To treat or not to treat
I have recently been diagnosed with stage IV mbc (lungs). I’m not sure if I even want to undergo treatment, given that it won’t cure me. I’m 68 with co- morbitities. Just not sure it’s worth it.
Anyone else feel this way, just letting the disease run itsnatural course?
Comments
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Cflbf,
Let me start by saying that regardless of what anyone else has done, all treatment decisions are ultimately yours. You are correct that currently available treatments will not cure you or any of us at stage IV. You mention co-morbidities. Have you spoken to your mo about how your proposed tx will effect them? I am not pushing you toward tx but just want to make sure you have a complete picture of how it might effect you.
TBH, there have been few who post on bco that have chosen to let nature take its course. This thread is not very active but might be helpful to you.
https://community.breastcancer.org/forum/121/topics/852086?page=23#idx_685
You should also check out the lung mets thread.
https://community.breastcancer.org/forum/8/topics/780588?page=71#idx_2101
I have bone mets that were dx’ed ten years ago when I was 55. I had no idea at the time whether tx would be easy or hard or if my bc would progress. A lot of wonderful things have happened in those ten years and I’m glad I got to experience them. I have also had an unusually easy time with the course of my disease as well as not having co-morbidities. This has been my experience and is not predictive of anyone else’s experience
You know your health situation the best and you are the ultimate decision maker. As mentioned earlier we have had very few members at stage IV who choose no tx. Wishing you the best as you work through this.
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Thank you exbmxgrl. I greatly appreciate your input.
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Hi, I'm sorry you find yourself here with this diagnosis. It sucks and especially early on it can feel so terribly devastating.
I have lung, liver & bone mets & while I have super aggressive triple neg cancer, I'm still around 19 mos later, active & doing stuff (and active enough to fall & break my arm while getting my dog crate set up in my van - oops)
it's always your choice of course
if you give us more details about your cancer (esp if you can put it in your profile so it shows in your signature line) we could give you a better idea of what treatment might look like for you to help give you context as you make your decision.
Also don't discount that depression is common post diagnosis and that can bring its own problems and can cloud our judgement. It's hard to adjust to having a terminal disease...
I think one thing to consider is that 'letting it run its course' is not always fast and may or may not be peaceful.
ultimately you have to decide if you want to keep on trying to live. Again, I'm sorry you find yourself here
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moth brings up a good point. Letting it run it’s course may be long, drawn out, and painful so should you choose that option please be sure to have some type of palliative care lined up.
I can only think of one member who chose to do nothing, and kept posting. She would not even go to the doctor for a dx but posted on bco almost to the end. She had IBC which was aggressive but she still had to deal with it for a few years before she passed away and she sought no medical help until she was almost on her death bed. She was in her 70’s if I’m remembering correctly. Now, her choices, not to even be dx’ed, were extreme, but it was not a peaceful, gentle journey. Her sister posted when she passed and confirmed she did have bc.
Again, not telling you what to do but please make sure you understand the repercussions of any choice you make. Take care.
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Cflbf, I am so sorry you have been diagnosed as stage IV. Another thing to consider as you go forward is that treatment for stage IV can be gentler and easier than treatments for early stage bc. If your cancer is ER+ or HER2+ there are some great new drugs that can work well and have very tolerable side effects. When I was first diagnosed and thought I had early stage bc, I was obsessed with trying to avoid IV chemo at any cost. As it turned out I was actually stage IV from the get go and have been living with mbc for 7 years without ever sitting in the chemo chair. So if fear of harsh treatment is weighing on your decision, please consider this and check out your options before deciding against treatment.
Also, I think it took me a full year of crying and planning my funeral before I was ready to pick myself up and learn to live with this diagnosis. It is a shock and a life changer, but not the immediate death sentence it seems at first. Life does go on.
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Thanks, all, for your input. I'm still weighing this. They want to give me iBrance - I don't have all the pathology yet, but will fill this in next week. I had ILC Stage 1 lumpectomy two years ago, and a never ending cough led me through all the scans and them finding the metastatic bc in my lungs a few weeks ago. Biopsy was yesterday. So I'll know soon. I've been reading a lot about iBrance today, reading that you go through all of this for 7 months additional survival? Doesn't seem like a great trade off to me, especially with the cost, the lost wages, etc. Maybe my mo will change my mind. Maybe my family will insist? None of us have a lot of money, and I'm sure we're all looking at our wallets, thinking how long long is this gonna last? I dunno. I'm not clinging to life all that hard I guess.My oldest son died several years ago, and life hasn't been the same since.
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The average* time that Ibrance works before a different treatment is needed is about two years. It was my second treatment after Taxol. I also started with stage I ILC. I am now in my eighth year of living with mbc and definitely feel it has been worth it. A counselor (therapist) who had experience helping people with cancer was very helpful to me when I was first diagnosed with mbc. She really helped me to get to a place where I could be happy in spite of it. You might consider looking into finding someone like that. There are various ways to afford the treatment, including co-pay assistance from the pharmaceutical company, and your medical providers can help with this. Wishing you the best.
I am very sorry for the loss of your son.
*Edited to correct, I should have said "median". See my post below.
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Check out the ibrance thread. Most of us find it easier than IV chemo. And the patient assistance program are fantastic. I don’t pay anything for mine.
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Cflbf, about the article I posted in the Ibrance thread re the 7 months benefit
so first thing, it was a median - so half the people got more than 7 months benefit.
second thing, it's not just 7 months. It's an *additional* 7 months. This is a pooled analysis of several trials. The other people in the trial were receiving other treatment (endocrine therapy) and this was comparing the addition of Ibrance to endocrine therapy and saying that by adding the Ibrance, median result was 7 additional months.
i wish they'd graphed the data but digging through it to me it looks like median survival was the 3-4 years and the Ibrance was adding a median of another 7 months ...
SP this is the article if you haven't seen it yet: https://www.sciencedirect.com/science/article/pii/...
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Thank you for the link, moth, and for reminding me to cite my source! I was thinking of this information from the Ibrance web site. In the trial they are speaking of, Ibrance + letrozole delayed disease progression by a median of 24.8 months, compared to 14.5 months for letrozole alone. And I mis-spoke when I said "average" when I should have said "median".
https://www.ibrance.com/about-ibrance#trial-results
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