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?

If you have capacity, you have the right to make decisions others may consider unwise or disagree with.

I've started a thread in Mental Health about stopping SSRIs after years of treatment (no replies yet).

one side benefit off coming off them would hopefully be that I can't be judged in this way.

If someone has capacity to give or decline to give consent for a treatment, then that's their free choice to make. Having capacity is not the same as agreeing with the doctor - it's about being able to understand the relevant information, weigh up the pros and cons and make a decision from that.

A healthcare professional may well have their own views on what they would do in a scenario, but shouldn't make anyone feel bad or 'wrong' for making their own decision.

If a doctor is aware that declining a time-sensitive intervention would have a high risk of hastening someone's deterioration or death, then they need to make sure the decisions being made are by a patient with capacity to consent (because sometimes even if the patient changes their mind later, the window of opportunity to intervene may have closed). So, they'll need to satisfy themselves that the patient has capacity, which may include asking for a second opinion on this issue. It's not about judging, though; it's to make sure that the patient is making an informed decision that they will be able to live (and potentially die) with longer term.

I'd suggest that the person in this situation might want to speak with a counsellor or nurse from a charity like Macmillan, to maybe get an additional perspective from someone not directly involved with their care and treatment. When a decision has life-changing consequences, it's worth taking a bit of time (if possible) and gathering a few perspectives, to make sure whatever decision someone makes is the right decision for them.

I dont know but personally i would refuse cancer treatment if i had onset of alzheimers or parkinsons or maybe ms

Same with a family member.
Treated for bc, lived after tte 5 years mark so considered ‘cured’ in statistics.
The reality is that all the years she had were with regular chemotherapy with all the side effects, incl on her MH.

In her own words, if she was making that choice again, it wouldn’t be to cure at all cost.

If a person is refusing treatment their capacity will be assessed - if they have capacity then legally they cannot be treated against their will. Sounds a difficult situation 🌺

@Pippu I refused cold cap too. I don't want to spend an extra 2-3 hours on the chemo ward for something that might not even work. Both my oncologist and the person I chat to at Macmillan tried to talk me into it, but was firm in my refusal.

Even though I have found losing my hair far harder than I imagined, I don't regret not trying cold cap.

Why would you care what the doctor thinks though? It's the patient's life/death ultimately.

It does seem an odd choice in someone young enough to have a decent lifespan afterwards, especially if the cancer has a good chance of being eradicated.

That's the only reason I'd see why a doctor would want to make sure someone was of sound mind. Does this person have children to consider?

Why would your capacity have to be assessed if you refused treatment?

I mean if the cure is many rounds of chemo/radiotherapy & surgeries why would it be a surprise that that is refused?

Surely it's conceivable that some people would rather not start at all?

I can't understand why it would matter if a doctor would judge you. If you decide not to take treatment for a cancer that has been caught early and with a good prognosis, I'm sure most people would have an opinion on this. Particularly if your decision will eventually lead to untimely death. But ultimately its your choice if you don't want to live - it won't affect the doctors. No one else's opinion matters, and when you get to the stage that you're really sick because you refused treatment, you'll probably have more on your mind than other people's opinions anyway.

A close relation has refused further investigation or treatment of liver cancer. He has full capacity but was warned about brutal side effects of treatment and decided not to start down that road.

Is this about you? Or a friend or relative?

You can elaborate.

No one knows you here.

The only reason (surely) to refuse treatment that can bring about a cure, is surely for religious reasons, or the fear of side effects of the treatment.

What reasons does this person have (assuming they understand the outcome without any treatment)?

Of course they can, its their body.

I had a partial mastectomy for cystosarcoma in my early 20s, I would not do chemotherapy though.

Chemo bought my mam 4 years (which is a decent amount of time) but made her suffer a lot of pain and complications. irony is chemo killed the cancer just to gave her a different mutation so she still had 'cancer'. Chemo destroyed her immune system which killed her (a horrible way to die).

My aunt got one year from chemo and said she wished she didn't as it was a year of pain and no life quality.

My other Aunt refused surgery (she was only middle aged) and she was entirely allowed to do that and supported in that choice even though surgery 'may' have saved her (there is absoloutly no 'definitely will' with cancer).

I am not stupid I studied medicine and have a degree which INCLUDED studying cancer at a university level with a respected cancer researcher. I know acutely the risks and effects of chemo and do not deem it safe or a 'cure' in most cases, it often just borrows time at great expense.

