Lung Cancer

The decision not to have any treatment for lung cancer

With some forms of cancer the value of treatment can be very uncertain. Doctors may not be sure that treatment will benefit the patient, particularly if a cancer is thought to be slow growing. In the case of lung cancer, treatments may lead to a cure, or they may relieve symptoms and extend life, but in some situations they may not help much, and the side effects of treatments may cause distress. Some people, especially older people, may decide not to have any treatment at all. Here one seventy-seven year old man explains why he decided not to have any treatment for suspected lung cancer. Cancer was suspected on a routine scan; he had no symptoms of lung cancer. He was reluctant to give up his work for treatments that might not be successful, and he did not want to be kept alive unless he had a relatively good quality of life. After the interview it turned out that he did not in fact have lung cancer, so this further justified his decision.

Explains why he decided not to have any treatment for suspected lung cancer.

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Explains why he decided not to have any treatment for suspected lung cancer.

Age at interview: 77
Sex: Male
Age at diagnosis: 76
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And the doctor in the hospital, who is a nice Chinese man, he said, “Well it could be a cancer or it, or not. But I'm going to give you the alternatives.  You can either have an operation, which”, as I have a slightly irregular heartbeat as well, he said, “The surgeon might not like to do”. And anyway I said, “How long would I be then unable to work?” “Well at your age probably about six months”, he thought, “Three anyway”. Well I'm doing a lot of singing and a lot of writing and all that, I didn't want six months doing nothing, or three even. And then he said, “And it mightn't be successful and you might die anyway at your age”. And then I said, “What about that horrible thing [chemotherapy] that makes you lose your hair”, and it doesn't anymore because they've got a helmet on now I think, like a drier in Bobby's [laugh] and Jerry's.  

And he said “Yes you could have that but it's, where it is, there is no reason why that would be very successful. And anyway, that leaves you, not for three months, but at least two or three weeks before you are able to do anything. Or we could inject you.  Poke a needle into it and see whether it was cancerous or not.” I said, “Well that sounds very unpleasant.” I'm not, don't like needles anyway. This one is about the size of a horse syringe, I think. So he said, “The alternative is do nothing. It may just stay as it is for ages.” I think, I think he said most people think older people develop cancer less quickly than younger people. I don't know if that's true. And I said, “I think I'll go for nothing, nothing at all. Because, I'm working very hard. I feel fine, and anyway I'm seventy-seven so I don't care as long as you promise to fill me full of illicit drugs when it really starts to hurt, yes?” And I've also written a friendly will which means they are not allowed to keep you alive after you've lost all quality of life, as typical modern expression as they use. So I said, “Well, that”. And he said, “Well you may be quite right”.

Explains that he might have chosen to have treatment at an earlier age, but his decision was not...

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Explains that he might have chosen to have treatment at an earlier age, but his decision was not...

Age at interview: 77
Sex: Male
Age at diagnosis: 76
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Do you think if you'd been ten years younger you would have reacted in the same way?

Ten, that would be sixty-seven. I don't know. I think probably but I'm not sure.

One of the things I was wondering is whether you anyway didn't like the idea of the kind of treatments you might have to have, or is it something you hadn't thought about before?

Not really. I've had operations before. And as long as they give you a local, I suppose they would in this case, not necessarily, I suppose but they don't like giving me anaesthetic apparently. So I'm, no I'm not frightened of an operation but if it's not going to be any good and it's going to knock me out for months I don't want to do it. Mean, I think seventy-seven is a perfectly respectable age to pass on, [laugh] say and if it doesn't show any sign of life for another ten years, so be it. Anyway after 80, I can't think that I'd have, I mean my memory is pretty shattered already. And I'm very absent minded and so on and forget things if they are not written down. So I think, oh after 80 I'd probably become insufferable and deafer still.

Says that more information would not have affected his decision.

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Says that more information would not have affected his decision.

Age at interview: 77
Sex: Male
Age at diagnosis: 76
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Are there any things about lung cancer that you feel that it would have helped you if you'd actually known about them or that if…?

No. I would have made the same decision I think, maybe not at thirty but I would certainly in my sixties, late sixties, seventies, eighties, nineties, hundreds yes. No I don't think there is. I am an atheist of course, which relieves me from a sense of doom or possible judgment. And which I don't regret at all. I'm not going to convert on my death bed like some. Yes. At least I don't think I am of course. 

Last reviewed May 2016.

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