To prognosticate or not to prognosticate

prog“So what’s your prognosis?”

If I had a pound for every time someone asked that question, well, I could probably fund a feet-up, rub-down weekend at Champneys.

But I’m just going to say it – it royally p***** me off!

I made the choice not to ask for my oncologist’s prognosis as to my impending mortality. Why? Well, firstly I wasn’t hopeful that I would hear anything I really wanted to hear. Just a cursory google about lung cancer survival had shocked me enough to know that. On top of which there were other serious issues I was dealing with, so I wasn’t in a hurry to hear the news.

I was also conscious of how our own minds can lock, stock and barrel influence the well being of our physical selves. How our beliefs can impact our health both for the good and negatively. I was mindful of the possible consequences of self fulfilling prophecy. If I am told I only have until Christmas, I could potentially limit my opportunity to survive beyond that, because I have so completely surrendered my authority not just to the disease, but to the medical establishment? I read  a famous account about a man who was diagnosed with liver cancer, he hoped to make it to spend one last Christmas with his loved ones which, happily he achieved, but sadly passed away soon after. An autopsy later showed that tests had shown a false positive reading for the progression of his disease. In fact, very little cancer was present in his body at all. The question is, was it his expectation of his own death that in fact killed him?

Sky Mood Chess Board Tree Hourglass Princess

Making a prognosis is not easy. To my lay person’s mind it is at best an educated guess based on a cohort of statistics. In my case, the statistics for lung cancer are taken most recently from 2010, so they are out of date. They reflect an older population, as at that time this is where lung cancer was most commonly found. In lung cancer terms, I am considered quite young.( Yay, knew I’d find a positive if I persisted) So the median, may not be as applicable to my situation, as I am not someone who is 70 with a lifelong history of smoking. And statistics don’t factor in what else one is incorporating into one’s healing journey such as lifestyle changes addressing nutrition and exercise, addressing stress levels and depression, or taking supplements, alternative therapies and treatments, counselling  etc and nurturng not just the physical and mental, but one’s spiritual life. Which research tells us, feeds into a person’s well being enormously, and therefore could potentially influence healing outcomes.

But back to prognoses – and just as everyone’s experience of cancer is unique to them , so is the decision to ask the doctor to prognosticate. I know that people want to understand what lies ahead for many reasons: practical matters have to be put in place, affairs put in order, maybe take that dream trip you’ve always put off, or what about those who want a prognosis in order to defy it, to exceed expectations, and to continue running right through the tape and beyond the finish line and into numerous triumphant laps of honour – gold medal hanging proud. For the doctors, having an idea of prognosis should enable them to establish the right options, and best care that is needed at every stage. Yes, they can get it wrong – they are human trying to do their best against a disease that has the skill to transform, hide, return, and persist and has outwitted the best brains for too many years.

So back to why I am royally p***** orf.

I think the question lacks sensitivity, compassion and understanding.

“What is your prognosis?” is akin to asking someone the question “how long do you have left to live? How long before you might die?”

It isn’t a casual question. It is profoundly personal, intimate and private.

Yeah, right. Not pleasant is it. At least, that’s what it feels like over here. I am quite convinced that you don’t mean offense. But it is deeply painful to hear. Please, please could you maybe be a bit more mindful if ever that question forms in your brain, and not let it escape your mouth. It might just be a passing question, or even a genuinely concerned question, but please think, engage your brain, and remember that there is someone who, despite looking absolutely bloody gorgeous on the outside is actually doing their damndest to keep on keepin on.

OK rant over. Keep well.

Oh, and I sincerely apologise if the cartoon offends. I find that sometimes black humour keeps the gremlins at bay.

Love always xx

Below is an article from the Guardian 2015 https://www.theguardian.com/lifeandstyle/2015/jun/02/doctors-predict-patient-die-prognosis-wrong

And for a less ranty evening do join me in London on Thursday January 18th.

https://www.cecilsharphouse.org/component/content/article/21-shared/shared-events/5090-cancer-and-the-art-of-living-an-evening-with-leah-bracknell

 

10 thoughts on “To prognosticate or not to prognosticate

  1. You are so correct, so often a persons ability to overcome and succeed is coloured by others peoples opinion and perception. A friend of mine was told her chances of surviving her breast cancer was slight however she is a determined soul and refused to believe her days may be limited. That was 3yrs ago and she is well cancer free and wonderfully happy. The mind is powerful xx

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  2. There is no kindness in asking someone how bad or good the prognosis is, as a medical student I there isn’t a lot of things I study without prognosis, and I will admit that medical professionals are somehow enslaved to prognosis, and numbers what this study said and what not, but I know very well life is deeper than that it can beat the odds. I very well also agree that the information you freed to your body can hinder your healing, or mend you slowly, I love that you are focusing on life instead of losing precious moments into focusing on prognosis:)

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  3. Well said (Ali) Leah. Life is all about the bit in the middle as in the living part which is what everyone concentrates on (or should!) and its like juggling jelly. I could fall off a rock face while climbing it tomorrow and Joe Blogs could be hit by a lightning bolt while hanging out the washing next Tuesday – none of us know how long we have and realistically none of us want to know – why would we! Life is about living in the here and now, for having fun, being spontaneous, laughing, its a daring adventure doing things you’ve never done before, taking yourself out of your comfort zone and feeling the overwhelming fear and doing it any way. The human body is a remarkable piece of engineering while our brain is the most powerful tool we have always be positive and use it well. xx

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  4. Sharing your story and the effect others can have on your journey is so clearly described in your post,the cartoon and picture ‘hit home’ .Your words have power as they will make us think twice before we ask questions that have such an impact and possibly negative outcomes.

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  5. Hi Leah
    I totally agree with you I had Crohn s disease in my early 20 resulting in two thirds of my stomach being removed after numerous operations on my bowel the surgeons finally left me with 12 ins of Colon then proceeded to tell my parents I would be very Lucky if I reached the age of 40 ! My mother gave me a really positive talking too & said I was the only person who could move on with my life thank god for mother’s i am now fast approaching my 60th in April ! Ifound yoga in my late 50 coming to your workshop in Weybridge & the yoga show I also do hatha yoga & meditation wow does that help I really hope you are able to do another talk as I can’t make this one good luck with it am sure you will be an inspiration you are such a delightful warm sharing person I’m sure everyone will go away feeling so much better than when they went in I wish you loads of joy happiness Namaste
    Jan

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  6. Leah, your musings are always interesting and thought provoking. They often make me re-appraise the way I live my life, none more so than to live for the NOW. (I know that this shouldn’t really be necessary, but currently life seems to find a way so suck me back to the mundane. Your frequent reminders give me the kick up the a*** that I sometimes need). I’m no longer making long-term plans though, but just taking each new day as it comes.
    Good luck with your talk tomorrow, I’m sure it will be a huge success.

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  7. I totally agree with you. Everyone’s cancer is unique to them regardless of what the statistics say. Who are the doctors to give us an expiration dat. Ridiculous. I also think that when we find out that there is cancer in our body, we must work harder to stay in the positive. Sounds like you’ve got that part covered. 🙂

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  8. I agree with you people are so thoughtless sometimes by asking such personal questions.I didn’t notice the Dark Humer at the top until you mentioned it.Unfortunately I lost The Love Of My Life in Oct to Lung Cancer he was 59.I am so lost without him💔Unfortunately the name is Mr Murphy so your Dark Humer came as a shock.But I can hear him chuckling about it. I Wish you all the best moving forward. Jayne X💖

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