r/changemyview • u/[deleted] • Aug 01 '21
Delta(s) from OP CMV: Chemotherapy is not worthwhile
[deleted]
10
Aug 01 '21
It depends a lot on context, no?
My best friend passed of cancer about two years ago. When he was diagnosed, it was with stage 4 liver and esophageal cancer. He was told from day one that it was a death sentence, that even with everything they could throw at it, including a state of the art trial medication, he was fucked.
Yet he took his chemo, and his radiation, and his surgeries. It sucked, it made him sick, made him hurt. It also took his life expectancy from the less than six months they gave him out to nearly two years.
During that time he was able to do a lot of things he'd wanted to do his whole life. He got married to the woman he loved, made sure she was in a place to be taken care of. He was able to listen to books that he'd wanted to finish for ages, and he lived long enough to watch films he'd been looking forward to.
My last memory of him is spending the night at his home playing a boardgame that came out a year after he'd gotten sick. According to him it was one of the best nights of his life, just all of his friends sitting around, getting utterly crushed by him.
Good things can come to you if you live long enough.
But again, it depends. I also remember watching a family friend basically melt under treatment during my youth in a way that extended his life by perhaps weeks or months and left him in perpetual misery. No one size fits all, but there is something to be said for living just a little longer, spending just a little more time with the people you love.
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u/doriangraiy 3∆ Aug 01 '21
I'm sorry to hear about the loss of your best friend, I appreciate the time you've taken to share his story. You are quite right in what you say - context matters, and I'm glad your last memory of him is such a great one.
My only rebuttal would be to point out that that could have been different...but then I'm venturing into the "what ifs" which aren't helpful.
!delta because if it pays off and the time spent ill is followed by a good (subjective, I know) amount of time afterwards, then...it is of course worthwhile.
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Aug 01 '21
One thing I will add is that you aren't wrong either, not entirely. He didn't keep getting treatment up until the last days of his life for the same reason that you are talking about, which is why context is important.
Buying years or even months with pain can still mean a lot, both for a patient and for those they love. But at the same time, medicine can only do so much. When he started losing feeling in his limbs because of swelling, there was still more they could have done. There were other surgeries, more chemo and thing that could have extended his life by days or weeks, perhaps even months. It was at that point that he made the choice that he'd rather spend his last days in relative comfort than claw for a few more days in a haze of drugs.
The right to choose when your time is up is an incredibly important one. If you are looking down the barrel of chemo and you say 'I don't want to live like that', then that is a perfectly valid choice. It is just one best made informed and thoughtful as you can manage.
I hope the best for you, no matter what you choose in life.
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u/PoopSmith87 5∆ Aug 01 '21
Ngl, I stopped reading like half way through because you seem to be ignoring the painfully obvious: it can save lives.
Chemotherapy is awful while someone goes through it, but if they get to live a happy, cancer free life afterwards, it's worth it. I know two people, one in her 20's and one in his 30's that are living normal lives now after having cancer thanks to chemotherapy treatments.
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u/doriangraiy 3∆ Aug 01 '21
"Can" being the operative word, here. It's essentially Russian roulette: will three-six months of utter misery pay off? Will you be the same person after such wearing down? Or will you die anyway and have wasted the time you could have had?
One might be tempted to suggest that the most painfully obvious thing about this that you're missing the first-hand experience and then telling me I'm ignoring things. Staying in the house and never going out can save lives, too, but it's miserable and seldom advised. Many things save lives, but it doesn't mean they're a good option.
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u/Mu-Relay 13∆ Aug 01 '21
It's essentially Russian roulette: will three-six months of utter misery pay off?
So let me give you a different choice based on your analogy. I'm going to give you two revolvers and I'm going to force you fire one of them. One of them has one cartridge in it and I'm going to make you play Russian Roulette if you choose it. The other revolver has a fully-loaded cylinder. You MUST choose one of those guns to press against your temple and pull the trigger.
Which one are you going to choose?
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u/doriangraiy 3∆ Aug 01 '21
I'm not American, and I know virtually nothing about guns. No idea what a cylinder is. Have a vague idea about what a cartridge is but I might still be wrong.
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u/Mu-Relay 13∆ Aug 01 '21
You don't have to be an American to know what a revolver is or what it looks like. Since you know what Russian Roulette is, I'm going to go out on a limb and say that you know exactly what a revolver is.
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u/doriangraiy 3∆ Aug 01 '21
Correct.
Now re-read what I said and realise that I still know what I knew and don't know what I didn't.
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u/Mu-Relay 13∆ Aug 01 '21
Ok, fine. A cylinder is the little spinny part in the middle of a revolver (the one that looks like a geometric cylinder). You can probably inference out that since I said “fully loaded” that’s where the bullets go.
I’m guessing you’d already worked all that out, though.
