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Posts with tag grown

Thought for the Day: When options run out

Today I offer you not so much a Thought for the Day but a Question for the Day. Before I ask my pressing question, though, I want you to consider this story.

Diagnosed with a rare malignant melanoma on her retina in 2001, Ann Guthrie, a South Carolina wife and mother of two grown sons, endured radiation and chemotherapy. The treatments shrunk Guthrie's tumor, but another mass appeared two years later, forcing the removal of her right eye.

At about the same time Guthrie lost her eye, cancer was discovered in her lungs. It was inoperable. Then cancer landed in her brain. And now, without any approved treatment avenues, Guthrie is out of options.

Like many people with terminal illnesses, this woman is willing to try just about anything -- a clinical trial, experimental drugs, risky treatments -- to extend her life. If she's going to die anyway, why not? She just might live longer. And if she doesn't, she could at least help advance science by offering herself up as a sort of guinea pig.

While the Food and Drug Administration (FDA) has proposed changes that would make it easier for patients to access options like these, it's just not that simple right now.

There are ethical issues -- like weighing the needs of people who think anything is better than death against the need of society to prove drugs and treatments work safely. The only way to ensure a sort of balance is through clinical trials -- and letting anyone participate in clinical trials, for example, would make the results harder to interpret.

And there are medical and legal risks. What if terminally ill patients end up in worse shape after a treatment with an experimental drug, for example? What if the FDA or a physician is considered responsible for adverse drug reactions?

Denying terminal patients their last bits of hope is difficult. "It's a hard discussion to have with a patient and his family," says one doctor. "There's a lot of tears. We all would love to be able to get them access to some form of therapy."

And now for my question:

What do you think about terminally ill cancer patients and their access to anything that might extend -- or save -- their lives?

Life after breast cancer steers clear of counseling chair

I have had a hard time keeping my counseling appointments lately. Life keeps getting in the way, and counseling keeps getting pushed to the side. The last time I called my counselor to cancel -- due to an emergency room trip with my three-year-old -- I mentioned that my inability to keep up with sessions was perhaps a precursor to an eventual termination of our counseling relationship. My counselor -- Lindsay -- said this was maybe an accurate assessment, that we should discuss the possibility of an ending point. We haven't yet discussed it, though, because I have not made the time to contact her. I have continued to leave counseling on the back burner.

But today Lindsay sent me an e-mail to check in. She wrote that I am probably going to be okay on my own now -- in the aftermath of cancer -- and that we should have one final session to reflect on my progress over the past 16 months. I have not replied to Lindsay -- not because I am busy with other things but simply because her words made me cry. They still make me cry, hours later. I'm not exactly sure why. And I'm not exactly sure how I will follow up on scheduling my very last session.

I assume my tears -- my sadness -- are part of the healing process, part of the separation anxiety I feel each time a part of my treatment ends and a part of my life moves on. I assume I am sad at the prospect of leaving a vital part of my recovery behind, about leaving the comfort of my counseling chair, about leaving Lindsay. The possibilities are endless. And I suppose we will cover all possibilities when Lindsay and I sit down for our last, final, concluding session -- when we recall how much I have grown since the day we first met, when I could barely mutter a word about cancer without weeping uncontrollably, when I could barely manage to find pleasure in my days, when I could barely imagine that life could -- and would -- offer me peace and happiness.

Today, life is good. And it's clear that counseling is no longer necessary for my survival. But that doesn't make it any easier to make my final appointment. To contemplate saying my last goodbye. To tackle life completely on my own. Which is what I will do -- in time -- so I can continue moving on, away from breast cancer.

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