Monday, August 6, 2012

In Defense of Chemotherapy

News stations are reporting that chemotherapy can actually make tumors grow, increasing their aggressiveness. My first thought upon hearing this was that people might unnecessarily turn away from cancer treatment on the assumption that chemotherapy does no good.

Back when I did my teaching practicum in the pediatrics department of a big city hospital, I used to sit with children who had any of a variety of ills. I met a wide range of children with cancer, from those with brain tumors to those with leukemia. Back then, the survival rate was dismal. Cancer was a death sentence. Cancer treatment was a tiny ray of hope to cut through that death sentence. In some cases, it was a little more time. In others, it was remission until the cancer kicked in again, if it did. We've come a long, long way since those days.

Even in my mother's case, that chemotherapy made her life better for a while. When I recall the days before her lung cancer was diagnosed, I remember days when she could not leave her chair because breathing came with great difficulty. For months, she had complained to her pulmonologist that she was having trouble. He chalked it up to emphysema and COPD. "Put her in a wheelchair," was his solution. It was only when an infection landed my mother in the hospital that the cancer was found. By then, it was inoperable. That's why I defend chemotherapy as a tool. I understand the effect it had on my mother and I know she was glad for the extra time she had to prepare for the end of life.

I say that she had extra time because that cancer was inoperable. She was already dying when the cancer was discovered. She was unable to eat, weak, stuck in a wheelchair, miserable and frustrated. Without that chemotherapy, she would have died much, much sooner. And there is much she would have missed in life.

Cancer can move quickly in some cases, slowly in others. For my mother, the extra time she had to live her life allowed her to finish the unfinished things that weighed on her mind. And when she felt that the struggle was more than she wanted to continue, she chose to stop. She was lucky. She had a great oncologist who was very supportive.

So, for this elderly woman with inoperable cancer, what did chemotherapy do for the extra months of her life? My mother went from being stuck in a chair, because she couldn't breathe, to getting out, traveling, having fun. She was able, for some months, to give up her oxygen tank, that heavy weight that constantly reminded her she couldn't breathe. That was freedom. That was heaven for a woman who lived to eat at her favorite restaurants and to go for long drives to see the sights. It was Red Hat gatherings with the ladies and senior lunches at the community center. It was family celebrations and reunions. The chemotherapy helped shrink that cancer enough that she could breathe on her own and she made good use of the extra time.

It's easy to think there is no point in going for chemotherapy when you hear news stories telling you that chemotherapy can make cancers grow. That's not necessarily the whole story you need to know. Cancer is a tough disease, and in the last fifty years, there have been many, many new ways to treat the disease. Every day, researchers are working hard to find the new medications that will target it more successfully. Every day, oncologists and hematologists are tweaking chemotherapy treatments to be less damaging and more effective.

Cancer treatment is always complicated by individual needs, by how the body handles this drug or that. No two patients are the same, and the better doctors get at profiling the cancer and determining the best course of treatment based on the type of cellular and molecular issues involved, the smoother the treatment goes.

Before you consider stopping any cancer treatment, ask for information that is specific to you, to your cancer, to your loved one's cancer. Don't ask your neighbor, your garbage man, your cashier at the grocery store, your Aunt Gert who runs a gift shop, or even a stranger on the street. Ask your medical team, the people who are on the front lines in the war on cancer. Ask those who have seen what works and what doesn't work over years, who have seen what happens to people who are treated and those who are not. Ask what your survival rate is without it. Ask what your survival rate is with it.

So many things have changed about chemotherapy treatments over the years. Some cancers are less aggressive than others, and over time, researchers have found that sometimes no treatment or a little treatment is better than a lot of treatment. That's why we need good researchers. That's why we need good studies that take a hard look at every aspect of cancer treatment. We should not fear finding the answers, even if they take us in a different direction. We need to know the truth about cancer and about its treatments.

When all is said and done, you want to survive cancer as well as is possible. You want quality of life, so you can spend your time doing what matters most to you and your loved ones. You want to manage your disease, so that it doesn't manage you. Don't let the news reports about chemotherapy terrify you or turn you away from chemotherapy that can make your life more comfortable and keep you active longer. Wonder, ask, demand, seek -- be active in the fight against cancer because it matters, life matters, you matter.

For more help with your role as a cancer caregiver, please visit The Practical Caregiver Guides