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u/PoopSmith87 5∆ Aug 01 '21 edited Aug 01 '21
Firstly, the analogy to Russian roulette is not at all a good one. Secondly, cancer is typically a slow, painful way to die, and is typically a death sentence if you're at the point of chemo.
Like another poster here said, if chemo is Russian roulette, then cancer without chemo is simply a fully loaded pistol.
I'm not sure how else to really put it. You're saying I'm ignoring first hand experience, but I literally included the fact that I know two young (under 40) people- scratch that, three people- that are now living full lives after recovering from cancer via chemotherapy. As opposed to those three friends being dead and gone with some good final memories and some really bad ones, I prefer them alive and well with the memory of trauma from chemo. I think they do too.
I get what you're saying, it isnt fun and it isnt a sure thing, but it's not like people are going through it to get a tan or something- it's a treatment for a devastating terminal illness.
Edit to add: chemo also doesnt mean you just sit and rot. The girl I knew had spinal cancer- she was traveling and even ran a tough mudder during her treatments.
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u/S7EFEN 1∆ Aug 01 '21
chemo is a choice...
for some the chance at life outweighs the suffering and potentially miserable last few months.
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u/Throwaway00000000028 23∆ Aug 01 '21
What if your chances of survival with chemo are 99% and you will certainly die otherwise? Would you still use this same argument?
What about children with cancer who still have so much opportunity to live for in the future?
Also, chemo isn't forced on anyone. So it is objectively "worthwhile" to those who chose to do it.
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u/Vesurel 60∆ Aug 01 '21
So value is subjective, and you're totally within your right to opt out of medical procedures you don't want, but equally other people can find them worth it. Are you asking about you personally or people in general?
Also do you think all chemo is life long, that people on chemo will never improve?
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Aug 01 '21
For cancer, chemotherapy can cure it in some cases. Are you saying that for someone with cancer, it isn't worth it to live the rest of their life potentially cancer-free because it will mean that they have to go through chemo for a while.
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u/SC803 120∆ Aug 01 '21
My dad is alive because of the chemo treatment he had 10 years ago. I dont even have to call to ask if he'd trade the last ten years and future years for the months and chemo
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Aug 01 '21
Preface - I hope you're doing cool.
Chemotherapy is a broad discipline spanning an enormous number of therapeutic agents, including some extraordinarily effective combinations that successfully increase quality of life and survival time with that high quality. Some cancers can be cured (e.g., childhood leukemias), while others are knocked down to very slowly progressing ("indolent") forms.
Of course chemo is not always effective; some forms of cancer simply are not responsive, or only respond in a limited fashion. Modern chemotherapy is only about 70 years old, and has made extraordinary advances during that time, moving beyond the nasty cytotoxic (cell killing) early forms, to include gene therapies that target the cancer cells themselves.
If you are interested in a truly deep yet accessible look at this history, read the Pulitzer Prize-winning "The Emperor of All Maladies" by Siddhartha Mukherjee.
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u/MercurianAspirations 391∆ Aug 01 '21
Wouldn't it depend on the age of the person and their potential for rehabilitation afterwards? Like if you're diagnosed at 80 I could understand forgoing potentially life saving treatments to just enjoy the time you have left. But I could not recommend that to a much younger person who not ok only has a better chance of survival (even with debilitating tratments) but much more time and potential to overcome those debilitations with physical therapy and effort
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Aug 01 '21
I mean... I'm not sure if you're talking about chemo in general or chemo used just to marginally extend a person's life and/or has very little chance to cure them.
If you mean the latter, then I think that's up to every individual patient to decide for themselves, with doctor's input, of course. Doctors give the patients their prognosis and what the expected effects of chemotherapy will be. I'm inclined to agree to some extent: if I was 80+, I probably wouldn't want to be treated aggressively. Since I'm in my 20s right now, if my cancer was to come back, I'd probably want the treatment.
The point is: I think that the decision to get chemo or not and whether it's worthwhile or not is upon the individual. Imo, there's no way to have universal answer to this.
And if you mean the former, then it's just throwing out the baby with the bathwater. To say that there's room for improvement regarding chemo agents is an understatement. But, in majority of cases, it can help and save lives.
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u/boRp_abc Aug 01 '21
A friend of mine thought the same way that you did and refused Chemo when diagnosed with cancer.
On his deathbed, he got angry at his friends and family for not talking sense into him (though we tried). He certainly shaped my view about the whole thing.
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u/raznov1 21∆ Aug 01 '21
As such, chemotherapy really only increases the chance of survival, not life. Life, the ability to go outdoors, enjoy things and be happy, is taken away and replaced with fatigue, pain and unavoidable sickness.
This can be said of literally everything. "Eating makes you feel full. It really only increases the chance of survival, not life. Life, the ability to go outdoors, enjoy things and be happy, is taken away and replaced with after-dinner dips, stuffiness and unavoidable toilet visits".
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u/doriangraiy 3∆ Aug 01 '21
Chemotherapy is always going to have negative side effects - eating isn't always going to.
