treating cancer--CLARIFICATION: If I have cancer, I don't know it

ps--FIRST A COUSIN, NOW A FRIEND, HAVE ASKED ME WHETHER I MEAN TO SAY HERE THAT I HAVE CANCER.  I DO mean to say that I refuse to have a colonoscopy because I don't want to know that I have cancer till it's too late for anyone to try to persuade me to fight it, rather than joining it as painlessly and freely as I can.  Sorry for any confusion--l&p hal  

             I will post this essay on the blog only, and expect to distribute it only to close family, as a form of living will.  I have just finished listening to a “Fresh Air” rebroadcast of Terry Gross’s interview with Bradley Cooper, just after Mr. Cooper’s father had died.

                Cooper’s father had had stage 1 lung cancer, been treated into remission, when Cooper describes getting a devastating call from the doctor that his father’s cancer had recurred, and that he had 9 months to a year left to live.  Fortunately, Cooper’s occupation allowed him to take time off to nurse his father at home in Philadelphia.  Cooper told how great a gift it had been to hold his father’s hand the moment of his father’s death.

                What got my attention was what Cooper then described: his father’s fear of death and unwillingness ever to mention death or talk about anything but getting on with life.  And, said Cooper, that was the way his dad had always been.  His dad also appears to have been a remarkably gentle and openly antiracist person.

                Recently, my mom, who will be 93 June 27, had the latest in a long series of strokes which has visibly paralyzed her right side.  Initially, it looked to me as though she might stop being able to swallow, and I made it known that she was not to be artificially sustained if she stopped eating or drinking.  The way I see it, the light of life in her body is dimming.  As so often before, she has rallied a bit.  Occasionally, she utters a “perfectly normal” short response to something I say, before her mind goes elsewhere.  This morning when I greeted her by asking how she was doing, she smiled gently and said, “I’m surviving.”

                Last week on impulse I stopped by to see her nursing home director, Kristine Provan, the one I join for weekly sing-alongs, to explain why I wanted no further therapy (including “occupational”) for my mom, and to thank her and the staff for giving her and me the gift of such a warm and loving place for her to die.  And I cried when I told Kristine that my mother had always been “scared to death of dying,” and now, in semi-lucid moments, had showed me she was scarcely afraid any more.  It happens that Kristine and I share kinds of a belief that the life in each of us is a concentration of energy that dissipates, goes somewhere else, as the bodily light dies out.  In the Kristine I harmonize with Thursday mornings on the sun porch, I was able to share my relief and release that my mother would die suffused with love rather than fear, confident that our lives have no beginning and do not end when our hearts stops beating forever.

                When I heard Bradley Cooper describe his father’s final fight with cancer, I saw where my theory of bodily life as organismic homeostasis leads me with respect to how I regard the prospect of cancer in myself.  Although I do not count the quantity of the life I enjoy in chronological units, I actually think my probability of surviving longer before cancer takes the life out of my body will increase if I leave internal tumors especially alone, and let the strength of my immune system take on that isolated target or targets.  I figure that trying to kill a tumor, whether by cutting it out, poisoning or incinerating it is another one of those wars that works like pouring water on a grease fire to put it out: It spreads.  Meanwhile, the “treatment” has so weakened the rest of the body that it can’t marshal nearly as much strength to surround or eat away at any of the new tumors that has been seeded, let alone get them all.  And so, when any of the cancer-causing agent has gotten out already in a tumor that is “treated,” the cancer is likely to have metastasized before long.  Meanwhile, instead of enjoying those extra years, if treated, I would largely be more miserable than if the care were simply palliative, and more active, and with less loss of immune response.

                What does “the evidence” say?  Nothing, because there is no control group I know of containing people like me whose cancer has been detected and has decided against interfering with the body’s own immune response.  I do know that a close friend of mine, the late Mike Andrews, a non-smoker, was diagnosed in his early 20s, at the Cleveland Clinic, with lung cancer, and decided to go elsewhere for a second opinion.  That took long enough that by the time he showed up for his new clinical workup, the cancer had disappeared.  Mike died some 30 years later of pancreatic cancer.  So frankly, if I skip checkups that might detect cancer in me “early” until I’m showing enough symptoms to seek treatment, no one can show me that my chances of extending my life by early detection and treatment are greater than if I one day go to get relief from a problem, and to my relief, discover that I have stage 4 cancer so that my family members won’t quarrel when I refuse “therapeutic” treatment.  Relieve my pain, let me just go out like my mom if I don’t just drop dead instead: lovingly cared for and cared about.  Thank you Bradley Cooper for enabling me to explain my death-defying attitude.  And thank you, Laurels of Worthington, for loving and caring so warmly and wonderfully for my mom.  Love and peace--hal