certainly lecture my children. Having been through chemo and radiation for a cancer for which there is great hope, it would cause me enormous pain to see them risk a cancer for which there is little hope. No we aren't moral guardians but we have emotional baggage that comes with cancer and therefore a strong desire to keep those we love from experiencing the same thing.

But having said all this, it is absolutely critical that we not judge the people who have lung cancer. Many didn't smoke and even those who did deserve support and understanding.

Sent by Deborah | 12:30 PM ET | 09-25-2006

If it is true that we all judge, then what do people think of me? I was diagnosed on April 13, 2005 with Stage 4 coloretal cancer, and am currently preparing for a SIR-spheres treatment on 10/10/06. And I still smoke.

My oncologist looks at it this way: "While I wouldn't encourage people in your situation to start smoking, I am not adamant that you quit. You have a lot of stress now, and if smoking helps you deal with it, who am I to say no? I would prefer you quit, but if you don't, I can understand. But with the tumors in your liver, I would highly recommend you stop drinking."

So I quit drinking, but still enjoy my cigarettes, much to the shagrin of others.

Are people judgemental? I have seen judgements being mad by my fellow cancer patients in the chemo room! The attitude taken is "I had no choice about my cancer, it just happened. But that person has lung cancer, and they smoked." Aren't we in a way saying SERVES YOU RIGHT!!??

Have we become such an anti-smoking society that we feel people deserve to die early if they smoke?

Sent by David | 12:36 PM ET | 09-25-2006

Leroy, did you ever smoke? I have smoked since I was 13-ears-ld and I am 61 now. Smoking to me is like second nature. Yes I have tried to quit but without success. In my life I've been told that I have achieved things others could not do on their own. I lost over 60 lbs with sheer will power and kept it off. I used to drink vodka everyday; I knew it was not good for me but couldn't stop for the longest time. I no longer drink today, sheer willpower. I've been told if you could quit eating and drinking you should be able to quit smoking, but I just can't. I have cancer and am going to have surgery to remove (hopefully) the entire tumor within 30 days. I've finished the pre surgery chemo, it did shrink it a little bit so now I have to see one more doctor, a lung doctor and were ready to schedule. I have esophageal/stomach cancer, I'll have two surgeons operating, one on my stomach and one maybe on my chest. I know I'm a damn fool but I think the only way I can quit smoking, is if they lock me up, which is about to happen. I have to stay in the hospital between seven and ten days, it scares me to death. Wish me the best. No lectures please.

Sent by Ruth White | 12:38 PM ET | 09-25-2006

When I see someone I know — even not well — if I get a chance I do say, "Do you have any idea how painful the treatment for cancer is?" I don't know if it helps, but when the clerk in a store looked me in the eye and said, "Im quitting, I haven't had a cigarette in a week," I smiled and said, "Wonderful." I don't know if the nagging helps, and I don't even know if the praise helps. But I do it, anyway.

Sent by Ann Frye | 1:33 PM ET | 09-25-2006

Nagging and praising never did a darn thing for me. Nagging only makes me mad and praising isn't necessary. When and if I ever quit I did it for me not for anyone else.

Sent by Ruth White | 3:40 PM ET | 09-25-2006

We all know smoking is dangerous. Yet we still do it. I have smoked since I was 11-years-old and back in the 70s it was cool. I was diagnosed with breast cancer last year and I still smoke. The cigs didn't cause my cancer and my oncologist wishes I would quit as well but has never asked me to — only offered me the patch for a lengthy hospital stay. With all the stress and changes in taste buds, the only enjoyment I get right now is a cigarette. My nerves couldn't take not having them.

Sent by Susan M. | 11:38 AM ET | 09-26-2006

What about others judging us? I've had many people both directly and indirectly question how I've developed an aggressive cancer at age 44. Did I smoke, drink, do drugs? Was I promiscuous? I'm not sure that people are looking for moral superiority, although some of that comes into play, but rather a feeling of insulation. If an event or an illness is not random, then you can protect yourself somehow. For the record, I grew up middle-class suburban and well-nourished in a non-smoking household. I've never so much as had a cigarette in my life, never tried illegal drugs, never misused prescription medication, have never slept with anyone except my husband of 20 years. Except for a brief eating disorder in my college years, I've maintained a healthy weight and active lifestyle. There are no known genetic mutations, so in my case it was random bad luck, and I cannot confirm your moral superiority! One of the things I worry about is how to instill a healthy lifestyle and teach my 3 kids (6, 8, 11) to make sound choices (smoking, drinking, etc.) when they see that there are no guarantees. Will they feel that being "good" is not worth the effort if it doesn't make any difference? Will this be another burden of my legacy (yes, I'm hopeful and positive, but more likely than not my children will be motherless sooner rather than later).

Sent by Holly | 12:12 PM ET | 09-26-2006

Embarassment comes from within, not from your surroundings. If he felt guilty, then it was his own doing. I wish that all smokers would feel guilty, embarrassed and ashamed to smoke around anyone, not just people who have cancer. Second-hand smoke is a risk for everyone. Smokers should realize that for the benefit of their friends, if not for themselves.

