Peter Pan, as written by Scottish author J.M. Barrie, expresses the idea, “To die will be an awfully big adventure.” Peter, the eternal child, doesn’t fear the possibility of his death. It’s simply a thing he hasn’t done yet. His attitude towards a final end is not sad or depressing. It’s not exciting either. It’s an experience to be had, and it’s one Peter chooses for himself.
There may come a time when the tide is rising, and there’s no Never Bird around to save you from drowning. That will be the moment you’re called on to decide whether to cease treatment for your cancer. It's possible you will choose the same thing. It may even be that you should make that choice.
A Shorter, Better Path
Cancer treatment varies in intensity, depending on how severe it is. Doctors, from the outset, typically select the most aggressive treatment they feel is appropriate. There are no half-measures when it comes to tackling this disease, in any of its forms. Even so, there are many reasons to choose to end cancer treatment.
It might be that the mathematics of life extension no longer add up to a positive number. Results and options may be in short supply. Chemotherapy side-effects may prove unbearable. Whatever your reasons are, the important thing to remember is that they’re your reasons. Ceasing cancer treatment, upon consultation with a doctor, is a valid option. Sometimes it’s even the best path to take.
Expect Resistance
Stopping treatment should be given significant thought. The reason you choose to end treatment is important. It’s possible that an impulse to stop is the result of depression or fatigue, which is why it’s important to consult a doctor prior to making this choice. It may be better to treat your depression and force through the treatment that offers a significant chance at a longer, more comfortable life.
In the event that treatment isn’t providing results, or your cancer grows despite all efforts to treat it, a switch to palliative care offers a chance at a more comfortable end to life. However, it’s likely you should expect pushback to making this choice for yourself.
It’s natural for loved ones to want you to stay for as long as possible. It’s also natural to want to oblige them. Coming from this place of love and fear, however, also makes it far too easy to choose an unpleasant, tortured end to your life – one that neither you, nor they, will appreciate experiencing.
Doctors may also come into this. No doctor likes to see a patient pass, and may press on with treatment – at your insistence – beyond the point where it remains rational to continue. After all, there’s always a chance. Only, sometimes, there isn’t.
It’s Not A Fight
Cancer treatment is often explained in terms of battle – you’re asked to fight against an invading presence. Friends and family will beg you to not stop fighting for survival. That can be a very unhelpful analogy. It does significant harm to your mental state when you find yourself unable to ‘win.’ Nobody bothers to explain that nobody has ever won this fight. Death will eventually claim everyone. You are not special in this regard, and it doesn’t make you a failure. You’re not a coward for choosing a shorter life over a longer one.
It takes far more bravery to accept that you will die, and make the most of the time that is left to you. Choosing between six months of quality, loving interaction with your family or eighteen months of intermittent visits, constant pain, nausea, and tests, (with the same result at the end of it all) isn’t hard. The longer route only makes sense if you’re merely counting the number of days available.
Accept The Honor
Those diagnosed with terminal cancer are given a rare gift. They are permitted to choose the manner of their death, an honor not afforded to many in this world. A time may come when it makes more sense to choose a handful of months spent clear-headed and in the company of those you love over a drawn-out period of addled side-effects. It takes a considerable amount of bravery to choose the former, but they can be the most free, full months of your life.
Why? Because the end is certain. When the outcome is predetermined, there’s no need for worry. Stress falls away. Fear may be present, but it’s a known quantity. Mostly what is left is the person themselves, choosing how they want to experience their limited days. Perhaps it’s telling your children and partner you love them. Perhaps it’s creating something to leave behind. Perhaps it’s helping others. Maybe it’s simply filling your mind with sights and sounds that leave you feeling content. Few are given such an opportunity.
Knowing When to Stop
Ceasing treatment for your cancer is an option, but it tends to be a last resort. It needs to be done in consultation with medical professionals and family members. Most importantly, it needs to be for your benefit. If ending treatment will greatly accelerate the growth of your cancer, or actively cause your death on short notice, it may be better to continue. There may be experimental programs worth exploring. It may be that pain and other side effects are being suppressed by treatment, rather than caused by it.
But the opposite might also be true. Experimental treatments might not be available, or might have a very minor chance of working. You might experience less pain, brain fog and unpleasantness without treatment, and this could be treated by palliative means. You might be in less immediate danger of death by ceasing treatment. Choosing this path might lead to fewer days, but they might well be better ones.
And, most importantly, it’s always possible to restart treatment if you feel the need. Your doctors will always be willing to advise you on what options there are, at any stage in your experience.
Cancer is your experience. You will be tempted to make choices for your family and other loved ones. Often those choices will align with yours. But everyone dies.
Eventually, you must choose how you wish to meet your end, even if it seems selfish. It might disappoint your family if you choose a 100% chance of several months in their company over a 5% chance of years with them, but those months belong to you. You can spend them the way you feel is right.
