What I Learned From My Patients

Throughout the years treating oncology patients, there are always a few patients who make a lasting impression. Some people think that oncology is a depressing field, all about death and dying. To me, it is about life and living it.

Larry (not his real name) was in his 70s when he was diagnosed with liver cancer about 3 years ago. He underwent the standard treatments but eventually had disease progression with each line of systemic therapy. In the most recent encounter, Larry was in the hospital because a growing mass was pressing on his stomach, causing him to have an outlet obstruction.

I remember the first time I met Larry. He was in his hospital bed in a private room. After being informed by his regular oncologist that he had exhausted the available treatment options to his end stage cancer, he was at peace. He did not fight to ask for more treatments.

Larry came to my hospital because he had progressive abdominal pain, nausea, vomiting and had not had flatus for 2 days. He felt much better after a nasogastric tube was inserted.

He greeted me with a smile. As we were discussing the goals of care, Larry expressed that since there were no other standard treatments available for him, his focus was on living his last weeks or months. He wanted to live in his house and be surrounded by his family.

Larry was sure what he wanted. He was committed to live as long as he could, with a decent quality of life. He understood his treatment options and did not argue with what he could not control. He was not afraid to express what he wanted. His focus shifted to be comfortable and to have the option of pain relief when needed. He did not complain. He was not angry. He was having a pain level of 3 out of 10 and told me he could live with that.

Sometimes it takes a serious life event to let you realize what your priorities are. Larry’s ability to accept and adapt to his new reality is amazing. He is clear on what he wants and what he does not want.

Do you know what you want? Once you gain clarity, you will realize what choices and actions are in alignment with who you are.

Ask yourself what your main goal in life is. Oftentimes, it is the littles things that we miss the most. Or things we used to take for granted. Larry simply wanted to stay home and be able to eat by mouth, without having the risk of another bowel obstruction.

Are you at peace with your circumstances? No one wanted to have an advanced cancer diagnosis. Yet Larry accepted it his reality. This does not mean that he gave up living or just sitting at the corner thinking woe is me. On the contrary. Larry shifted his main goal to be pain free (or at least with a pain level that is manageable), to maintain a decent quality of life. He chose living rather than dying.

When you are at peace with your situations, you get to decide to focus on improving your circumstances. You get to decide to focus on what matters the most to you: family, close friends or just simply maintaining basic bodily functions.

Life is short. Let us have peace with what we cannot change, and focus on controlling what we can control.