Sent by Steve | 12:27 PM ET | 09-26-2006

My husband is going through his second round of chemo (Taxotere) for lung cancer with brain mets. He has smoked for many years, as have I. We both want to quit and have discussed it even before his diagnosis. Now, I'm smoking much less even though my stress level is much higher, but my husband is smoking more than ever. He's really tried to quit and told me just last night that he is embarassed and disappointed that he hasn't stopped smoking. He says that smoking is the only thing that is left of his "old life" (meaning before cancer). Just like everyone else, our lives have completely changed. Can I blame him for holding on to one thing that makes him feel like he has a part of his "old" life? Even though the treatment results have been positive, with a 20 percent shrinkage in the lung tumor in 3 months, and the brain surgery and radiation are going well, we know that he will be living with cancer as long as he is on this earth. We will be in constant fear wondering where the cancer will rear its ugly head next. I told him that he is only feeding the cancer that is killing him, but I only said it once. I do not nag. He is too tired to do any of the things he used to do, and because of the effects of the brain tumor, he is unable to concentrate long enough to find something else he's interested in doing. If he can't quit, or really deep down wants to hold on to that one little piece of his old life, who am I to criticize? I am just truly grateful for each year we have had together and for each day we have left.

Leroy, my husband told me to read your blog to help me understand the things that he was thinking. He said you expressed his feelings much better than he could. Thank you. You've helped our family understand my husband's inner thoughts. We wish you peace and no pain. God be with you.

Sent by Nancy M. | 12:31 PM ET | 09-26-2006

We never had the right to be the moral guardians for anyone before we were diagnosed. Why would or should we have that authority now? But let's not confuse moral guardianship with the responsibility to honestly share with others what we are going through. Where possible, though, we should advocate that friends, family and others important to us get those routine recommended screenings that are so easy to postpone — mammograms, colonoscopies, PSA tests — all those tests that might catch something earlier and make it easier to treat. And don't ignore those symptoms, those irregular moles, those suspicious lumps, etc. Get them checked out. Get out the message. Please don't join our cancer club — get that "membership screening" done now with your physician and ensure that you don't pass the qualifications for entry!

Sent by Bob Maimone | 12:36 PM ET | 09-26-2006

My only beef about watching people smoke while I am being treated for cancer (I'm being treated for sarcoma, which is unrelated to smoking — I've never smoked) comes from watching medical personnel smoke outside the hospital where I have been receiving radiation. Every day, we would drive by the little shelter outside the hospital that was built specifically so smokers could escape the elements, not being allowed to smoke inside, of course. And I would complain loudly to my patient husband about these people whom I view as angels. They are saving my life. They are saving many lives. I don't care if they're nurses or orderlies or doctors. They participate in saving lives. And here they are, in their "angel-wear," their scrubs, lighting up outside. And the hospital built them this shelter to enable them to smoke and not get rained upon. I have spent a lot of time judging them, frankly! I hold them to a higher standard than "regular folks," and this drives me crazy.

Sent by Jennifer Haan | 12:40 PM ET | 09-26-2006

Sounds to me like your friend was giving you a compliment. A compliment because it means he's taken the time to think about your situation and what you've gone through and had to fight for. He "gets" it. Unless you've been through it yourself or have been a caregiver, not too many people do "get" it. And because he gets it, he's embarrassed. I bet he doesn't see you as a moral judge at all, because your friend is too busy judging himself and feeling like he's coming up short. I think that shows respect and deep caring for you, his friend.

Sent by Carol Eagan | 12:43 PM ET | 09-26-2006

I too, am a stage 4 colorectal cancer with liver mets. I have done 12 doses/cycles of FOLFOX with avastin. It has been an amazing journey. I have had a decrease by 92% of my CEA. I am working on my sir spheres treatments. Maybe as soon as Nov. Thank all of you for your insight, support and great gift of sharing. David, keep us up to date on theraspheres — it maybe the next big step in cancer treatment. As for lecturing others, the most I do is encourage everyone to get the recommended screening colonoscopy. I was already doing all sorts of things which SHOULD have protected me. I exercised daily, I had been a vegetarian for 17 years, I was taking Celebrex for 4 years, I had absolutely NO cancer in my family back for 5 generations. I never smoked except those early teen days of inhaling, which I gave up decades ago. Why I have cancer is an absolute unknown. The doctors are mystified. They hate that ... I accept. Now my life is filled wtih treatment, not prevention. BUT MOSTLY it is filled with living! Now the choices are based on what will afford me the most quality time with family and friends. They will all make their own choices; if asked I tell them what I know about my experience. Nothing more — I have not become the guru of cancer, just me with more love of life!

Sent by Cherie Brown | 9:28 AM ET | 09-27-2006

Guess I'll just be different add that I think cancer patients/survivors have every right, and maybe an obligation, to get in the face of smokers and yell at them, grab the pack and stomp on it. Gracious, as a society we take the haughty moral high ground all the time by taxation and transfer, by regulating this and that, codes, labels, etc. We tell children they can't sing Christmas carols at Christmas and to leave peanut butter sandwiches at home. Someone might get hurt or feel bad. Scream at them if you have to. If only one person out of 100 listens, what have you lost?

Sent by Norma | 2:47 PM ET | 10-02-2006

My mother-in-law was diagnosed with sclc with brain mets. She had been smoking and drinking for more than 30 years. She did quit smoking for about three years but she then picked smoking up again. Prior to her diagnosis my husband used to get into her case about her smokinfg and drinking, and do you know what her response would be, "I'm old enough to do whatever i want with my life". She had just done her last chemo and radiation and the brain mets were resistant to the radiation.She is now experiencing cognitive problems, her speech is slurred and sometimes she is confused. She is sometimes attacked by chronic fatigue. My question is why smoke, when you know you might develop such a debilitating disease? She now cuts a soory figure and my heart goes out to her each time she has a bad day. The Doctors have not told her that she might not have long to live as a result she is optimistic that since she has finished her chemo sessions she is healed and she will soon get back to work. Should i tell her about the seriousness of her illness or should i let her let her continue on believing that the chemo and the radiation has worked?

Sent by Olive | 3:54 AM ET | 07-20-2007