Treatment for metastatic cancer can mean asking a tough question every single day.
Martha lives in Illinois and was diagnosed with metastatic breast cancer in January 2015. She has a husband and three children, ranging in age from 12 to 18, a dog and a lizard.
"Can you live like this?" asked my oncologist at my last visit.
Closing in on three years with a metastatic breast cancer diagnosis, this was the first time she’d asked such a question. I honestly didn’t know how to answer. My first thought was that there really isn’t an alternative and what, exactly, was she referring to with the word "this."
I didn’t say either of those things.
I said, "Yes."
Because, really, there isn’t a great alternative for me, right now. The treatment is still holding me steady and, fingers crossed, will hopefully continue to do so for some time to come.
A lot of times, when a patient goes to another drug, I finally find out that the side effects were making life miserable, she continued — although not in those exact words.
That would be me," I answered. Patient know thyself, right?
Maybe I could explain away a lot of my silence. Female, 52, introvert, high pain tolerance, Midwestern, Scandinavian, etc., etc. But I know it’s always better to speak up about side effects and quality of life than to remain silent and accepting.
It does take me a while to get to the point of saying something though. It’s a problem I work hard to overcome. Sometimes, a friend will point out that quality of life is really what matters and that, as a metastatic cancer patient, it is what I should be concerned about. But at what point does the quality of life outweigh life?
I suppose I’ll know that point in the scale when I reach it. For now, though, I do what I can to alleviate the "this" in my doctor’s question.
I can continue to come to the hospital for a treatment that makes me feel a little out of it for a few hours, for scans and EKGs, and blood draws, and whatever else the doctors think I need. I can find ways to live with the anxiety of my diagnosis, to find the good and positive while not pretending the bad doesn’t exist. And I can be grateful for my smart, kind, rushed oncologist’s question that told me she understands ongoing treatment and life with cancer is not easy.
There are a lot of things a person with metastatic cancer lives with that just isn’t what others experience. The idea that quality of life matters to patients would seem to be a no-brainer, but in truth it is frequently ignored or shoved to the side for a variety of reasons, the most hurtful of which is the unspoken sentiment of "Well, you’re alive aren’t you?"
Beyond the understanding that my doctor showed by putting into words the question that we must ask ourselves, I was grateful that she seems to be attuned to the focus on patient experience. It’s been almost a month since that "Can you live like this?" and it’s now a question I ask myself daily. I try to be honest with my answers and do something quickly about the "Nos" when they come up. My doctor would be so proud.