The choices you make should be based on a complete understanding
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| illustration of a cancer patient (freepik.com/freepik) |
If you are diagnosed with lung cancer, the two main questions that come to mind are how long you will survive and whether you can tolerate the treatment.
In some cases, the cancer is detected at such an advanced stage that the treatment is so impactful that it can reduce your quality of life and may make you feel like you can’t take it anymore, leading you to consider forgoing treatment.
If you decide not to undergo treatment, you may want to know about how long your lung cancer life expectancy is without treatment and what your options are.
1. Life expectancy
While the stage and grade of cancer can help doctors predict the likely prognosis, few healthcare providers can predict the exact length of life expectancy.
There are several factors that can help doctors predict survival time in lung cancer patients:
Cancer stage: Classified by the characteristics of the tumor, whether lymph nodes are involved, and whether the cancer has spread (metastasized).
Cancer grade: Describes the characteristics of the cancer cells, their likelihood of spreading, and how fast.
Age: Especially in the elderly.
Health status: General health condition, fitness, and any chronic diseases.
Performance status: Describes the ability to perform daily activities while living with cancer (JAMA Oncology, 2015).
One factor that almost always affects survival time is whether or not patients seek cancer treatment. Even among elderly patients with advanced cancer, some forms of chemotherapy have been shown to significantly improve survival times (Journal of Clinical Oncology, 2010).
If detected early, lung cancer may be completely curable. In people who are older and have metastatic lung cancer, treatment is still possible and increases the chance of living at least one year to less than 40 percent.
However, for some people, survival is not their primary goal, especially if they have poor performance status. If the cancer is at an advanced stage, one’s ability to tolerate chemotherapy may be poor. If this is the case, it is natural to ask the doctor what the life expectancy is if one chooses not to seek treatment.
Given that about 80 percent of all lung cancer cases are diagnosed when the disease is advanced (stage 3 or stage 4), this is a concern and decision that many people have (Open Biology, 2017).
Without treatment, patients with non-small cell lung cancer, the most common form of lung cancer, can live for 5 to 12 months, depending on the stage. On the other hand, small cell lung cancer patients generally survive for 3 to 15 months without treatment based on their stage (Thoracic Cancer, 2014).
2. Weighing the benefits of cancer treatment and its consequences
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| illustration of a cancer patient undergoing chemotherapy (freepik.com/freepik)) |
Sometimes, the survival benefits of cancer treatment may be small. For example, if your doctor feels that a particular chemotherapy program may extend life by a few weeks but may have potentially debilitating side effects, you may decide that the consequences of treatment outweigh the benefits. And, that is a very reasonable and fair choice.
However, it is also important to understand that there are many myths about lung cancer. One of them is that a person is considered “too old” for cancer treatment. In fact, cancer treatment in older people often works well, especially with newer immunotherapy drugs called checkpoint inhibitors that may be better tolerated than traditional chemotherapy drugs (Journal of Thoracic Disease, 2018).
Similarly, targeted therapies, which directly target cancer cells and leave normal cells untouched, generally have milder effects than some chemotherapy drugs, according to the American Cancer Society.
It is also important to acknowledge that chemotherapy programs used today do not cause the problems they did in the past. For example, they cause less nausea, vomiting and fatigue from treatment.
3. Some reasons why some people choose not to undergo or continue cancer treatment
There are many reasons why some people decide not to undergo or continue lung cancer treatment besides quality of life and fear of treatment side effects.
Religious reasons
Followers of Christian Science, Jehovah’s Witnesses and the Amish may choose not to seek cancer treatment due to religious beliefs.
On the other hand, some people may turn to religion for healing purposes, believing that prayer or other practices can cure cancer. There is little evidence that this works.
While faith is important in dealing with any illness (and can make a difference in how well you deal with the illness), it is important to keep an open mind about the benefits and risks of cancer treatment if your beliefs do not preclude medical intervention.
If in doubt or in crisis, talk to a faith-based spiritual advisor to address any fears or struggles you are experiencing. This can help you make an informed decision.
Financial barriers
Some people may not want to deplete their limited savings, have no insurance or limited insurance, or think that certain treatments are unavailable to them because they earn too little or too much, and so on.
Before avoiding treatment that you think you can’t afford, talk to a social worker at the cancer treatment center who can help navigate the services and programs available.
Stigma
Some people decide against treatment because of the stigma of lung cancer. For smokers or ex-smokers, “smoker’s guilt” can affect them and make them believe that they “deserve” the disease because they made the conscious choice to smoke.
No one deserves cancer, and lung cancer can occur in both smokers and non-smokers. As with any potentially life-threatening disease, lung cancer is treated with care, regardless of the possible cause.
If you are having trouble dealing with your diagnosis, ask your doctor for a referral to a psychiatrist or psychologist who can help. Support groups are also available to help you understand what you are going through if available.
4. Making decisions
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| illustration of a cancer patient (pexels.com/Ivan Samkov) |
If you are thinking of stopping or not undergoing cancer treatment, make sure the choice you make is based on a complete understanding of the disease and its possible outcomes. Information should also be provided as fully as possible without influence or coercion.
If you are struggling to make a decision, there are four things you should do:
- Take your time, don’t rush into a decision.
- Seek second, third, or even fourth opinions if needed-whatever it takes to help you make a decision.
- Ask as many questions as possible. Your doctor should not dismiss or minimize your concerns.
- Work closely not only with your doctor, but also with therapists and counselors who can help you deal with emotional issues.
Ultimately, the decision is yours. Try to walk this path by keeping an open mind, taking time to listen and educate yourself before closing the door on treatment.
If you decide to skip cancer treatment, it can be helpful to explain why not only to those close to you, but also to your healthcare provider. Also, keep an open mind in case you change your mind someday.
