Treatment Options for Terminal Illness

Why do doctors offer treatment options, if you are dealing with a terminal diagnosis? The options being considered are either aggressive or palliative. Again, I can't stress enough how important it is to understand what your physician is saying when they offer you "treatments" for a terminal illness. I know you are scared. I know you just want to get this thing out of your body and hold on to any last thread of hope but, false hope is just as bad as no hope! Please think and ask questions!!!

Palliative care is a treatment option usually offered to provide you with some relief from your symptoms or pain. It is an option not given as a cure and is not a treatment intended to slow the progression of the terminal disease. The care is not intended to prolong your life, merely to provide you with comfort, and hopefully, quality. Palliative treatments (this link opens to a site explaining it from a doctor's perspective) are usually supported by hospice agencies.

There are times when receiving a treatment such as chemotherapy is still considered palliative. The physician knows that, based on the progression of your terminal illness, the treatment will not "cure" you but can buy you time allowing you to get your affairs in order, say what you want, and do what you need to do in the time you have left. Hospice agencies may still consider this treatment option aggressive enough to exclude you from hospice services. Once this treatment is completed, you could qualify as a hospice candidate.

Aggressive treatment is a treatment option which is the polar opposite of palliative care. Aggressive treatment options are recommended when you, your physician or a family member managing your healthcare believes that there is the chance for recovery or, that your extended life will be of an acceptable level of quality. This means that every trick in the medical bag will be pulled out; chemotherapy, radiation, surgery, dialysis, transfusions, cardiopulmonary resuscitation (CPR), pacemakers, antibiotics, ventilators, the works! Despite being given a terminal diagnosis there is the hope/belief that one treatment might be successful even if it is experimental, even if the "treatment" is worse than the disease.

Before you decide on a treatment plan, you may wish to seek a second opinion to be sure you are fully informed of the pro's and con's of all your treatment options.

Trying to decide which treatment option is right for you can be very difficult. You may be influenced by the media reports of celebrities who are "fighting" or "battling" a terminal illness. You don't tend to hear reports about people who have opted to forgo aggressive therapy, wishing to live out their remaining days doing the things they enjoy most with the people they love.

Regardless of outside factors, you do have a choice in treatment options. Ultimately the treatment plan you opt for should meet your needs. Be sure to find a health care team that is able to support your decision.

Why would your physician recommend such an aggressive plan of treatment if he/she didn't believe you could be cured, that you could "beat" this illness?

It is important to understand that physicians, like other healthcare providers, are trained to heal, to cure, to save lives. You don't go to your doctor to hear the words "sorry, but there's nothing that can be done." You go to get the magic pill or hear him/her say "you will be good as new in a week!" There are some lessons medical schools may miss. One of the things that may not be covered is knowing when to let go, or how to tell your patient there just isn't anything they can do for them.

As a result, even though you may be on your last breath, the doctor will continue to "aggressively" treat you to the very end. It is easy to believe that, as long as the doctor "wants" to treat you, there must be hope, when in fact, it is just that neither of you know how to let go.

Electing to forgo aggressive treatment may be seen as "giving up" by those you are leaving behind. They may associate your decision as "not loving them enough to fight" the way everyone else "fights" and "battles" terminal illness. Initially, it may be very difficult for them to understand your decision. Their reactions may be the result of not understanding all of the facts.

The decision to forgo usual treatment options may be difficult for your physician to accept as well. As discussed before, you go to your doctor to receive treatment. Depending on your doctor's training, they may be less "willing" or able to accept your decision to terminate aggressive therapy. It is important to select a physician who supports your requests.

Whether you decide to receive treatment or not, the decision is very personal and, needless to say, difficult. You will need to weigh all the options to see what makes the most sense for you.

What about the experimental treatments?! Could they hold the cure?

Understanding the reason you were selected to participate in a study is important. You are able to participate in research studies as long as you are able to meet the study criteria. Just as important as understanding why you are selected for a study is understanding how research studies work.

Research studies for experimental drugs or treatments are set up to determine if the treatment or drug is effective. If it shows promise, then the organizer of the study has to determine how to safely administer the drug by finding the right dose and frequency to give the treatment.

In order to do this, the study is set up into groups. To prevent any possible bias, most studies are blinded, which means you will not know if you are in the group that receives "too much", "too low" or if you will receive any of the experimental treatment/drug. As part of a "blinded" study, neither your family nor your physician will know which group you will be assigned to.

If you don't know whether or not you will receive the potentially "life saving" treatment/drug then why participate in the study? Hope. Hope is often the reason given by patients for participating in research studies. Either the patient is trying to hold to the hope that this will be the cure or they are trying to give hope. They may see their participation as a learning opportunity for physicians, giving hope that knowledge gained from this experiment will help save the lives of others.

If you do elect to participate in a study you may wish to know if it is blinded or unblinded and, be sure it has been approved by a government agency. Government agencies review research studies to insure the participants' safety and privacy are being protected. If you are in the United States, studies must be approved by the Federal Food and Drug Administration (FDA). If you are considering going outside of your country, do your own research and confirm it has been authorized by that country's FDA equivalent.

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