Inevitably, recurrence is a distressing event. Many people, both those with cancer and those who are caregivers, say that these are the times when they need each other the most, yet these are also the times when relating and communicating are most challenging.
Different Approached to Recurrent Disease
While first time cancers are treated in a fairly standard fashion, there are differences in the ways that oncologists approach recurrent disease. This is when both the art and science of medicine are important. Because of this, it is often good practice to get a second medical opinion. Good doctors expect patients to seek second or even third opinions, so you and your loved one should never worry about hurting the original doctor’s feelings!
When a cancer can no longer be cured, the emphasis for treatment will be on both quality and quantity of life. Oncologists tend to describe metastatic (Stage IV) cancer as a chronic illness (an illness that must be managed throughout the life of a patient). Unlike an initial diagnosis, when the medical goal was cure, the new goal will be to make life as long and normal as possible.
The basic plan of care for Stage IV cancer is ongoing treatments for the rest of your loved one’s life. The reality is that no single treatment will be effective forever. Cancer cells, unfortunately, are smart, and figure out how to be resistant to any drug or medication. Periodically, there will be evidence that the cancer has grown, spread, or “progressed” and this will mean that the current treatment is no longer useful.
Since you will be in this for the long haul, you, your loved one, and the doctors should care a lot about how he or she feels every day. This is why treatment decisions should be based on the impact of side effects and cancer itself on his or her daily life.