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When Do You Stop Fighting?

The war on cancer began in 1971 when Nixon signed the National Cancer Act. Since then, the war rages on. MD Anderson vows to make cancer history. Walking fundraisers urge people to join the fight, one step at a time. People who win the battle against cancer are survivors and those who don't—did they not fight hard enough?

Sometimes I wonder if I have multiple personalities. I love oncology. I love learning about cancer: how it invades, how chemotherapy and targeted therapies treat cancer. When I worked on the blood and marrow transplant unit, I felt like a war hero administering the conditioning chemo before transplant. In the infusion center, there always seemed to be another drug to be tried, and I would never want to tell the patient otherwise. But as oncology nurses know, sometimes there is a fine line between treating the cancer to help the patient, and ultimately causing more harm than benefit.

So I also find myself hating oncology. I hate the way the treatment makes patients feel. I hate how the side effects of treatment can kill patients instead of the disease itself. I hate the look in patients' eyes when they are fatigued and nauseated. At those times, I love palliative care. I love hospice. Because it's no longer about the disease; it's about patients and families.

How do I find a happy medium in nursing? How do patients find a happy medium between cure and comfort? Does that happy medium even exist? 

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Comments

Posted by dchristensen on Mar 31, 2014 12:09pm
Your posts are always thoughtful and very thought provoking. Thank you. My perception of a happy medium is by being fully present in the moment, even when it is hard, and knowing that each of us can make a difference in the lives of another. Oncology provides that opportunity and what I learn from others in how they deal with adversity as well as their individual choices enriches my life.

Posted by Angela Quinn, B... (not verified) on Apr 1, 2014 6:42pm
This is such a beautiful blog piece about oncology. Thank you for sharing this, Carol! I have some personal experiences in seeing how cancer treatment has deteriorated the lives of some while in other cases it has preserved life. There is a balance in finding the passion to be an oncology nurse and I am in admiration of all professionals who work in this area of nursing! Best of luck to you!

Posted by Anna (not verified) on Apr 1, 2014 9:24pm
When DO you stop fighting? How DO you find a "happy medium?" More importantly, how do we help families/patients struggle with these questions themselves? The first thing is that we LISTEN. And then we listen some MORE. Then we find people who will listen to us. And we close each day by knowing that there is no right answer.

Posted by Ashlei (not verified) on Apr 2, 2014 10:37pm
First, thank you for all of the care and support you give your patients. Second, I would encourage everyone who provides care to people with life-threatening illness to consider palliative care as "and/with" not "either/or." Palliative care is appropriate at any age and any stage of illness and should be provided "and/with" curative intent therapies. The value it can offer to patients is terribly diminished when it is thought of as "either" curative intent "or" palliative care. I have helped care for many people who felt significant guilt for "losing their fight with cancer" and feeling they somehow were letting everyone down. Cancer doesn't fight fair, and I think we should all be cognizant of how powerful words are--especially when we say things like "giving up." Maybe we should help change the perspective and re-frame the decision to stop curative-intent therapies as choosing to change focus to symptom control and quality of life. Thank you again for your dedication to the field and posing the question.

Posted by Glen'L (not verified) on Apr 3, 2014 4:54pm
I am a haematology/oncology nurse... I asked that question many times... But I now know the answer - when the time is right for you!!!.. I know this because I'm now fighting cancer.. I now realise how very precious every moment is... I now realise that it's important to make as many memories as you can in whatever time you have... When my treatment started I was a warrior, ready to fight on no matter what.. As time has gone on I'm slowing down & the fight is getting harder... But there's still some fight left so, for now, I'll carry on... I've learnt that your perspective as a nurse is different from that of a patient & I have a different view of things... When I'm talking to my patients I can say "I know exactly how you feel", I understand their pain, their frustration as well as their fear... So in reality you don't give up you just wind down... Keep up the wonderful work nursing sisters.. It is amazing...

Posted by Shirley Bomar (not verified) on Aug 11, 2014 10:02pm
I have worked predominantly in the field of oncology for 30 years, I have seen so many changes for the better, esp. in survival time. However, side effects and endless medical appointments, drug resistance, and disability upon disability take their toll. I also had a husband who lived with Stage 4 colon ca for nearly 5 years. I think I would have stopped fighting long before he did, but as long as he was wanting treatment I supported him. I have no regrets at all. But I would like a choice for palliative care treatment that is combined with active therapy so that life would be worth living as long as a pt. is alive. And when not, I would advocate for euthanasia when palliative care isn't enough to bring relief of suffering.

Posted by Shelly (not verified) on Aug 11, 2014 10:38pm
I'm glad to see that others see oncology as a love-hate relationship. Bittersweet. Triumphs. Trials. Courage. A mind-bender. A never-ending goal of focusing on the journey in hopes of a destination that is peaceful, regardless of outcomes. Warriors of different tribes coming together to fight the same battle. It truly is an honor, and a horror. Beautifully said, Carol. Thank you.

Posted by Debra (not verified) on Aug 14, 2014 12:20am
Thank you all for blogging. I have been in oncology since I became a nurse. I have worked in patient, outpatient and hospice. Adults and peds alike. You have all experienced the triumphs and losses with your patients and have watched the war wage between them and their disease. What strength and courage it takes to face such an enemy. I think it is very much an individual choice and to that person they did it their way, so they did not give up! Thanks for sharing

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