Many women want to be remembered for having tried absolutely every treatment possible. They feel this proves their love and commitment to their family, and to life. If you are a mother with young children, you probably feel this need most desperately. Even if you develop widespread disease and are simply lying in bed, looking and feeling sick as can be, just being there for your children may be reason and meaning enough. A month more of life can be worth it if your mind is at relative peace, even if your body is not.
Pursuing every last possible form of treatment can come at the price of increasing side effects and a great deal of misery for you and your family—including an unmanageable financial burden. This can be a bitter time for you. Perhaps your funds are nearly gone, and maybe your health care plan is unwilling to pay for one more therapy. Your doctor may be able to help you work with your insurance company to get more treatment.
But when the cancer is advancing despite all efforts, the physical, emotional, and financial cost of treatment can exhaust you and all those close to you. "Enough," your body and your family may be saying, though not in so many words, and you may sense their feelings. Realizing that you've reached the limit can increase your anger, depression, despair, and confusion. You may feel helpless to make your last wishes come true.
For others of you, it is your families who expect too much. They may urge you to pursue every available treatment and seem determined to prolong your life. But if you are close to death, you may just as soon stop your treatment in order to have peace and relief at the end of your days. This may make you feel cowardly, and guilty for betraying their love.
But you have to respect your needs. It's up to you to decide when enough is enough, when it's time to stop treatment—as much as you want to please those close to you. Can you say it, or do you need your doctor or religious counselor to step in? When the possibility of remission may no longer be real, controlling your care and how you want to live until you die should rest in your hands. You have to do it your way.
End of treatment
The point will come when your anti-cancer treatment ends. It may come at the moment of death, or you may decide to end it before then. This could be the hardest decision you have ever had to face. Or it may simply feel like the right thing to do. It's not up to your family, but having your family's support for whatever decision you make is crucial.
You may worry about being abandoned by your doctors after you stop anti-cancer treatment. But they can still be actively involved in your care. However, you may be giving up regular visits to your doctors and regular tests. You may no longer be seeing the caring nurses, therapists, and secretaries. You may miss the camaraderie of the patients in the cancer center.
Your care still continues and may even improve when you decide to stop anti-cancer treatment. At that point, you can get access to a whole new realm of care at a hospice or with hospice services in your own home. Most insurers pay for hospice care for patients who are expected to live less than six months. So hospice may not even be an issue for a significant period of time.
You receive this care in your own home, or at a hospital or hospice facility. Hospice tries to improve the quality of dying by providing:
- pain relief and other medical supportive care
- psychological and spiritual support for you and your family
- help with daily living tasks such as bathing and dressing
Once you are in hospice care, you get visits from nurses and home health aides as often as needed. Your doctor usually still oversees your medical care. But your hospice nurse becomes your main source of medical care. She talks to your doctor when medical problems come up that need a doctor's advice or prescription.
The hospice experience helps many families to transition between the urgent search for answers through medical care and the acceptance of what has been and what is to come. It can help you and your family make your peace—not only with death but with life as you have lived it.
"My oncologist told me something that I will always remember. 'You can wake up each morning and worry about dying, or you can wake up each morning and celebrate living. Before you know it, several years may have passed. Do you want to waste that time with mourning, or use your time to celebrate?' "