Quality Or Quantity Of Life: Supporting Patient Choices

It is hard for me not to compare my mom's breast cancer experience in her 80s with mine when I was in my 40s. I was healthy and I wanted, if possible, to stick around to enjoy more travel, watch my children launch themselves as young adults, and maybe even hold grandchildren in my arms someday. Mom already struggled with health issues, had held her grandchildren and had her own ideas about how much oncology treatment she wanted to have. We were at very different life stages and circumstances when each of us faced breast cancer.

I often asked doctors about my likelihood of survival and I was trying hard to figure out how to "ensure" success. Mom was told by her surgeon, our surgeon actually, that she would have choices, including whether she wanted to work toward quality or quantity of life! As her only child and a breast cancer survivor, that was really hard for me to hear, even though it was a sensible way for Mom to think about her treatment choices.

At age 84, my mom was a tough strong woman. I was not. Helpless, in many ways, it was hard to watch my mom go through her cancer. I remember bringing her to the oncologist and the radiation oncologist and all the other appointments, but it was my job to bite my tongue and help her get her questions answered. I remember that I was much more emotional than she was. I remember crying and ranting in my car when no one was around.

I worried about her suffering in any way. Unfortunately, in some ways, I knew what cancer felt like, or at least I knew what it had felt like for me. I couldn't protect her. That hurt. It gave me a new appreciation for our loved ones as they watch what we as cancer survivors experience. It is hard to be the caregiver.

Mom passed away this past year. Recently, I was having a sad day. You know, the kind of day where you tend to focus on the unhappy things that have happened rather than looking forward? I was on the verge of tears — missing my Mom's death, missing my children being home as I’m a new empty nester, recovering from a broken foot and facing my PALB2 genetic abnormality and upcoming prophylactic double mastectomy. There were a lot of losses in less than one year, so I called one of the wisest women I know: my mother-in-law.

"How do you do it?" I asked her as I tried not to burst into tears after making some small talk. "How do you cope so well with all the losses that you have seen?" The first thing she said was her belief system, and then she said she tries to look forward rather than back. Still, she went on to point out that I could still have a lot to look forward to, but that she, in her 90s, no longer had as much. She also pointed out how normal aging and death are as a part of life. I was chastened by her perspective. I also am happy to report she has since learned that she will become a great grandma very soon! We never know if we will be making quality or quantity of life choices. The important thing is to focus on the quality of each and every day we have right now. Please try to hold that thought close, especially on difficult days.