I support anyone else to try whatever they think is best in their journey if thats chemo I wish them luck but its my right too choose not to put myself through that unnecessary pain for a bit of extra time and that does not make me 'insane'.

I find it rather impressive, and an indication of a man who knew his mind and what he wanted.

@Hbh17 You are entitled to your opinion and that’s fine.

If the treatment is a cure ( and some is, if cancer is caught early) then the reasons to refuse are unclear.

If the choice was 5 years more life with treatment (not a cure but a delay) or 1 years with no treatment, that's a valid point IF the treatment took away quality of life.

Might not happen these days but it did in the 1990s to a woman I was in a psychiatric ward with. The psychiatrist deemed that she was not mentally capable to decide to refuse treatment for cancer. Can’t remember whether she had bipolar or schizophrenia but she seemed perfectly sane to me!

Lots of posts here are focusing on chemo.

There are newer treatment now many of which are less troublesome - eg immunotherapy.

Chemo is only one type of treatment, but there are others.

I imagine for cancer treatment it’s done very informally for the majority. So someone says they either want or don’t want treatment, the doctor is assessing whether or not they’re making an informed choice. So asking questions about their understanding of consequences.

so someone declines treatment because they know the stats aren’t great, they don’t want chemo because of side effects, etc that’s probably as far as the capacity assessment goes.

but if someone with a much better prognosis if treated, declines treatment and when asked why says that it’s not the side effects of the drugs they’re worried about and that they really don’t want to die but they can’t cope with a needle. They are more likely to get a formal capacity assessment.

I can only post my experience. My 62 year old battleaxe aunt, in an Asian country not UK - refused any treatment at all for her highly curable stage 1 lymphoma. I suspect she thought she’d quietly escape the horrors of chemo, of losing her waist length thick black hair, and that it would quietly and calmly one day send her off to sleep.

My dad and their other siblings and all of us her beloved nieces and nephews (she was a spinster and child free), coaxed, cajoled, fought, argued and battled till we frothed at the mouth.

Battleax aunt remained adamant, that she was simply going to ignore the cancer and I strongly suspect she thought she was taking the easy route out.

She died the most agonising and prolonged death I can describe ever, as the untreated lymphoma destroyed her.

I flew from the UK with 9 month old DS to show him to her and she recognised him and saw him and knew she’d had a grandnephew.

Then she died. I will never stop wondering what would have happened if a woman of 62, with stage 1 highly curable lymphoma and no co morbidities had been less stubborn and accepted the chemo.

My poor dad who lost his beloved little sis is still not over it. He thinks if only he had argued more with her… if only…

Yes as long as the person has mental capacity to refuse then they can refuse. The doctors would do a mental capacity assessment to make sure the person fully understands what they are refusing, why and the consequences but if they are happy that they have capacity they can refuse whatever they want.

I'm in the US so this may not apply where you are. Where I live you can do an advanced directive regarding your medical care. This is a legal document that lays out your wishes, made when you are fully 'cognizant' and mentally capable.

If you (I assume it's you, apologies if I'm wrong) have serious concerns about your wishes being carried out, I suggest you see a solicitor to see if there is an equivalent document where you live.

These documents not only protect your rights to determine your care, they also absolve medical practitioners from being accused of neglect or malpractice in the event your death would have 'technically' been preventable had they intervened.

I wish you peace and strength.

My grandmother refused treatment for cancer and died aged 67. I'm not sure of her reasons. Your body, your choice, no one can be forced into a medical procedure.

i had a tumour in my colon in August. They removed the whole thing and hadn’t spread, no lymph nodes damaged. But some cells left. I had the option for chemo for 6 months, tablet form or blast with IV drip and tablets for 3 months. They told me it was my choice if I wanted to go ahead with the treatment but because I’m still young 50. I chose to go with the chemo I though it was my best interest and chose the three month treatment plan. Sometimes I wish I hadn’t as they make me feel awful. The oncologist worded it, I’m selling you an insurance policy.

This is just a horrific post.

A woman with cancer was apparently HARRASED because people didn't like HER choice with HER body. Her husband left her, took the kids, actively witheld them from having a relationship, decided to play happy families with another woman and now you are mocking her death.

Off the chart disgusting behavior.