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?

The post heading is wrong. There's no way of knowing if it "WOULD" cure you. There are probabilities and statistics about how successful different kinds of treatments are for different kinds of cancers, different stages, etc., but nothing is guaranteed. There are also statistics showing the likelihood of the treatment itself killing you, harming you, or simply not working. So it's not simply a case of "have the treatment, you'll be cured"!

I'm torn on this. My father died of skin cancer (even if sceptical, this IS very curable if caught early).
It makes me sad he didn't go to doctors until too late.

But, on the other hand, there is no doubt whatsoever that some cancers ARE over diagnosed AND overtreated.

Mammogram diagnosed dcis, for example.

It's a fucking scandal, frankly.

Doctor does not always know best.

Sometimes people are just unlucky or lucky. I felt a lump above my breast then it appeared to disappear so I thought nothing of it. Though I’d just become pregnant so in hindsight it disappeared as my breasts changed size. Then they stayed bigger as I was breast feeding. Then 6 months later I stopped breast feeding and the lump became evident again. By the time I went to the doctor it had been there for 2 years!

So based on what we think we know about early diagnosis I should probably be dead. But I was just lucky that it was a slower growing cancer, just hanging around not doing anything. No spread to nodes.

Many people go to the doctor the minute they find a lump/ have symptoms and it can be too late. If you have an aggressive cancer it can progress very quickly.

It’s never clear cut with cancer.

My OH was diagnosed with bone marrow cancer around 5 years ago. The chemo nearly killed him. His "bad" blood result levels had halved after the first round, then halved again after the second round, but oncologist insisted on going the full six rounds at the same dose. OH could barely get out of bed after the first round of treatment, it knocked him flat. OH asked about a lower dose, but was told, no, it had to be the full dose for all six rounds apparently. He just refused to turn up for the third round as he couldn't face it. Suddenly, oncologist decided they "could" reduce the dose after all, so OH went along with it, and even a reduced dose nearly killed him. He refused, point blank to have any more, and "missed out" on the 4th, 5th and 6th rounds. But his "bad" blood result levels halved and halved again, even when he wasn't on the chemo, and ended up being very close to normal. Even the oncologist agreed that even on the full six rounds of full strength chemo, they don't often get the "levels" down that low. Doctors aren't infallible - patients need to be listened to more and there should be a more open/honest dialogue with medical practitioners, and yes, they should sometimes be challenged. 5 years later, OH is still showing very low "bad" blood levels despite being on the lowest possible "maintenance" dose of drugs cocktail. OH and I have no doubt that had he gone through with the oncologist's "recommendation" of full dose for six months, he'd not have survived it!

Carmago can you share some of the info you have over-diagnosis /treatment of DCIS please?

Hi, this is genuinely not meant to sound sarcastic (honestly!) but all you need to do is Google Dcis and overtreatment and overdiagnosis.
There are plenty of articles on it.

I hope you find them useful.

You say “ caring that the patient makes the right decision “, right for whom ? Yes, as medics we think we know what the right decision is, but holistically, it’s so much more. I worked in palliative care for many years, and had countless conversations around this issue. So long as the patient is fully informed of their options, and has capacity, I would have no opinion.

As a former breast cancer patient I'm aware of the dilemma over DCIS. However when it's you on the spot taking that risk you might choose caution over keeping a breast.
In my case the cancer was a very aggressive one but tiny. I had the works, surgery, chemo and radiotherapy plus herceptin.
This was four years ago and I am still NED.
Only when they operated did they find the cancer was embedded in a larger area of DCIS which hadn't shown on mammogram.
So in my case if that DCIS had been picked up and removed when I had a mammogram a year earlier it might have saved me having chemotherapy.

I can't see the point in this thread now, only as a 'debate' with personal experiences which vary hugely.

OP disappeared long ago anyway.

My guess is it was never about 'her' or she'd have been far more emotional.
It's most likely about someone she is close to, maybe family, and wants to know if she can intervene legally, so they have treatment.

That's been covered ad nauseum here.