My dad pointed to my mom’s pic: “That’s my wife!”

Me: I know. Where is she?

Dad: Heaven 

Me: Where are you going?

Dad: Heaven 

Me: I’m sure you will meet her there. 

Dad: I try every day to join her in heaven…

Me:  “Heartbroken and Crying”

Love, living and loss – are so intertwined and bittersweet. 

This, of course, broke my heart. But, it also made me wonder about my patients who are waiting while counterintuitively yearning for something. Those #livingwithcancer wait for the next scan, scared their cancer will return, they spend their lives always having cancer but yearning to be truly free of it. People with more advanced diseases and those who are #livingwhiledying long for some final peace, as they wait to die but do not want to die.

My dad is 91 years old and has dementia, and can understand everything you say and has the usual thoughts but struggles to get words out. However, he is still wickedly funny – #wordsmatter. He loves very tactilely too. 

There is an interesting concept of ambiguous loss, for example, when a person is still physically present but psychologically gone, as with those with Alzheimer’s, or if you have someone who physically isn’t well but psychologically present like those with a terminal disease. In both cases, you cannot resolve the question of mourning and loss because you don’t know whether they are here or not? 

My sadness for the frail and elderly comes from knowing there is nothing lonelier than loneliness. 

Loneliness and social isolation in the elderly are associated with decreased survival and declining daily activities. Considering the overlap between cancer symptoms and depression, depression is particularly difficult to assess in older geriatric cancer patients. In addition, according to several studies, elderly people who experience high levels of loneliness are at greater risk of becoming physically frail.

A frail person is very prone to stress because they have lowered physiological capacity, a reduced ability to maintain stability, and generalised weaknesses. Consequently, there is a growing subspecialty in geriatric oncology, and out of this realisation that we need to treat this group differently, excellent tools have been developed. 

One of the critical issues is giving chemotherapy or active treatments to the elderly and frail. How far should we go? 

I guess the question is how can we spend our and their time better…

Dr. Prinitha Pillay is a Specialist Radiation Oncologist in Gauteng. She is practicing in Johannesburg, offering radiation cancer treatments, comprehensive palliative care and psycho-social support. She offers a variety of treatments including Breast Cancer Treatment, Gynaecological, Gastrointestinal, Lung Cancer Treatment, Paediatric, Head and Neck, Prostate Cancer Treatment, Brain Cancer Treatment, Dermatological and Musculoskeletal Cancer Treatment.

This article was first published at https://treatingcancer.co.za/fragility

This article was first published at https://topclickblogs.co.za/radiation-oncologist-dr-prinitha-pillay-2/