Redefining Hope in cancer

I spent 37 years caring for cancer patients. Cancer is a frightening diagnosis. Advances in surgery, radiation, chemotherapy, immune therapy and more recently targeted treatments ( designer therapy) not only increased cures but also increased survival rates for cancer patients.

Understandably, the definition of hope for those afflicted with cancer is cure. Unfortunately not every one with cancer can be cured. Does this mean they have no hope? Yes, they do have hope.

My definition of hope in those whose cancer has spread is “prolongation of quality and quantity of life”. This can be accomplished in many types of cancers with newer treatments. This message has to be shared by oncologists with their patients. A typical example of such hope is a woman I saw in 2005 with breast cancer. At the time of her diagnosis cancer already spread to liver and bones. Treatment resulted in disappearance of cancer in liver and changes in bones consistent with healing process, both documented in her scans. She maintained her job, maintained normal activity, watch her children finish college. As I write this, she has very tiny spots come back in liver and on a different treatment. She continues to be free of any symptoms.

How about in patients who have exhausted all treatments for their cancer. Is there any hope for them. Again my answer is Yes. At this stage of their illness definition of hope is “how to keep them comfortable”. Comfort can be accomplished by various methods including hospice, pain control, acupuncture and many more.

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