By Larry Rees – The Guardian.
Contrary to Dr Richard Smith’s piece in the BMJ last month, the psychological effects of cancer and the toll of chemotherapy make it a far from ideal way to die.
“Cancer is the best way to die,” declared Dr Richard Smith in an article in the BMJ last month.
And what’s more, we should “stop wasting billions” trying to cure it.
As an oesophageal cancer survivor of nine years – and now a terminal pancreatic cancer patient – I was deeply offended by Smith’s assertions.
My first reaction was to pen a scathing attack on the author and publisher who, in my humble opinion, acted irresponsibly, resulting in a global media frenzy that focused on those shocking sound bites.
But on reflection, I concluded that I should not focus on the offence, but engage in the debate and test the hypotheses that Smith’s article put forward.
So, is cancer really the best way to die? Richard suggests two reasons for this hypothesis:
- A slower death gives you time to put your affairs in order and resolve your goodbyes.
- A cancer death is only unpleasant for a few weeks at the end.
Well, I’m now in my fourth month of my death sentence, and I will share with you my direct experience on these two points.
To be fair to Richard, I do believe that a slower death has the benefits that he suggests in his first point. BUT – and it’s a big “but” – this would apply to many other terminal diagnoses as well, and is more an argument for delayed versus sudden death, NOT an argument for cutting back cancer research per se.
Additionally, I would point out that it really doesn’t take very long to put your affairs in order. In my particular case I would say that I had mostly completed this part of the process in 2 to 4 weeks, which included legal, financial and communications with family and friends.
So let’s move on to the second point: a terminal cancer death is “only unpleasant in the last few weeks”. Sorry Richard, but you couldn’t be more wrong. Here are some insight into my own experience.
While I was on post-operative chemotherapy, when I was faced with the reality that my cancer had spread, I went into denial and thought that my medical team must be wrong.
I inundated them with questions, and suggestions of how my previous history of liver aberrations could be responsible for a misdiagnosis.
Of course I realise now how futile that was. But I needed counselling to help me to that realisation. However, what this highlights is that I was immediately suffering from the news. That meant not being able to sleep, not being able to get it out of my mind. Being scared, bewildered, confused and angry.
Now as I highlighted earlier, those feelings would probably be appended to any terminal diagnosis. But I had already undergone a Whipple operation with extreme difficulties because of my previous oesophagectomy, and had spent 24 weeks in post-operative chemotherapy.
On top of this, I was convinced that I had yet again miraculously beaten “the big C”. I felt strong, (well strong-ish) and was holding my weight. I was planning to return to my high-powered job.
But the moment those liver lesions came up on the CT scan, it all got dashed on the rocks.
So, sorry Richard, but the psychological impact is way bigger, and occurs earlier, than you seem to realise…read more.