pancreatic cancer Archives - The Practical Caregiver Guides

Dying from complications….one day busy with holiday shopping and ordinary errands, the next irreversibly transformed into a shell of herself, all because of unexpected developments that seem to accompany some of the more difficult cancers to treat.

It’s a shock for all who knew and loved her. Less than a month ago, she finally discovered why she hadn’t really felt well in a while. Not only was she diagnosed with one of the most difficult cancers to treat — pancreatic cancer — she was Stage 4. At best, she might buy a few extra months to get her affairs in order and say her goodbyes with chemotherapy. There was a slight possibility that she might enter clinical trials and discover some small miracle that knocked back the cancer enough to allow her to enjoy a little more time, a few more moments of joy. But there was also the very real possibility that palliative care would be the only real Band-Aid for what ailed her.

The shock of such a brutal diagnosis coming just before Thanksgiving was hard for those of us who loved her to accept, but it was especially difficult for her. It came as the great holiday season commenced. This was her time of year. She adored decorating her house. There were tiny little Christmas scenes everywhere — miniature cottages set upon white batting on tabletops and snowmen tucked into nooks and crannies. There were always decorative candles scenting the air, pine cones and boughs draped on fireplace mantels, and angels on high. She even scattered little treasures throughout her winter garden. The walk up to her gingerbread-like house on a snowy night was magical, especially enhanced with the tiny twinkling lights she draped here and there.

She loved shopping at this time of year, whether it was for people or pets. She was the only person who always remembered, after my mom died, that my dad likes real handkerchiefs. Every year, she would make sure he had new ones. She made sure that cats and dogs had toys that would offer hours of playtime that would amuse their pet owners. She took great pains to shop for the people she loved. I thought about that the other day when I donned a fleece top she had given me more than ten Christmases ago. I am reminded of her every time I pull it on over my head.

The last time I saw her was at her son’s wedding a few months ago. We spoke on the phone a few times as the countdown to the ceremony began. She was ruminating on the fact that the planning and execution of the wedding was an exhausting process. Did she really want to wear silver shoes and a lace dress? I told her she would look lovely. I advised her to smile and focus on having a good time, because that’s what her boys would remember years from now. I had no idea it would be the last time we would all be together for a happy occasion. There was so much fuss, she lamented. She remarked that she would be glad when it was all over and she could relax again. I think that was indicative of what was happening to her body as the secretive cancer began to spread. She wasn’t feeling quite right, but it was the kind of feeling that was too vague to be remedied. The symptoms could have been anything. That’s the trouble with pancreatic cancer. By the time the doctors figure out what the trouble is, it’s often too late.

That wedding, in the end, will be our salvation in many ways. I am so grateful we had that chance to gather. It was poignant when the mother of the groom took to the dance floor with her son. It was even sweeter to see her out on the dance floor, wiggling and wriggling as the sound system pounded out a steady beat. She was smiling and laughing, laughing and smiling. That is how I will remember her.

But I will also remember the tremendous tribute to her motherhood that came in the form of her two sons at her bedside during her sudden and unexpected final hospitalization. There, in her hospice room, these fine young men took turns watching over her, making sure that she was as comfortable as possible after the heart attack and stroke robbed her of her faculties. Their compassionate efforts were testimony to the love she raised them with and the time she dedicated to their upbringing. As her new daughter-in-law gently leaned in to check on her breathing and cover her up when the blanket was kicked away, I realized her son had chosen a bride who would stand with him in difficult times. But I also watched another young woman, newly engaged and soon to join the family, gently place her hands on the bedridden patient whose life was about to end. This dying woman would not be there to share the joy of seeing her second son marry the woman he loves. She would not have the chance to dance at another wedding because cancer caused these terrible, irreversible complications. My father keeps saying she would have been a wonderful grandmother. It’s too true. She would have thrilled at the prospect of that. She would have loved to spend hours outdoors with little children, working in her garden as they napped in their playpen in the shade on a fine summer’s day.

That is perhaps the hardest thing to accept about her untimely death — all of the experiences she never got to have, all of the joy and the laughter she dreamed she would someday know. It’s so easy to imagine what would have come next in her life if cancer hadn’t come knocking at her door. It’s so easy to picture all of the activities that would have brought family and friends together to celebrate the good things in life.

It will take time for all of us who knew her to find our equilibrium once more. There is no denying that there is a hole in our circle now that she is gone, never to return. But I hope that with time, those of us who love her will find ways to keep her with us as we gather. We will recall her passion for cooking that set amazing meals on her table, her endless hours of nurturing her charming cottage garden, and her love for Christmas. With every passing year, we will incorporate a little more of her goodness into our own lives, finding ways to share the warmth she brought into our lives by offering it, in turn, to others. It won’t happen instantly. It will take time for us to realize how much we miss the little sparkles of joy she shared, the small touches she added in our lives. But I am confident that we will do it. We will be here with her sons, their wives, and her grandchildren, remembering the magical moments she gave us over her lifetime, and we will honor her by embracing her essence, by letting her live through our own inspired actions. In that way, she will never really die. She will always be a part of us, eternally residing in our hearts.

Recently, there was great controversy stirred up by a UK pancreatic cancer charity, which launched a promotional campaign in which people spoke of wishing they had a different kind of cancer, because their outcome would be better. I was dismayed. Not only is this a misguided effort, it’s downright dangerous. It leaves viewers with the idea that there is some “good cancer” out there, and that if one gets it, “no problem”.

Such an unfortunate campaign sadly misinforms the public about the real face of cancer. In all my years, I’ve never known anyone to get a “good kind of cancer”. Cancer is cancer — a generic name for thousands of different kinds of biological reactions in the body that often attack organs and blood, creating tumors, autoimmune issues, and other maddening, life-changing, life-challenging issues.

