A good quality of life issue to consider when terminal.

interesting but I won't be sending the article to my mum who is fighting until the bitter end with chemo, tarceva, you name it.

It's a hell of a feat to ask someone who believes in miracles to give up hope and expect them to do so.

The article ignores the complexity of the human spirit.

Post Edited (davidg) : 3/4/2014 7:57:37 PM (GMT-7)

thanks but I'm going out fighting and I hope the insurance companies don't like it

ed

“Recently, the American Society for Clinical Oncology identified end of life chemotherapy as one of the top five practices that could improve patients’ care and reduce costs, if stopped."

ahhh yes.

ed

I think it's most important to tell family what we want if we ever get in that situation. We just watched my mother in law die from cancer. She was with family instead of in a nursing home so that was good, per her wishes. But the morphine to keep her comfortable put her into a state that she never wanted back when she was able to express what she wanted.

Well put Logoslidat!!!!
Michael

Most of you know from my posts that Mark is now an inpatient at our local Hospice facility. The thread topic caught my eye. QOL is so important to many and the guys who have been through HT or chemos or surgery/radiation with post op problems understand that QOL can have many meanings. I think it depends on where you are in the process (journey). When you have exhausted almost all medical options, and there is one more treatment out there, some of you will go for it. You will fight until there are no more options. Sometimes this means you end up in the hospital with SE's. If you don't have a living will, healthcare surrogate or a DNR when you get to this stage, the medical establishment will take over. You have lost your options for choosing what QOL means to you. Mark fought all the way to the end of his medical options. He was barely able to dress but insisted on going to his Xofigo injection. He needed to have his last face-to-face with his oncologist to close the book on medical intervention. Through all of this, he said "no hospitals!"

It seems like most of the guys on HW want to be aggressive, to hit this PC with everything they can. Perhaps many on HW are young men, in their 40's and 50's, and willing to do whatever it takes to live. We do hear from others who will choose less medical intervention and perhaps a better QOL at the end. Everyone has the right to make their own decisions, hopefully consulting with their loved ones, and communicating their wishes to the medical team.

To David/Purgatory and Logo...I think you nailed it, again, only my opinion.
Pat

I want to think that I have the courage to live out my life to its end without fighting the inevitable, without exhausting myself and putting my people through the trauma and drama of watching my long slow death.

We are going to die. Each one of us. Somehow. And for some of us here we will die of prostate cancer.

Looks like that's how I'm going to die. Earthquakes and traffic accidents aside.

We need a topic about making the most of life when the click clicks.

When I was much younger and reading about death, about how people doomed by some diagnosis discover the meaning of life, I tried to think myself into it. I thought of it as grabbing the ring, but I could never do it.

And now it is clear. I am going to die and to die probably soon.

Some want to go down fighting to the end as if they could actually fight hard enough to live forever.

I don't want to spend my final days in some war against an unbeatable enemy. There is more to life than that.

There is a difference in fighting a losing battle, getting tired and letting nature take it's course and not fighting at all

there it is there Todd. that's what I believe. i think if we as a species were disposed to make preparations to roll over and die while we are still perfectly healthy we would have been extinct a long time ago.

ed

Amazing how you guys are so certain. Fight or roll over (to those who fight).

Die with dignity and know when to quit, or just blindly fight.

I suspect I would fight to the end, but I really don't know. Cheryl and I have our advanced medical directives on file. We do not want to be kept alive by heroic measures unless an increased QOL is a possible outcome. To me, the worst horror is losing my decision-making ability and letting the medical establishment fight to keep me alive a few more weeks...as a quasi-vegetable.

I have learned through experience of friends and loved ones that it is crucial to have a loved one in there watching out for your own interests when you can't.

Even with my incurable PC, the question for me remains largely academic. I have no answer. I won't know until I get there. Hopefully, my doctors can forestall the day of reckoning for many years. But...who knows?

Mel

I vote for large doses of morphine

I have to agree with Purg's statement that it is the right (responsibility???) of the person to make the decisions. AND I would add TO START THINKING about THOSE DECISIONS EARLY- AND TO REVIEW THEM OFTEN. Everyone in my family now has a living will/advance directives. Each has spelled out their current preferences about what kind of treatment/interventions they want and don't want. We had them before my husband began to deal with PC. We can change them at anytime. Our children all know our wishes. If we change our minds we will be certain to inform them and change the documents. In addition, we have explained our desires regarding our cadavers (we don't want to be buried- we are donating our entire , whole bodies to medical research or medical schools for cadaver/anatomy studies). We put that in our wills, too. They can hold whatever 'service' or 'celebration' they want to- we have expressed a few desires about that, too, but see that as more for them than for us.

Our children (ages 35 and 27) have begun such conversations with their spouses and our daughter and husband have already executed their living wills. Our son and his wife are still talking (he just turned 27 toady and she is only 23). My mother-in-law already has executed a DNR (do not resuscitate)order and a MOST (medical orders for standard treatment) which serve as back ups to her living will and actually REQUIRE doctors and EMTs to follow her wishes regarding specific treatment standards. It will help forestall any family 'disputes' about 'what Mama would want'.

I STRONGLY encourage everyone to begin having such conversations with their spouses, children, other family members, and even close friends. Then prepare the documents your state requires to ensure YOUR wishes are carried out. DESIGNATE A HEALTH CARE POWER OF ATTORNEY WHO WILL CARRY OUR YOUR WISHES AND GIVE HIM/HER THE AUTHORITY TO DO SO WITH THE CORRECT DOCUMENTS. It doesn't matter which 'side' of this question you are on. There IS NO ONE RIGHT ANSWER! ALL ARE RIGHT! Just right for different people.
There is a web site that might help if you find such conversations difficult. It is called aging with dignity or five wishes. There are other sites too.
http://www.agingwithdignity.org/five-wishes.php

If you are interested in info about becoming a cadaver donor, please contact me or do a search on the web. There is a shortage of cadavers for medical students, nurses and other medical professional to use in their training and also for medical research studies. (My father-in-law donated his body to UNC-Chapel Hill Medical School and my father's body was donated to Anatomical Gifts Registry- parts of his body went to at least 5 different studies!)

Worried: you brought some very important points to this thread, well said
===========

It's very important for everyone here to at least give some serious thoughts to some of the legal points being made in this thread. If you haven't thought about any of this, or if you are avoiding it, or just not comfortable about talking or thinking about the "end", you need to come to the point where you can and you will deal with these details. It may not seem important now, but one day, under much harsher and more severe and stressful times, you will have wished that the end details had been well mapped out.