I was having a conversation recently with a couple of baby-boomers who had been walloped by the economic crisis that is squeezing the middle class. After a sustained unemployment situation challenged their savings, they were starting to get back on their financial feet, but it will be a long struggle for them to regain economic stability. With new income going out to pay financial obligations as soon as it arrives, it's hard to feel like there is much reason to carry on. Add to this some other stressful changes in their lives, with the death of a loved one and an empty nest as their child entered college, and they are right smack dab in the middle of a psychological obstacle course.
How does this apply to cancer treatment? The subject arose as to what they would do if either developed a serious illness. The feeling was that they wouldn't bother to take extreme measures to treat the illness, because who wants to live a long life if it means suffering?
In reality, this couple is suffering from what amounts to battle fatigue. People who face prolonged struggles often come to have this kind of mindset. When it occurs during treatment for a manageable disease, it can imperil the outcome.
Sometimes patients who have been treated for cancer more than once come to feel that it's not worth the effort. Or that they are burdening their families by seeking treatment for a recurring disease. When this kind of situation arises, it's important that caregivers appreciate what is really happening and why.
If your loved one seems reluctant to seek treatment, perhaps the biggest problem isn't the cancer itself, but the battle fatigue that accompanies it. What are the chances that your loved one can get past the obstacles and go on to live comfortably with the disease under control for several more years? Is there a reasonable expectation that the cancer can be brought into remission with treatment?
Sometimes the hardest job for a caregiver is to understand the real prognosis for the disease. When people talk about quality-of-life care, some will avoid it until the last minute, because they hope desperately for a cure. They're willing to fight the fight and take on all the discomfort that goes with that. Some of these people would benefit from understanding the reality of their prognosis, that end-of-life care can be a better option. Sometimes people need to live their lives more than they need to pursue the potential brass ring. But other people sometimes opt for surrender long before that may actually be the best option. If a disease is manageable and the quality of life can be good with treatment, people need to understand that a negative mental attitude can prevent them from pursuing viable opportunities. If there is battle fatigue, patients often won't see the potential for a future. If they are scared from their emotional and physical battles, they will think it isn't worth fighting anymore.
Cancer treatment is always more than just surgery, radiation, and chemotherapy. It's about helping the patient and the family understand that there are so many details in treating the disease.
Every combat veteran on the battle field dreams of the day he or she can go home again, to live in peace and leave the war behind. Your loved one is really no different. Cancer is an enemy that wages war with a ferocity that can intimidate. Help your loved one to recognize the realistic opportunity to survive. Keep the home fires burning. Work on the morale of your loved one. That what real support is all about.
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