Newly diagnosed cancer patients are sometimes told they are terminal with 3 or 6 months or a year or two to live. Why does the physician say this? Because, they say, they must be honest, they must be frank, and the patient and their family has a right to know and must prepare for death. The truth is that this physician, in playing God, is trying to protect himself in case of poor results or wanting to take sole credit for saving a life. Either way, the physician is a winner and the patient, family and friends are the losers.
Doctor, suppose you were able to access a machine and read the local newspaper printed six months from today. On the front page you see your picture and read that you were the victim of a drive-by shooting. You were killed the previous night! How would this help you and your family? What would this do to your quality of life this afternoon? Tomorrow? Do you believe that if you had the power to look back the day after that shooting you would have believed your life was better for having known it would happen? When you tell a patient they will die in a lengthy period of time, you are trying to allow them to read a paper that date in the future.
As to honesty, the truth is not that the patient is going to die in 6 months. Only God knows when that particular individual will pass away. That person may get hit by a truck on their way home and be killed today. Every doctor knows stories of “terminal” cancer patients who are seen years later alive and well. No one knows what is going to be discovered in the next 6 months that could help. In other words, the whole truth is that you, the physician, have never seen a patient with this type of cancer successfully treated. But some have made it and you can make some phone calls to see if someone somewhere can do something to help.
I attended a tumor board where a patient had cancer throughout both lungs. Surgery, radiation and chemotherapy were all ruled out. The head oncologist told the attending physician to go tell the patient he was terminal and nothing could be done. I asked why he didn’t state that they knew of no medical options but why didn’t the patient talk to their minister or look into psychological counseling. The oncologist’s answer was that he would rather see the patient die than resort to prayer or psychology. I’m not trying to suggest that prayer or psychology would have helped, but it was obvious that the oncologist would have preferred to see the patient die rather than take the chance of sharing success with anyone else.
Fortunately, there are very few doctors who think and talk like this. Most doctors are considerate, kind and compassionate and have the best interest of the patient at heart. But, do you want to bet your life that your doctor is not one of the few self-centered egotists or placing the almighty buck above life. A qualified, independent second opinion could be worth your life.
Over 21 years ago I was told I was terminal with lung cancer by a top doctor and nothing could be done. I had 90 days to live. Had I believed him, I would have fulfilled his prognosis. I went elsewhere where a team of doctors cured me. And then and there I learned that whether you make it or not, it is a lot better to fight to live than wait to die. I do not want anyone given false hope but that is not what we are talking about. We are talking about denying them the right to fight, the right to try, the right to look elsewhere where someone might have the answer. We are talking about denying hope.
Dr. Herbert Benson, a specialist in behavioral medicine at Harvard Medical School, states, “Belief is the hidden ingredient in Western medicine . . . A new drug given by a doctor who believes in it enthusiastically is far more potent than the same drug given by a skeptical doctor. . . . Clinical studies have shown that a patient’s belief in a medicine can make it far more effective.” Once your doctor tells you that you are going to die in six months, how effective are the treatments going to be when you trust and believe in your doctor? Patients tend to fulfill their physician’s prognosis.
Doctor, don’t be responsible for your patient’s unnecessary demise. That’s a possibility. Don’t be responsible for shattering their quality of life. That’s a certainty. Don’t play God. Tell the truth, the whole accurate truth, that it is serious but somewhere someone might know a way to treat it. Then help them do research as to where to go or what to do or refer them to another physician who will help. Know in your heart that you did everything in your power to help the patient’s quality of life along with their chance of recovery without any ego involved. Once you try it, you will find you like it. It gives a great feeling to truly contribute to an individuals well being without any thought of self reward. And once it is started, it is contagious. You will find other physicians practice the same high ethics and soon you will find that cancer patients do better.