Chapter 2
Living with a Stent

Chapter 3
Living with Palliative Care

1)
Introduction
Background
Endoscopy
2)
Initial Diagnosis
3)
Telling the family
4)
First Appointment
Taking the tests
5)
Second appointment after tests
6)
Treatment -Chemotherapy and Radiation
7)
Remission
8)
Coping at Night
Coping with Fear
9)
Relationship with Doctors
Keeping Track of Medications
10)
Deciding on a Stent
Conclusion

Last Revised, 05-Nov-2002
Copyright © 2002

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The appointments with doctors after the tests

        The meetings with the doctors after the tests are of great importance as at this point a full diagnosis, the extent of the cancer and its stage will be known and possible treatments will be discussed. It is imperative that you have your moral support person with you, and take all the notes you can and ask all the questions you can think of.

        In my case the courses of action were limited to palliative radiation and/or chemotherapy. By the time the initial Endoscopy was done, my throat had closed to the point that only liquid could pass. The cancer had spread to the lymph nodes and to my right lung. The EC was at Level IV (cancer had spread to lymph nodes and to my right lung). I have angina and asthma and while both are well controlled at this time, they precluded any major surgery, intensive radiation or chemotherapy. My decision was limited to undergoing palliative radiation and chemotherapy or just giving up. Be aware that at this point you may again get more horror stories of Chemotherapy/radiation treatment from well meaning friends or relatives. Ignore these stories as they do not apply to you and are always the worst cases they have heard of or could imagine.

        I was spared the very difficult decision of trying for a “cure” or having just palliative care to improve my quality of life and possibly extend it. This choice of trying for a “cure” or just taking palliative treatment can be a very difficult one and depends on the cancer being detected at a very early stage. Other factors such as age and general health also affect your decision. The danger of trying for a “cure” is that if it fails, it could in fact shorten life and degrade your quality of life. This decision must be taken with the advice of a number of doctors, your spouse and of course your own feelings. This decision cannot be taken lightly!

        Due to my poor health in general and the fact that the cancer had just about completely closed off the esophagus, the only option was to take the palliative treatment or allow my kidneys to fail and let it end in a couple of weeks. At this point my quality of life was OK except for my difficulty in eating. Considering my heart and lung problems I looked and felt reasonable healthy! Again it was pointed out that people react differently to cancer and treatments. I discussed the options with my wife and we decided to try for the palliative treatment mainly in an attempt to try to extend my life and maintain or improve my quality of life. Thinking about how things might have been better if you had made a different decision is a sure road to depression.

        Once the decision is made and a course of treatment or action is embarked on, you must remember that the decision was based on the best knowledge at that time. There is no reason to believe that taking another course of action would have resulted in a better outcome!
 
 

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