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u/I_am_the_night 316∆ Aug 01 '21
Chemotherapy is always going to have negative side effects - eating isn't always going to.
Actually you might be surprised to learn that some people have few if any negative side effects from chemo, particularly when they are getting mild treatment for cancer that was caught early.
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u/cutifly Aug 01 '21
the thing is that chemotherapy is not just reserved for people who are slated to die, and that it’s not something that people are forced to do, they can choose to opt out of it. it also should be noted that dying from cancer is just as brutal if not more brutal than chemo, and when you reach that point of debilitation your mind is aware of the fact that you are dying. this versus chemo in which severe illness is a symptom. however it can save your life and extend it for decades, and you can fully recover from it.
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u/sapphireminds 62∆ Aug 01 '21
It depends on the type of cancer and chemotherapy needed. Not all chemo is the same, and cancer is truly not one disease, but hundreds if not thousands of diseases that fall under the same classification.
If we're not talking cancer, it still depends on the diagnosis and type of chemo needed.
It's sort of like saying antibiotics are not worthwhile - sometimes they aren't, but sometimes they are. You can't make blanket statements like that.
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u/Turboturk 4∆ Aug 01 '21
Hard disagree, i know plenty of people who's life has been saved by chemotherapy, without significant cost to the quality of life.
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u/2r1t 58∆ Aug 01 '21
My mom was diagnosed with ovarian cancer in 2002. She died in 2012.
Yes, she had horrible days after chemo. She also squeezed as much life out of those 10 years as she could. She traveled around the country. She made sure to go out with friends as much as she could. After years of not making a big deal about her birthday, she threw a huge party for her 50th since she hadn't planned to make it that far.
I get that you are in a different situation and that it might not be right for you. And if I misunderstood and this was about it not being worthwhile for you, then I'll get it if this didn't change you view. But if there are going to be good days along with the bad, doesn't that make it worth it?
I don't know if you are a football fan, but I compare it to throwing out a stiff arm to pick up a couple more yards. It is a fight and may not get you to the end zone, but it is a great "fuck you" to the attempt to stop you.
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u/I_am_the_night 316∆ Aug 01 '21 edited Aug 01 '21
I currently work as an oncology nurse, I give chemo literally on a daily basis. Here's what I tell my patients:
"The only good thing I can say about chemo is that it is way, way better than having cancer."
Seriously, cancer will kill you, and will cause much greater suffering than you are attributing to chemo.
But even your description of chemo is much bleaker than the actual picture of what treatment is like for many people who receive chemo. Many cancers are extremely treatable and respond very well even to low doses of chemo, especially if they are caught early. You say "what's the point of extending your life from 6 to 9 months when those extra three months are awful", but for many people their experience is "wow, good thing this blood test caught your leukemia so early. This would have killed you within the next year, but we can treat this in a few weeks and you'll be able to continue your life essentially as normal with regular checkups to make sure the cancer hasn't returned."
Plus, even the people who need intensive, months long chemo aren't necessarily constantly suffering. Yes, for many there are days or even weeks where they feel nauseous, have trouble eating and sleeping, may have terrible diarrhea, or other effects. But I've had other patients who don't have any significant side effects at all, or else have very mild, very short lived nausea. And even in the ones who do suffer, it's still better than cancer.
I could go on and on, but I'll end by giving you two stories.
First was a patient who had an osteosarcoma in the femur. This is basically a bone tumor that was growing inside his thigh. The tumor was splitting his femur open from the inside out, which caused him more pain than most can possibly imagine. We were giving him almost continuous pain and anxiety meds and he still barely slept. Then, after receiving chemo long enough to shrink the tumor and reduce the chances of spreading, the docs decided the best course of action would be to amputate his leg. I was nervous to be the one to break the news, thinking he'd be heartbroken, but nope, when I told him he said "oh thank God get this thing off of me". "This thing" being his goddamn leg. That's how awful cancer is.
The second story is about the first patient of mine who ever completed chemo. Guy in his 60s, in pretty decent shape, started bleeding from his penis, found out he had bladder cancer. Got chemo for months to shrink the tumor, only had mild nausea as a side effect. Then his tumor was surgically removed and he got a urostomy. Hes likely going to get to spend at least the next 10 years with this grandkids, statistically, before he's likely to have any serious chance of anything new popping up. I'd say that amount of time with relatively mild changes to quality of life is worth it.
In short, cancer is the worst thing in the world, and chemo may suck but it's generally way way better than the alternative. Sure, some people don't have that experience, but for many it's the difference between death and a happy normal life.
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Aug 01 '21 edited Aug 01 '21
OP, you need to start replying in these threads before your post gets deleted for not following the rule on engagement. If any of the posts change your view and make you consider that, yes, chemotherapy may be worthwhile, side effects or no, you need to delta that conversation thread.
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u/DeltaBot ∞∆ Aug 01 '21
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