Chemo is a Beast
Recently I have been wrestling with how much chemo is too much.
Two patients come to mind who have died of chemotherapy-related complications rather than active cancer killing them. How do I justify recommending chemo for similar situations after this?
One patient had metastatic disease - meaning we knew curing his cancer was never an option. However, treatment had been keeping it well controlled, and he felt good (not back to baseline, but good).
The second patient had surgery to remove his cancer and was on adjuvant chemotherapy. Meaning, this chemo was given after all visible cancer was removed to decrease the chance that it would come back. Studies have proven this treatment does increase the length of most lives by killing remaining cancer cells that are not visible to the surgeon’s eye, thus keeping the patient cancer free for longer than if they didn’t have any treatment after surgery.
They both developed side effects from treatment which led to hospitalization. This caused a downward spiral and eventually they both passed away.
Not because their cancers were growing, but because chemotherapy is a beast.
I understand the research. I know why we give chemo.
I have seen chemo save lives, cure cancer, actually improve quality of life.
But you try sitting across from a patient with a case similar to these stories as they prepare to start their chemo and ask them to sign a consent form that lists death as a potential side effect.
Previously, I breezed over that. Now, I will be highlighting it (gently). Not to scare people away, I still know these treatments to be beneficial and have seen them prolong lives many times over. I just want my patients to be able to make the most informed decision possible.
They need to understand the risks.
And once they understand, I feel comfortable proceeding with treatment.
I have seen the helpful and harmful sides of these treatments; it is all about the balance. Together we review the pros and cons in order to continue prioritizing quality and quantity of life — to the level the patient chooses.
Chemotherapy is a beast, and it can save your life.
Thank you for being here,
