My husband says he would rather die than live with the surgery the doctors suggest. Can’t he just let his disease take its natural course without subjecting himself to this treatment?

20. My husband says he would rather die
than live with the surgery the doctors
suggest. Can’t he just let his disease take its
natural course without subjecting himself
to this treatment?

Being diagnosed with cancer is a tremendous burden
on anyone, and the ability to cope with feelings may be
more difficult if someone is told that a permanent (or
even temporary) physical change may be necessary. For
example, most people do not want to live with an
ostomy (which entails wearing a “bag” to collect bowel
movements or urine), or having their breast removed
(mastectomy), or a prostatectomy, or other surgeries
that change the look and/or function of their bodies.
Some people may consider declining surgery or other
treatments, such as chemotherapy or radiation therapy.


Ostomy =  Surgery to create an opening from the
skin to the urinary or gastrointestinal canal, or the trachea.

Mastectomy = Surgical removal of the breast.

Prostatectomy =  Surgical removal of part or all of the
prostate, which can alter men’s physical/sexual responses.


If your spouse is having a similar reaction to a proposed
treatment, help him take a step back and review his
decision-making process so that he can be sure that he
is making the best decisions. Patients need to weigh
their own values when making any treatment decision,
including whether or not to have treatment at all. Some
people who initially decline a procedure later change
their minds, after the initial shock subsides. Sometimes
taking the time to talk more to the physician, talking to
other people who have had the same procedure or
treatment, and/or seeking a second opinion can help
ease this decision-making process. Use this added
information to help your loved one make the right
medical decisions for him. Encourage him to research
his choice and to take control over his decisions.

When discussing the pros and cons of an operation
with a surgeon, ask about the location and reason for
surgery or treatment, and confirm the need for the
particular medical intervention that has been proposed
as opposed to other options. If it is indeed recommended,
and you and your partner are still unsure of
whether or not to proceed, make sure that you are
aware of the consequences.

It is important that you understand that “letting nature
take its course” does not necessarily mean slipping
gradually into a gentle death. For example, not having
a surgery such as a colostomy can result in medical
complications, including possible obstruction of the
colon and tumor invasion of other organs, potentially
resulting in lower quality of life including pain and
frequent hospitalizations. Foregoing surgery or treatment
can hasten a patient’s death.


Colostomy = Surgery to establish an artificial connection
between the lumen of the colon and the skin.


Sometimes patients and family members disagree about
whether the patient should undergo the treatments/
surgery the doctors offer or suggest. Occasionally, family
members are adamant that the patient undergo the procedure
despite the patient’s reservations or explicit
refusal. If this describes your situation, first, talk to your
spouse about why he has made this decision. Be sure to
listen—not argue—with the reasons. Then, after your
spouse has finished, explain your point of view as calmly
as possible, understanding that the final decision is his
to make, but that the decision does affect the rest of the
family. If tensions are high, then you and he may want
to talk to a trusted friend or a more impartial person,
such as a nurse, counselor, minister, or social worker, to
help focus the conversations and keep the lines of communication
open.

Furthermore, be aware what your reasons are for wanting
your husband to have the suggested treatment. As
social workers, we have seen family members sometimes
fear the loss of their loved one so much that they
are willing to do anything to keep him or her alive.
Sometimes the proposed treatments can be invasive
and lead to side effects that may not be worth the suffering
to the patient. You need to consider your feelings
because you, too, are affected by your husband’s
diagnosis, but be sure that your opinions are based on a
fair assessment of his wishes as well.