It's a known, sad fact that 90 percent of women with metastatic breast cancer (breast cancer that has spread beyond the breast and lymph nodes to other organs in the body) will die of their disease within a few years of diagnosis.
This includes women who are being aggressively treated. The goal, of course, is to be in that remaining "10 percent club" and have good quality of life while a club member.
It's hard for doctors to tell a woman she has metastatic disease. It's worse for patients who have to hear those words. Doctors and nurses are taught to make patients well again.
By nature, they want to be positive and optimistic for and with the patient. When recovery isn't in the cards, it can be tough to determine when to throw in the cards.
At some point, though, the decision needs to be made to discontinue treatment and encourage the patient to get her affairs in order and proceed with closure in her life.
When and how that decision is made varies a great deal. It's one of the reasons why the length of time between a doctor's decision to enroll a patient into hospice and the patient's passing is less than five days.
This is worrisome to me, because hospice is a program designed to help the patient die with dignity, with about six months to plan and prepare for it with help from the wonderful hospice caregivers.
Sometimes it's the patient who insists the doctor keep trying. Sometimes it's the doctor who doesn't want to give up, even when family members are clearly aware that the patient is failing and withering away.
You surely don't want someone giving up on you if there's even a chance you'll be among the 10 percent who live longer or experience a miraculous 11th-hour remission. You probably also don't want to be tormented by treatment that makes you so sick you wish you were already dead.
What would you do if someone told you that you had advanced metastatic disease? What would be your expectations of your doctors? of yourself?