In all my decades of life, I’ve seen so many things happen. People who had good prognoses died and people who had bad prognoses lived. You can’t always predict how cancer will affect the body, and the idea that having a “good cancer” means you will survive is just wrong.

Don’t believe me? Answer this question. Which vehicle would you prefer to be struck down in the street by at ninety miles an hour:

A. a 7-ton double-decker bus
B. a 2-ton Mercedes Benz
C. a half-ton Fiat 500

Did you say the tiny, “cute” little Fiat? Did you perceive that because of its public aura, its marketing campaign, its ability to navigate through tight spots that you would be safer being struck by one? At ninety miles an hour, does it really matter what type of vehicle strikes you? I think not. Impact on the body is a critical factor in a traffic accident. The same is true of cancer’s impact on the body. How much cancer is there? That’s what helps to determine outcome. If doctors have to treat a body riddled with cancer, the chances of survival are about equal to being hit by any type of motor vehicle at ninety miles an hour.

Here’s another question:

If you fell overboard without a life jacket, where would you have the best chance of surviving:

A. In the middle of the Atlantic Ocean
B. In the middle of Lake Superior
C. In the middle of the Amazon River

Three different bodies of water. Three different types of challenges and risks. You might think that the ocean is the most dangerous. After all, if there are sharks and other predators in the water, and the waves are rough, your survivability rate will be sharply curtailed. We know that the Amazon has piranhas, those nasty little fish that work themselves into a feeding frenzy, not to mention black caimans, those alligator relatives, and any number of other critters, so that’s probably not a great option. If you said Lake Superior, did you consider things like the shipping traffic? Or the ongoing risk of hypothermia? Or the dangerous rip currents?

Whether you’re about to be struck by a vehicle going ninety miles an hour or you’re dropped into the middle of a huge body of treacherous water, the end result is the same. It probably won’t end well.

The same is true for any advanced cancer. In this past two weeks, I have read the posts by friends who lamented the passing of this person and that person. They were all individuals with different kinds of cancer and they died.

I have also read wonderful things by people who survived their battles. Everywhere I go, in public, online, people share their stories with me. Never have I found that one kind of cancer is better than another when it comes to survivability. What matters is the stage, the treatment options, and the cancer patient’s ability to sustain the effort. There are so many variables, so many ways things can go, no one is ever promised complete cure or extended life, except perhaps in Stage One, where it’s easy to be optimistic.

Understanding the broad spectrum of diseases with the generic title of “cancer” is more complicated than most people appreciate. While the pancreatic cancer organization in the UK erred by their promotional campaign’s suggestion that there are better kinds of cancers to have, I’ve seen people make the opposite mistake. I once had a conversation with a cancer caregiver who actually thought her husband’s taking a pill once every couple of months was the same experience as my mother’s being at the cancer center five days a week for months of treatment. It wasn’t the difference between prostate cancer and lung cancer that was the problem. My mother was dying of the disease. She had no treatment options, other than to keep her comfortable. To have her cancer dismissed as the equivalent of an active man with managed prostate cancer fully engaged in life was hurtful. Four years after my mother’s death, the same man is still going strong, still enjoying life. Do I begrudge him that time? Absolutely not. I’m glad he made it. I wish everyone did.

But I also wish his cancer caregiver understood the difference between a well-managed cancer and one that is out of control — not through a failure by patient, caregiver or doctor, but because cancer is what it is. When it overtakes the body, options are fewer and the toll is much greater. We need to support cancer families in crisis with real action. We need to be there for them through thick and thin. These are the cancer patients who have the greatest hardships. These are the cancer caregivers who need a hand in providing care.

I wish everyone survived their bouts with cancer. That’s really the bottom line. Many more do now than did forty years ago. Some people manage their cancers for a while, thanks to new treatments and better diagnoses. But there are still some people whose cancers are so aggressive, it’s impossible for oncologists to do much other than try this or that. Cancer is still a mystery to figure out.

While it’s tempting to attack with an “Occupy Cancer!” attitude, as if we can sit in and force cancer researchers to cure this type of cancer or that type, the fact is the developments in disease treatment are often made in unusual ways. Just recently, there was an announcement that doctors think a new acid bath for cancer cells might be an amazing weapon in the fight against cancer. Acid bath? It sounds so much better than a cancer drug that knocks patients on their fannies and sometimes even coldcocks them. In reality, it’s not always the cancer that kills the patient. It’s the rigors of the treatments, with the dangerous side effects. Many chemotherapy patients find their organs permanently damaged by the very treatments that keep them alive.

Getting hit by a Fiat going five miles an hour is probably a survivable event — the impact on the body helps to determine the extent of the injuries. Getting hit by one going ninety miles an hour is probably not. Perspective is important when assessing cancer survivability, and the better able we are to see what is in front of us means we will act in good faith and to the best of our ability when meeting the cancer challenge.

Let’s stop assuming that the happy face social media slaps on cancer is the real story. Let’s stop thinking of the disease in terms of “good cancer” and “bad cancer”. Let’s stop thinking that some people are “lucky to have the good kind of cancer” and others are “unlucky”. We need to join together in supporting every cancer patient, every cancer family, without the rancor or bitterness. Cancer is cancer. It doesn’t care who you are or what you do or how much money you have in the bank. It doesn’t care if you’re a worthwhile person or the vilest of the vile. Cancer can’t be dreamed up or wished away. It’s a challenge that can only be met with a positive attitude, a realistic perspective, and a gritty determination to learn as much as we can to insure quality of life, not just quantity. Cancer is what it is, but life with cancer is what you make it. Choose wisely.

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