| I have a terminal diagnosis of metastatic rectal cancer at the age of 27. I'm receiving treatment at Memorial Sloan Kettering and the disease is under control. However, it's still incurable, and making the patient aware of this was clearly difficult for my doctor, despite his incredible bedside manner. It was actually sort of humorous because the news didn't phase me; I had already come to terms with my death months ago. The reason I mention this is because today I finally went over the long term plan for my life and death. Essentially Sloan Kettering embraces palliative medicine and combination therapies and they don't give up on you even as you transition from a control-focused treatment plan to a palliative one. Furthermore, your team of doctors orchestrate all of this so you and your family do not have to stress about how to manage end-of-life care. It's really amazing. So in my case, I will continue treatment until the disease becomes progressive and we've exhausted all treatment options (chemotherapy, immunotherapy, etc). Then comes the experimental stage; MSK is a research institution so they could potentially have experimental treatments I could trial. Failing that, my primary oncologist will work alongside a doctor here specializing in palliative medicine and coordinate all future care together. Once the cancer has progressed to the point where I can no longer live a normal life (I'm still working and living life fairly normally, with caveats), they will coordinate hospice and such. It's nice to not have to worry about that stuff despite the terminal nature of the disease. My hope is that MSK will be "good at death", to paraphrase the title, when it comes to my own. So far I have received amazing care and treatment here, so I am very optimistic. All I know at this point for sure is that I'm going to keep hacking until my last breath. |