Tuesday, April 5, 2016

We Still Have Choices: Cancer Patients and Their Families

In recent weeks, I hear on the radio, almost every day, another heart wrenching story about the end of life and the accessibility of life-extending drugs.
It is so hard to know what to do in such cases especially as we hope that staying alive and hanging in there, with the help of life extending drugs, could mean that perhaps in the meantime a new cure would appear on the market.
We made our choice and there is no way to tell if things could have been different had we made another decision.
In late 2006, my husband, a healthy man of 54, went to a conference in South Korea. He came back with a pain in his leg which turned out to be a blood cloth. For a while the doctors believed that his condition was caused from sitting down long hours during the flight, but short time later he was diagnosed with stage four lung cancer.
My husband, a practical engineer, asked his doctor how long he had to live, the answer was that normally in similar cases, the prognosis was death in less than a year.
My husband considered not taking any chemical treatment, but his doctor convinced him that, in spite of the side effects, chemotherapy could help him feel better and breathe easier. Thus,  instead of being a “dead man walking” (his words), he decided to  receive chemotherapy.
The first course of chemo was not effective, I can still feel the pain in my stomach once we got back the results of the PET Scan.
The doctor suggested a new drug, tablets which worked differently and were less harsh on the patients. At that time, Tarceva (erlotinib), was not covered by our health care provider or by our additional insurance.
We wrote a letter to both insurances asking to allow us to receive the drug, but our request was denied. Thus, my husband got another treatment, which apparently was too aggressive, and he died  few days after receiving the second dose, only 5 months after the diagnosis.
Because of the way it works, Tarceva could have made his last months easier, and indeed it became part of the standard treatment for advanced-stage non-small cell lung cancer soon after my husband passed away.
Of course, he wanted to live, and like many other cancer patients my husband agreed to try all kinds of costly natural remedies. But what helped him most was his decision, which he made once he was diagnosed, to be a role model to his daughters at that difficult time.
I believe that this was also the reason why he chose not to complain about the Tarceva's decision, or to contest it. Being prudent with our money, he also didn’t consider buying it in the private market.
Instead, he kept busy: he continued teaching, talked to us about the future, made plans and even forced me to go over the books with him and to write down important names and phone numbers. In those five months we sold our house in the suburb and bought a new one closer to town. I moved there on my own few months after he died.
Whenever I hear about a new drug for lung cancer I am pleased for the cancer patients, but feel a pang in my heart. We received a death sentence and had no medical answers.  However, after taking a deep a breath, I try to remember that at least my husband had the freedom to choose the way he wanted to spend his last days, and I know that those decisions made our life without him much more bearable.
In memory of Tzvi Raz, 1951--2007

The essay appeared in the Times Of Israel

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