Recently I got a comment from cancer caregiver who was finally able to come to terms with a friend's death following a long battle with the disease. It raises an important issue, one that deserves some serious consideration. What happens when a cancer patient gives up the fight?
I remember when my very frail mother was facing cancer treatment on that first day. The radiologist gave her a lecture, in the kindest possible terms, that set forth an important reality. Unless she was willing to do the work, there was no point in him treating her. Sounds cruel? It was actually a positive thing to say to a woman who was struggling with her feelings about having cancer. He put her in the position of deciding whether or not she wanted to fight. That was very empowering for her, because it stripped the cancer of all control and returned some of it to my mother. No one could do the work for her. We could only support her.
He also said that she had to treat eating as part of the prescription for improving. Just as she would expect to take a pill because it would make her better, she had to force herself to eat, even when she didn't feel like it. We worked hard to find foods she could tolerate, and in those moments she balked at just one more bite or one more sip, I would simply remind her that it was good medicine for her. "The doctor said...."
My mother did improve. Despite many complications, she outlived her prognosis by several months, time she used to get her affairs in order, to finish what mattered to her, and to decide when she was ready to stop fighting. And in between finding out she had cancer and succumbing to it, she managed to fit a lot of living into her "to-do" list. You can really only enjoy life when you appreciate it.
Cancer patients often have mixed feelings about what to do when they receive that dreadful news. That's certainly understandable. It's a scary road. Some cancers are treated aggressively and the course can be difficult to endure. Patients have to be committed to doing the work involved.
As cancer caregivers, it's important for us to understand the issues involved for our loved ones. What is the treatment? What does it take to optimize the outcome? And what happens when a patient begins to give up?
Not every cancer patient has the same tolerance level for treatment. Some patients are tougher, hardier than others. Some are too timid, too ready to quit when there's a light showing at the end of the tunnel. And some are just plain tired of fighting, especially after the years begin to add up.
If you find your loved one is feeling like it's time to raise the white flag, you need to take a hard look at what's going on. Are there new symptoms popping up? Is depression sapping your loved one's energy? Is the treatment too harsh for your loved one's battered body? All of these things can affect a loved one's motivation to continue the battle, but not all of them are necessarily physical limitations to how far a loved one can go in continuing cancer treatment.
First and foremost, what's really at the heart of your loved one's fears? If it's a physical issue, it needs to be addressed by the medical team. Some drugs aren't well-tolerated by patients, and rather than stick to the course, it's likely the oncologist can make a change and improve your loved one's comfort. When comfort improves, motivation often goes along for the ride. Sometimes, if a new spot of cancer pops up, it can be easily treated, but only if the cancer team knows about it.
But when it comes to the spirit, things can become very complicated. A good cancer caregiver is an advocate for positive action. Sometimes that means hearing what the heart is really saying. You can't help your loved one fix what's broken if you don't understand what the problem is. Any cancer patient can feel overwhelmed at times by the disease and its treatment. Even without cancer, some people find life challenging. Knowing the difference between a blue funk and something more serious is important. We cancer caregivers walk a fine line when we encourage a cancer patient to go on struggling in the face of overwhelming hardships. In the end, it's really the cancer patient who decides when enough is enough.
That said, it all comes down to more than just motivation. It also comes down to finding the best treatment options for a patient who is willing to do the work. Cancer treatment is work. Some things have to get done. Compliance with chemotherapy, radiology, surgery gives a patient a better chance to make it through to the other side.. Good nutrition to maximize treatment options and minimize side effects means a patient is going to feel consistently better than someone who doesn't make the effort. But most of all, knowing that the treatment options were thoroughly vetted means a patient is likely to remain motivated to get through it. We hear that phrase a lot, "the best doctors", but there's a good reason why it's important to seek the best medical care you can find. Those "best doctors" are up on the latest treatments, the clinical trials available, and the options that offer the best hope. And without hope, it's hard for a patient to stay the course in cancer treatment.
Hope isn't something borne of magic fairy dust and imaginary vibrations. Hope comes from a deep-seated belief that what is being used is tried and true. It doesn't involved guess work or experimentation. Hope is all about "this is what has been shown to be the most effective way to treat this situation". When you and your loved one take the time to to do the research on what's available, it's much, much easier for you, as cancer caregiver, to help your loved one stay motivated, even on those tough days.
Think about that. If your loved one doesn't believe that what he or she is going through is going to make a difference, it's more likely that your loved one will surrender when the going gets tough. Like the Little Engine That Could, your loved one has to feel that "I think I can, I think I can, I think I can..." until it becomes "I know I can, I know I can, I know I can...." We're all human, and we all sometimes cave into our emotions, ignoring physical evidence because we feel something. That's why, when motivation starts to slip, it's important to help a loved one focus on the facts. What do the tests show? What's the normal course of action? How long does it take to notice positive results? Start with the best medical doctors and the best medical treatments to insure that your loved one remains motivated throughout treatment.
Each of us wants to feel that life is worth living because that's what gets us out of bed in the morning. We normally look forward to the start of a new day because we're motivated to make the most of it. Sometimes, when cancer totally overwhelms the body, mind, and spirit, it rob us of that joie de vivre. If your loved one is struggling to find a reason to go on fighting, don't despair. One way to recapture some of that motivation is to put the cancer aside and just live like it's not there. Make a habit of ignoring cancer at least once a week. Start small, an hour at a time. Build it up until you have a "cancer-free" morning, afternoon, or evening, not because you're in denial that your loved one has cancer, but because it will give your loved one a chance to let go of the disease for just that little while and practice living again.
If you find that he or she is unable to do this, it may indicate that it's time to speak with the medical team about options, such as a session with a health psychologist, someone who understands that disease affects the psychological health of patients (and sometimes caregivers). Living with cancer is important. Otherwise, your loved one is just surviving, and that's no fun. Carpe diem!
For more help as a cancer caregiver, visit The Practical Caregiver Guides
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