Today’s New York Times had an article written by Jane Brody that discusses the painful issues surrounding the decision to stop treatment, and its negative side effects, and let a cancer survivor live their last weeks in relative peace. This is always a difficult decision as many of us wish to hold on to life, even if it just for a few days or weeks. However, receiving aggressive treatment close to the end usually does not extend live.

What is unusual about this article, besides its being a very important and relevant topic for those of us dealing with advanced prostate cancer, is that it opens with a story about a man names Forbes Hill who was diagnosed with prostate cancer at age 50 years.

Mr. Forbes elected Watchful Waiting and for 12 years his prostate cancer remained under control. Then in 1990 the cancer progressed. He elected to receive radiation which provided some additional control, eventually starting hormone deprivation.

When his PSA again went through the roof he was found to have metastatic disease in his bones and liver. His doctor informed him that “90 percent of patients die within five years no matter what the doctors do, and about 10 percent survive six or more years” when in his situation.

He did agree to have some radiation to the brain to relieve some of the effects of the tumors and also “I’ll try chemo for six months, but if it gets too uncomfortable and inconvenient… ,” he said, trailing off. “Having lived 80 years, I’ve done a lot. I don’t have reason to think I’ve been badly treated by life.”

Mr. Hill has made the decision that many people are unable to make, to limit treatment and instead allow the end of his life to be filled with preparation for the unavoidable, ones own death. This time is better spent preparing a will, resolving interpersonal issues left unresolved. Saying goodbye and locking down ones legacy.

Ms. Brody’s excellent article may be read on line at: In Cancer Therapy, There Is a Time to Treat and a Time to Let Go

Joel T Nowak MA, MSW