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Terminal Illness and Death- Quality or Quantity, the Debate Goes On

Terminal Illness and Death- Quality or Quantity, the Debate Goes On

What’s more important to You, Quality or Quantity of Life? How far do we want to go to prolong our lives?

What a complex life!! Amidst the web of relationships I am entwined in, I am caught in this strange cycle of life and death. Where birth brings in joy death sure does bring sorrow.  But strangely, in my 36 odd years of existence, I have learnt that not always must death bring in sorrow. I have had situations in life when the death of my loved one has brought in an altogether different feeling. It is that unique feeling of relief and sadness mixed together.  At such times, you seldom shed those tears of sorrow, but give a sigh of relief instead, thanking God that the life has come to an end. Strange isn’t it, but I have experienced this weird feeling twice in my life.

Appa’s last few years were a fierce battle- with cancer. And it was not only his, it was all of ours. Metastatic colo-rectal cancer has a poor prognosis with only 5% of the cases crossing the five year mark, post diagnosis. I still remember the doctor telling me this. Yet, we decided to go ahead with the fight. Despite the multiple surgeries, and numerous rounds of Chemotherapy, Appa didn’t make it to the five year mark. Amma and I still ponder over the fact whether it really was worth fighting such an aggressive form of cancer, ‘cause despite the treatment prolonging his life by a year or so, it did reduce the quality of his life drastically, and also burnt a big hole in Amma and Appa’s savings. A healthy Appa was reduced to a mere frame.

I still remember the last day of his life. As the body began the process of shutting down, I sat by his side rubbing his palm that was turning cold by the minute. The cancer had spread through his body and the pain it caused is indescribable. As I sat there that night, I said those silent prayers hoping those few traces of life would leave his body soon. Every minute of pain, seemed to be a lifetime. And finally after more than twelve hours of moaning in pain, Appa slipped away slowly.

I was glad his life ended!!!!

My Paati was the kindest souls in my life. I still remember my childhood days spent in her lovely little home in Chennai. The kitchen would be stocked up with the most yummy savories and sweets and every meal would be a surprise.  She did belong to a generation that was far healthier. No wonder Paati outlived many family members who were younger than her, finally closing her eyes at the age of 97. Despite having lived a contended life, her last few months were spent simply lying on the bed. Unable to move, due to a stroke, she would have pipes to feed her and an attender who would take care of the body and its needs. It seemed to be a mere existence as Paati slowly failed to recognize any of us. It was a painful sight to see the woman who taught me so much, to be motionless. For some strange reason, her life clung on to her body, refusing to let go. Unable to see her that way, I would secretly pray the ordeal ended. And finally when it did, I gave a sigh of relief!!

Advancements in modern medicine present us with opportunities to live longer lives and keep life threatening diseases at a chronic stage for longer periods of time. But is it worth being kept alive in this way? Just how far do we want to go to prolong our lives?

It’s truly tough determining this, because there is no one right solution. The process of knowing what you want may take time and deep reflection as well as conversations with your loved ones. Of course we all want our loved ones to live for eternity, but prolonging life and living life are two totally different things.

Isn’t quality of life more important than quantity???

CEA- The KIller Count

CEA- The KIller Count

CEA is the tumor marker used in certain types of cancers especially for colo rectal cancer. An abbreviation for ” Carcino Embryonic Anigen, it is nothing but a reflection of a “certain antigen produced by these cancers”. So typically if you have a raised CEA, it is generally synonymous with a cancer thriving inside you.

Getting CEA measured

A very simple procedure, CEA is measured by doing a blood test. Of course it could also be done by testing body fluids or  biopsy tissue. But the most common method prescribed is a blood test. you wouldn’t need to really prepare your body for doing the test.

Normal Range of CEA

For a normal adult CEA should generally be around 2.5 ng/ml and for a smoker 5.0 ng/ml. Anything way above this isn’t really a good sign.

Readings and more of CEA

CEA count is used as a tumor marker. In simpler words it is used to detect the presence of malignancy. Generally levels>20 ng/ml before any form of treatment or surgery is an indication of a metastatic disease(diseases that has spread to other organs/parts of the body). Docs use this value as a base line at the time of beginning treatment and see if values drop in response to the treatment.

In general a high reading means:

  • There is cancer in colon, lung, pancreas, breast, or ovary.
  • If after chemo or radiation, there is an increase it means cancer may not be responding to treatment.
  • For those with a steady rise in readings after chemo or treatment, it means, the cancer has come back.

How accurate is a CEA reading?

Many docs often look at CEA with a pinch of salt. It isn’t often looked at as an effective screening test. This is because, hidden or occult cancers or those in early stages do not show up any significant elevation in the blood. Also many a times a temporary elevation may be seen during chemotherapy or radiation. This is because of increased activity seen at the spot of cancer cells, with the death of the cells and, release of CEA into the blood. Many a times, benign tumors may not show n increase. Benign tumors may turn malignant at a future date. It is for this reason a scan is recommended by most docs.

Why Has Your Doc Asked You to Do One?

Your doctor :

  • May have suspected cancer of the colon, rectum or other specific cancer.
  • Wanted to check recurrent tumors/malignant cells
  • Check for your response to treatment

Finally.. Its not About the Value Honey

With my experience during Dad’s treatment, I have learnt that its not about value alone thats a concern. The main wory is when, there is a steady increase in CEA, which does not reduce even after a cycle of chemo or radiation. It shows the cancers negative response to treatment and increasing metastatic activity.

This is a clear sign that the cancer is showing activity and spreading.