Guest guest Posted November 22, 2010 Report Share Posted November 22, 2010 Thank God, in America, the government or well-meaning people cannot force us to have treatment. By your description, this person is coherent (has a blog), knowledgeable, and opinionated. I fail to understand why you would even think of posting his blog name, or his name, or whatever. I've known several people with terminal illnesses who are tired of fighting. They are in pain, they are fatigued, or they are suffering from the side effects of treatment. They have chosen to stop fighting and given in to their diseases. One was one of my parents. It is indeed difficult to deal with your own feelings at a time like that; but they are...YOUR feelings. You've said your piece to this person, recommended ways of getting care, and so on. That's enough. For you to want to do more is understandable. For you to actually violate this person's expressed wish to not have treatment is troubling. And for Dr. Furman who likens this to suicide, I don't agree. For all of the above reasons. We can't force this person to get treated. We treat him like the adult he is. Thankfully. > > > > I just had this discussion with a CLLer who refuses all treatment on the grounds it won't do him any good or extend his life, while being toxic. > > I believe in the accurate usage of the word as you cite it, yes it is palliative, except sometimes people don't have recurrences for 10 or more years. So, in CLL, it is a grey area. > > Treatment generally does not cure; hence palliative.. .but being disease or at least symptom-free for 8,10,12 years is a lot more than most of us mean in the general parlance. > > I think we use " palliative " to mean treat the symptoms, but the patients will die anyway. With CLL, it may be treating symptoms, but we hope it also extending life. Another wrinkle is that treating symptoms or complications of CLL may in fact be life-saving. I would avoid calling CLL treatments palliative, not because it is incorrect technically, but because it's general usage makes it sound like we mean it only makes you feel better, but doesn't extend life. Sometimes that's true, but we all enter treatment hoping and believing it is not.. > > Heléne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2010 Report Share Posted November 23, 2010 I very much respect your opinion. There is nothing more important than choice. The one obligation we all have is to make sure decisions are being made with accurate information. Many people have misconceptions regarding chemotherapy and would approach it very differently after having completed it. While I would never say it is a " good " experience, the vast majority of patients feel much better at the completion of chemotherapy than before. You will always find exceptions, but most do better. Many of my patients have heard my statement that my most important role is as a " cheerleader " . In summary, everyone gets to make their own choices. I would feel awful if someone's choice were not made with all of the necessary information. Rick Furman > > > > > > > > > > > > I just had this discussion with a CLLer who refuses all treatment on the grounds it won't do him any good or extend his life, while being toxic. > > > > > > I believe in the accurate usage of the word as you cite it, yes it is palliative, except sometimes people don't have recurrences for 10 or more years. So, in CLL, it is a grey area. > > > > > > Treatment generally does not cure; hence palliative.. .but being disease or at least symptom-free for 8,10,12 years is a lot more than most of us mean in the general parlance. > > > > > > I think we use " palliative " to mean treat the symptoms, but the patients will die anyway. With CLL, it may be treating symptoms, but we hope it also extending life. Another wrinkle is that treating symptoms or complications of CLL may in fact be life-saving. I would avoid calling CLL treatments palliative, not because it is incorrect technically, but because it's general usage makes it sound like we mean it only makes you feel better, but doesn't extend life. Sometimes that's true, but we all enter treatment hoping and believing it is not.. > > > > > > Heléne > Quote Link to comment Share on other sites More sharing options...
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