Moving on from diagnosis and prognosis, what about the treatment options? How do you develop a comprehensive treatment plan that is most likely to work and take account of your individuality, your personally unique situation? How to move beyond generalizations and standard treatments, to taking account of individual needs? How do you personalize the appropriate response for your particular situation?
Again, we rely on logic for the framework and then aim to draw on experience, wisdom and insight for the details.
Nearly everyone in the Western world will be diagnosed and consider initial treatment within the conventional Western medical framework. This makes good sense and is as it should be.
Given that the diagnosis and prognosis will be provided by the best medical people available, it is they who will recommend an initial treatment plan. This too makes good sense. Certainly if there were a simple, medical solution to cancer, one piece of surgery, one pill we could take that ensured a cure, we would all do it. You would be a fool not to. But it is not so simple.
Definitions • Curative Treatment, Palliative Care or Living with Cancer?
While the medical treatment of cancer tends to focus on one of two outcomes, to be curative or to be palliative, there is a third option. Let us be clear with the definitions.
Curative Treatment
Curative treatment involves more than what many people imagine it to be, which is to be free of cancer after five years. Actually, curative treatment aims to render the person clinically free of detectable cancer and restore the person to their normal life expectancy.
Palliative Care
On the other hand, palliative care is an umbrella term for assisting those approaching death—a fundamental need and right. It is generally used in the context that death is imminent and inevitable and aims to make dying as easy and comfortable as possible.
Palliative Treatment—Living with Cancer
Palliative treatment is a specific but integral part of palliative care. Palliative treatment can be more interventionist. It is noncurative by definition but aims to extend life, ameliorate symptoms, and increase quality of life in situations where a cure is not medically feasible.
The lines between palliative care and palliative treatment can often be blurred, but these days, palliative treatment is often called living with cancer.
While overall survival rates in the conventional management of cancer may not have improved all that much, in recent years many people are living longer with cancer. This can involve significantly slowing the progression of the disease, minimizing any side effects and maximizing all the quality of life issues. Palliative chemotherapy often plays a significant part in conventional medicine’s management of palliative treatment.
What to do When a Medical Cure is Likely
Now the logic. If a person is offered medical treatment for cancer where there is a high probability of a cure, then, in my view, what to do is fairly straightforward. Embrace that treatment as your main focus while you go through whatever it entails. The common treatment options are surgery—which often comes first—then maybe chemotherapy and/or radiotherapy.
However, right at the start or even better still, before you start your treatment there is more to do. As soon as possible, review your lifestyle and do whatever you can to complement and support the treatment with your own efforts. The details of what this entails follow in the subsequent chapters. Lifestyle medicine will have your body and your mind in the optimal state to get the best out of any treatments and to minimize the potential for any side effects.
When it comes to the complementary, traditional and alternative options, there may well be useful things to consider that will support your body’s healing capacity, minimize or manage side effects and have other useful benefits. These options will be discussed in later chapters as well.
The Choices When a Medical Cure is not so Likely
However, what if a cure is not so likely from the medical point of view? What if at first diagnosis, or further down the track, it becomes clear that a medically based cure is improbable? What if palliative care or living with cancer is all that remains medically? There are three options.
1. Acknowledge Death as the Likely Outcome
This is probably not the option you are opting for if reading this book. However, we do need to recognize and accept that some people do accept their prognosis and do acknowledge death as the likely outcome. They then may choose to focus on what can be done to garner the best from whatever time remains, to live with cancer as long as possible and to prepare for a good death.
Yes, prepare for a good death. Death is like everything else in life. We can stumble into it, hoping for the best, or we can prepare for it and, in all likelihood, have a good death. To be open about this, when I started working in the early eighties with others affected by cancer, I knew little of death and I was preoccupied with the desire to help people to recover. I admit to being apprehensive about what would happen if and when people died of their cancer. While many did recover, others did go on to die of their disease. Over the years I have worked closely with many of these people and it has been incredibly heartening to observe how consistently the people I have known who prepared for death were able to die well. What they learned and what they did stood them in good stead, and the quality of their deaths was exceptionally high. We will speak more of this in a later chapter.
For now, it needs to be said that some people faced with the situation where there is no medical cure on offer do accept death. Some are content to focus on living with cancer and are keen to utilize palliative care when the time comes. Again, that is a perfectly reasonable and logical choice. However, if for whatever reason you are not ready, if you do not accept death, and if you are still intent on getting well, you need to be logical. If medicine cannot cure you, what will? Can anything?
2. Seek a Cure from the Nonconventional Medical Options
Remember the different styles of medicine: conventional, traditional (TM), complementary and alternative (CAM). If conventional medicine says a cure is beyond them, do any of the others have a solution? I have the personal knowledge of many individuals telling me that individual TM or CAM therapies were very significant in their recoveries. But I do not have the experience of consistency in this. It seems that from time to time, for some individuals, individual TM and CAM modalities fit really well with that particular person and are highly effective. But I am not aware of a TM or CAM therapy that reliably will be of major benefit to a wide range of people. I do not know of a magic bullet in the realms of traditional, complementary or alternative medicine.
3. Seek a Cure Within—Recovering Against the Odds
Even when conventional medicine says there is nothing more we can do toward a cure, I do believe there still is real hope on offer. Where the “magic bullet” actually does reside is within you. In the face of difficult odds, a cure may be much more likely through mobilizing your own inner healing than through chasing after some elusive external TM or CAM treatment.
Remember, it only has to be done once to show that it is possible. You only need one person to use their own inner resources to recover without the aid of external, curative medical treatments and you know that it is possible. Just one case demonstrates that there is the potential for the body to react, to reject the cancer within it, and to heal.
