Can you refuse cancer treatment even if it would cure you?

[Jinglestreet]

I'd rather not post specifics as it'll become outing. My question is as the title, can you flatly refuse cancer treatment? Say the cancer is curable and in a middle aged person. it's caught at a fairly early stage and prognosis is excellent, is refusing treatment seen as an option or could family/next of kin go down the "not of sound mind" route even if the person was of perfectly sound mind? The cancer will eventually lead to death. Would doctors support treatment refusal?

I don’t mean to be patronising. I was simply saying that there is a common misconception, probably due to medical TV dramas, that the alternative to unpleasant treatment is a slow fade away.

If i had been 'made' to undergo the recommended treatment for what was at that stage a potential secondary tumour, I would have had a lot of entirely unnecessary surgery with serious implications for my future health. The limited treatment I agreed to revealed that I didn't have cancer after all.

I haven't read the whole thread but I am retired from the NHS and know a bit about capacity and patient choice. Capacity is not a yea or nay thing and pretty much has to be considered on a decision by decision basis. If someone is adjudged not to have the capacity to make a certain decision, the first thing that has to be thought about is what the person would decide to do if they did have capacity and what evidence that there might be either way. An example is whether someone should have a flu jab. You can't just say "oh its best for them" and do it, you have to consider if they have a history of accepting preventative medicine or not and whether they have ever said anything either way. When the nurse approaches with the syringe does the person accept the treatment or do they pull away? If that consideration doesn't help, only then can a "best interests" decision be made. I suspect that if the person really really did lack the capacity to make a decision about cancer treatment then if there was no health POA in place, the decision would likely be to treat palliatively as cancer treatment can be so horrible. Even with a health POA in place, doctors can refuse to agree to the POA or parental decision if they feel its not appropriate.

Have you not heard of bodily autonomy. No one has the right to force their own personal choices on another, unless the individual does not have mental capacity.
How very judgemental.

Speaking from the experiences of family members, I don't understand how someone could be forced to undergo cancer treatment (which I think was your initial question). It is so invasive and gruelling and requires the patient to be up for the fight. It often requires a lengthy stay isolated from friends and family in hospital... stuck in a room on your own for weeks on end. It is often not about "curing" the patient but prolonging life, for which repeated interventions may be required. Certainly my relatives were told at every stage that treatment was completely their choice, and every option was discussed in detail.

Oh my god
Another case of someone being told they have cancer when they don't?

there's way too many of these.

But nobody has been forced….

Are there any restrictions on palliative treatments, or will those be refused too? Having known several people who have died from different forms of cancer, it can be a slow, painful and horrible way to die.

Anyone can refuse or say yes then change their mind. Watching someone close to me with incurable cancer having chemo and being encouraged to fight it all costs whatever it takes. I wonder at what point they could choose to slip away after this. She's at war against cancer, but she can't win that war. Not now. They only person that's opinion matters is that central person

As an aside, OP hasn't actually stated that she's the person with cancer, she could be asking for someone else.

GP here - I have had patients do that. Invariably by the time they regret it, it's too late as it has spread. So think very carefully as over time you naturally lose the ability to change your mind..............

Exactly.

My take on it is that it's not the OP who has cancer but a close relative.
She appears to be asking to see if she could override the relative's wishes.

If someone that isn't extremely elderly or with other severe health problems has an early, treatable cancer and doesn't take the treatment they're either mentally ill, stupid or both

@porridgeisbae Not necessarily. Some people have hard lives, whether financially, emotionally, or mentally, and quite frankly, they’re worn out. They’re not mentally ill or stupid, they just can’t face overcoming another challenge, especially if they don’t have much support from family/friends.

Cancers are as varied as the people who get them.

Exactly. When my husband was diagnosed and chose palliative chemotherapy, I was infuriated by friends who questioned me 'allowing' him to make that decision, insisting on giving me horror stories about chemo.

But his wonderful consultant had given every bit of information that he could. There was no pressure, but he'd assured my DH that the chemo for his specific cancer was not one of the more difficult ones. He talked about the exact side effects of it, and we had every bit of information we could want for DH to make his decision.
Yet random friends and acquaintances seemed to think they knew better because their friend/relative (who had an entirely different type of cancer and an entirely different chemo regime) had an awful time.

Cancer is not one illness. It's one type of illness, and there are dozens of different types, and dozens of different chemo drugs and treatments. It horrifies me that people with very treatable cancers with quite bearable treatments, choose not to be treated because they've listened to those people who LOVE to share the worst case scenarios.

Don't listen to random people on here or in real life. Listen, and ask questions of your consultant and the specialist nurse allocated to you. Your situation is not the same as anyone else's. No-one else's story is going to be yours.

You really can’t say most people will die of their cancer. Cancer is anything from skin cancer, which I’ve had and has been removed, to more complex cancers. Some people live years with it and die of something else entirely. We are late to diagnose in this country and people are late to present. Our stats aren’t good compared to other countries and we could do something about it with education and more funding and a better government. It really isn’t an automatic death sentence that it used to be and it’s an appalling thing to say on a thread about it as it just isn’t the case.

As others have said, you can refuse treatment. I have cancer and have had quite a difficult time in treatment. For me personally, I would think seriously about undergoing treatment again if it was unsuccessful this time. The only things that would persuade me I think would be how my death would affect my family.

Nope they won't, it isn't the NHSs treatment plan it is tbe patients.

That sounds utterly horrific for her. Whats the point of asking for consent then ignoring it. I'm hoping this isnt true. Surely to God if she was an adult of sound mind then she gets to say no and have that respected.

That sounds utterly horrific for her. Whats the point of asking for consent then ignoring it. I'm hoping this isnt true. Surely to God if she was an adult of sound mind then she gets to say no and have that respected.

The whole point is that if someone lacks capacity, consent isn't straightforward. That's easy to understand the other way around. Someone lacks capacity to understand sex, they shouldn't be having it, even if they 'consent' because their consent isn't informed. If someone cannot understand that (for example) they are in anaphylaxis and need epinephrine to live, and are scared of the needle, it makes sense to administer it.

These treatments do not 'fix' cancer, they buy time and for a few lucky people that might get decades of remission.......... however for most its a few years with serious health complications.

This is utter rubbish. There are many, many cancers which are treated with no long term effects. To say that most people are left with serious complications is just not true.

I've had cancer and had to sign consent forms for all treatment.

Nobody has to have treatment if they don't want to.

What if a patient refuses to engage at all though? How can they assess capacity if a person walks out with cancer and never returns? I'm assuming they can't force an assessment on you unless they have significant grounds to think your capacity is compromised.

It's an interesting question OP - I'm sorry you're in the position to ask it though. I hope you have support if this is about you

That's a bit different though as it sounds like treatment might have bought a small amount of time but wouldn't have been life saving.

People are free to make unwise decisions but it is sad when you know what's coming for that patient especially if you know it could be avoided.

You are quite right. There is so much misinformation on this thread.

If the person would refuse treatment, why did they get diagnosed in the first place?

Genuine question, no judging here. I have a similar mindset x