top of page

Armchair Ponderings
Hospice versus chemotherapy

Guy Geller

Donuts on Cake

As a disclaimer, I have no formal medical training but I have 86 years of observing life around me. I am not reporting my own opinion but that of others that either have suffered or are presently suffering for what is diagnosed as terminal cancer.

That appears to be the conundrum that cancer patients have to conquer. Whether to follow the oncologist’s advice of chemotherapy or opt for perhaps shorter life with a better quality of life for the last remaining days.

The television reports, for the last few days have been replete with the decision that the ninety-eight years old, thirty-ninth President of the United States, Jimmy Carter has opted for; in his case hospice for his remaining days, at home close to his family instead of receiving medical intervention. Reportedly his family and friends are supporting his decision. For those who may not be familiar with hospice care. It is really a type of medical care for end of life patients that focuses on pain management for the most comfort available. Depending on the patient and the patient beliefs it can also be spiritual and psychological support.

This past Saturday I had lunch with an 88 years old lady and her family that has made the same decision. A few months ago, she was diagnosed with non-Hodgkin’s lymphoma, stage four. That is pretty much a diagnosis that holds very little hope for an extended life span. Her oncologist recommended that she undergo chemotherapy treatment as recently as two weeks ago She having seen two sisters suffer for a few short months under chemotherapy, she decided that she would spend her last days at the home of her niece under the care of an outstanding hospice staff. Nurses, physical therapists, aids and a social worker along with visits from the hospice chaplain who also will make regular visits to insure that her quality of life can be as good as possible.

There are at least two schools of thought. Can I live a few weeks more under chemotherapy? Is there a chance that I can be cured and live an extended life with the reputed discomforts and sometimes violent physical illness? It’s not a lottery but it is a life-changing decision one has to make.

A case in point. My wife had an aunt who had been diagnosed with colon and breast cancer, she was convinced to have surgery; a colon resection removing around seven inches of her colon and a double mastectomy, all on the same day. She made up her mind that it wasn’t time to go, she lived another twenty years after, refusing chemotherapy. She played cards once per week with three of her friends, walked to the mail box and picked up fallen limbs in her yard. At the very end, she did enter a nursing home to last out her few remaining days at ninety-seven years. Would she have lived longer with chemotherapy? One can only guess.

So, the conundrum remains. For me, needing at least an aortic valve replacement, what will I do when the time comes. Fortunately, and at this time the prostate cancer that I had eleven years ago and that I attacked aggressively by agreeing for a robotic prostatectomy, but opting for no chemotherapy seems to have been a good choice. For the last thirty years, I have said that since we all have to go, there is a lot to be said for a quick heart attack.

I must praise Hospice organizations for the very professional and sensitive care they give to their charges. Some of course may be slightly better than others, but as a one-time hospital administrator, I have to give credit to the local hospice organizations. I never heard anything but praise for any of them.

Donuts on Cake
bottom of page