Thursday, March 3, 2011

THE RIGHT TREATMENT


When Jack, a recently diagnosed member of our cancer support group, said he hadn't yet chosen a treatment, other members voiced their concern.

“Cancer cells don’t take time off, you know,” advised one.

Jack said standard oncology was too toxic for his taste, so he’d first like to try alternative approaches like dietary regimens and coffee enemas. Two weeks later, though, he hadn’t begun alternatives, either. Other members began to lean on him, even suggesting that his strategy was flat-out wrong. During a lull in the conversation I found them looking my way, presumably because as group facilitator and ostensible medical arbiter, it was up to me to convince Jack of The Truth.

That moment begged the question of “support's” nature. Would supporting Jack mean aiming to extend his survival? Maximize his life quality? Keep him from wasting his time with quacks? Help him access a miracle? What are we after, here, anyway, in a world that has no guarantees?

It's strange that while knowledge of cancer generates confusion in the newly diagnosed, everyone else knows clearly what to do. Opinions flood in, along with books, clinic ads, diets, prayer cards, crystals and affirmations. Apparently there are as many routes as ways to slice an onion. Obviously, no one can buy into all of them, especially the ones that are mutually contradictory.

This emotional maelstrom following diagnosis is one of those rare moments poets describe, the intersection of crisis and opportunity. While the stakes are high and treatment choices abundant, there's little clue as to which might prove most effective. That's why a helpful act at this point is to simply stop and contemplate the situation. When we do that, the question, “What to do?” becomes, “What are my deepest values, anyway? What do I really believe in?”

Over my forty-some years in this business, I’ve seen people choose hither and yon. Sure, most opt for standard oncology, and most of those throw in an alternative or two as well. Some go wholly for alternatives. Of those approaches, many look weird even to me, and I’m not exactly orthodox. Occasionally, when someone heads toward an intervention I believe to be harmful (one example: intravenous hydrogen peroxide), I warn them. A few people opt for no treatment at all. And you know what? An individual's success—defined sometimes as longterm survival, sometimes as contentment—correlates best with his or her faith in the chosen direction.

These are adults, after all, making mortally personal decisions. I'm not about to frog-march them down to the oncology clinic since I’m not sure which way I’d go if I were diagnosed. My own history includes treatments that range from standard medicine to visualization to pranayama. I don’t feel mandated to influence anyone toward any particular treatment.

To me, support has come to mean helping people navigate this slippery reality. It's no easy task for any of us since, as the Wise Ones say, “If you can see the path, it can’t possibly be yours.”

So what does Jack need? For him, now, support consists of unconditional love. In fact, when should it not?

5 comments:

  1. The Irreverent ReverendMarch 8, 2011 at 7:05 AM

    Sounds like you are doing spiritual care in there Dr......right on!!

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  2. Might I add, everyone who hasn't had a kid also knows precisely how to raise them...ha! Just went through that with my sister advising me...now that SHE has her first kid, the shoe is on the other foot...
    Same with all this hoopla about "what teachers need to do." Folks, it's a community effort and before we solely blame the teachers, how about figuring out how to get more jobs and better wages so 25% of kids aren't homeless and growing up in poverty? (As just featured on 60 Minutes?)

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  3. DreamsAmelia,

    You're spot on, as usual. For that reason plus your passionate writing, I've included a link to your blog, Shelved In Cyberspace. And thanks for linking my blog in yours.
    - Jeff

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  4. Dr. Jeff,
    thanks so much for your insights in the world of cancer care, specially in that decision making period to go or forego conventional treatment choosing quality as a priority over quantity.

    I hope you can help by bein an arbiter for WOM in this discussion board

    http://community.breastcancer.org/forum/79/topic/765299

    - regards Ruth (nanay's daughter)

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  5. Hi, Ruth,

    I looked at the forum. What's an arbiter there?
    Thanks,
    Jeff

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