(My original post didn't work, so replying to it)
I agree hope is becoming a very realistic attitude for cancer patients with the exponential acceleration of research and findings. I of course wish the new information and formulations could be made available sooner to patients, especially access for patients with no conventional options (I know that is controversial, expensive, and statistically not shown to be very successful - I don't care). Before the microbiology revolution, hope was a mixed message -- would patients running out of options be better maintaining hope or learning "acceptance". Probably depends on your personality. But now I think we can hedge closer to the hope side because of the incredible research and development of cancer treatments. I think actually doctors are still stuck in the old mentality and when they see a situation the is typical of "end of life" they are quick to stop treatment and give up. Patients today are unfortunately still responsible for researching clinical trials or off-label treatments that might have at least a small chance of extending their life. Doctors think extending life only prolongs suffering, and sure, if the suffering is bad it is probably not fair to ask a patient to hold on for a slim chance. But because new treatments and trials arrive every day, extending life has a new meaning for patients. The dream is that you can kick the can down the road just long enough to get a really durable treatment and turn your disease into a chronic condition if not a cure. Since my wife died of ovarian cancer, I have come across several fairly benign off-label drugs that might have slowed her disease significantly - at least worth trying if the side effects are low. I believe more attentive and aggressive doctors could have not only extended her life but given her better quality of life in the final months. My advice to patients for now is, you still need to be your own doctor when it comes to anything not strictly conventional. In particular, research Metformin, Beta Blockers, COX-2 inhibitors, post-surgery anti-inflammatories (to prevent healing from stimulating the tumor - tricky but research is being done), TTF (tumor treating field devices for brain tumors), VEGF inhibitors with immune checkpoint inhibitor combinations, heat with chemotherapy technologies, even nanoparticles; there is so much out there. My philosophy is, if your prognosis is not good with conventional treatment, then you can consider gambling on some ideas which have very low side effects and where there is some evidence it might help. Although unapproved ideas can potentially hurt more than help, you need to understand the nature of the gamble - that you want a shot at outliving your cancer in return for some risk. I think motivated patients can do better than standard of care. And very important is to keep your overall health and fitness in as top shape as you can (yes, a fair amount of work. Try hiking and learn to enjoy all the wonderful benefits of it, the peace, calm, and beauty of the outdoors as well as the fitness).
Best of luck to all!
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