“Therapy” was put in the “What to talk about” section of this web site. I am not sure of the meaning of this request. There are many kinds of therapy: psycho, physical, occupational, massage, music, art, and on and on. I will address chemo since that relates to end of life issues.

Wikipedia definition: Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is the treatment of cancer with one or more cytotoxic anti-neoplastic drugs (chemotherapeutic agents) as part of a standardized regimen. Chemotherapy may be given with a curative intent or it may aim to prolong life or to palliate symptoms. It is often used in conjunction with other cancer treatments, such as radiation therapy, surgery, and/or hyperthermia therapy.

In simpler terms chemotherapy is a program of drugs used for the treatment of cancer. It is not necessarily given with the intent to cure but very often is used to “prolong life” and/or to relieve symptoms created by the cancer.

What I have found is that most people think they are taking chemotherapy to be cured. They expect to return to their normal way of living, disease free. We seem to be able to adjust and deal with very difficult situations when we believe the end result will be a positive one. For some cancers that will be the case. The cancer will be gone and they will be disease free. A side note here is that they will remain worried and concerned about the cancer returning forever so really their life will not return to “normal” but it can be a good, actually great, life that they are given by enduring a difficult treatment.

For most people receiving chemotherapy their life will not return to “normal”, they will not be disease free and will in all probability die from the diagnosed cancer. For some they will buy time although it will be time spent being sick, weak and generally incapacitated. For others it will actually speed up their death due to the side effects of the drugs themselves. For all, chemotherapy will affect the quality of the life they are living and possibly will ever live.

I am not against chemotherapy. I am for treatment/no treatment choices based on knowledge, realistic odds, information and projected outcomes (tumor elimination vs shrinkage, percentages, realistic time frames). Too often we are overwhelmed with the information we are given. We don’t really understand the medical terms and implications. We don’t ask enough questions (because we are terrified of the true answers).

My recommendation is to have an advocate with you when you ask important questions of your physician. Someone who will listen with you, ask questions, help you process. The Internet has put a world of information at our fingertips. We need to use it to research the disease and treatment options for ourselves. Knowledge reduces fear and helps us to make wiser decisions. Get a second opinion before you commit to any program. Not from a physician in the same office, clinic or health system but someone as far away from the original physician as possible.

If we don’t die a fast death we will either die from a disease or from old age. This is part of life and we will all experience it. The question is not, “Will we at some point in our life have to make decisions about chemotherapy for ourselves or someone close to us” but “When?” Knowledge will help us make choices we can live and die with.

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