When someone is diagnosed with cancer, we often see comments like “keep fighting, you’ve got this!”. Is there any scientific basis behind this actually having an effect on the outcome / survival and remission rates? What exactly are they doing when they’re “fighting” that helps to beat the cancer?
In: Biology
Kind of a meta question with a whole lot of variables to consider…
Let’s take an example of a cancer with a high mortality rate, such as glioblastoma or pancreatic cancer. Primary GBM remains incurable, median survival without treatment is 3 months from diagnosis, with treatment is 15 months. Five year survival rate is 5%. Treatment consists of surgical resection, radiation, and chemo, and all the side effects that go along with it. So objectively, those who choose treatment (“fight”) get a median difference of 12 months over those who don’t. For pancreatic cancer, five year survival rate of those diagnosed who are amenable to surgery is 7%, for those unnameable it is 10%. (Newer treatments may increase these numbers in the near future.)
However, on the flip side, take that same pancreatic cancer patient nearing the end of his/her life, and ask them if they’d prefer hospice care, focused on comfort and quality of life over curative goals and quantity (moments over minutes) and studies show that such a patient will live on average 29 days longer in hospice over those that choose to “fight” on.
The treatment for an aggressive cancer can be incredibly damaging to the body, and the side effects often worse than the cancer itself. I’ve seen so many patients choose to fight when the fight was already lost, basically clutching on to this nebulous hope that by “not giving up” they’d find a way back to living their life as it was before they ever knew about cancer in the first place. And I’ve also seen patients so afraid of living the rest of their life in a battle against this disease that they give up the battle early, when there was still ground to be won. To this day, I’ve never been able to make a general rule about when it’s appropriate for someone to keep fighting, and when it’s time to throw in the towel. It’s always case by case.
But I do know that we all make choices throughout life, whether to go to college and where, whether to get married and to whom, where we live, and work, and play, and whether or not to have or adopt kids, etc. But with cancer, the choice between fighting and not may be one of the last choices, and it’s theirs to make. And at the end when so many choices are being taken away from you, maybe that choice is the most empowering thing you have. Choosing not to fight is just as brave as choosing to, often more so. So who knows, some live longer by fighting, and others live longer by not.
The people and families that switch their mindset from fighting for time to fighting for quality at the most appropriate moment, in my experience have the better outcomes, subjectively. In a way though, you could say that both of these categories of people are still fighters nonetheless.
Hope that helps…
Edit: thanks for the gold, my first one!
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