Two Weeks of Chemo: Day 11

This is part of an ongoing two-week series. For more info, see this introductory post.

After I was diagnosed and had returned to Ithaca for treatment, I met up with one of my academic advisers to discuss my plan for the semester. Most of our conversation, however, was actually spent on cancer. My adviser, it turns out, is a cancer survivor and Ithaca being the small town it is, it wasn't surprising then to find that we share the same oncologist.

At the time, I had only met my oncologist once or twice, so I was curious as to my adviser's opinion of him. She grimaced and prefaced her response by saying that he was very good and that she received great care from his office. That being said, she continued by trying to put into words her very subtle critique. Essentially, our doctor gives too much power to the patient regarding their own care. I was hesitant to call this a criticism at the time because I felt that some humility and cooperation between doctor and patient is always a good thing. I have since come to understand what my adviser meant.

At the onset of my treatment, my doctor was rather vague on how long we were going to do chemo for and whether we'd need to do radiation at all. He essentially said we would play it by ear, seeing how effective the treatment was.

After the two-month PET/CT came back clean, I asked for some clarification. We had tossed-out 4 and 6 months as the two main options, with radiation tacked on to the end as a possibiliy. Now, upon further reflection he said the radiation was a must, because the size of my initial tumor put it into the classification of "bulky." I hoped that the mandatory radiation, coupled with the good imaging results would mean we could opt for the 4 month treatment option. However my doctor was still hesitant. But rather than give me a confident recommendation, he left it to me.

I consider myself an informed and capable patient, but I will admit that it is hard to think rationally about the decision to end or continue a treatment with the miserable side effects of chemo. Of course I wanted to end the chemo, but not if there would be a significant change in long term recovery. What I really needed was an expert on cancer to help me make this decision and that is exactly what my oncologist is supposed to be. I felt like I was being forced to make a decision that I wasn't qualified to make.

It turned out not to matter because my lung function deteriorated, necessitating the discontinuation of one of my four chemo drugs. This meant I had to do the full 6 months. As frustrating as it was to be tempted with a shorter treatment plan that was never going to be possible, I am actually kinda glad this happened because it ended the ambiguity and took the choice out of either of our hands.

I have learned from this experience that, though including the patient in the decision making process is important, a doctor should never forget that they are the highly trained expert. A patient can't make an educated decision unless they have been properly educated in the choices.

Back to Day 10.
Ahead to Day 12.