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Lynne Eldridge MD

Lung Cancer Survival Without Treatment

By May 20, 2013

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Over the years I've had many people ask me what their lung cancer survival would be without treatment. A few have asked because they have chosen not to pursue treatment. But more were interested for another reason. They wanted to know the survival advantage, in terms of time, that treatment was giving them.

A new study set out to answer this question. It's hard to find enough people who have foregone treatment to get an accurate estimate, so they searched through electronic databases, contacted experts in lung cancer, and pored through bibliographies.

Lumped together by stage they found that people with untreated non-small cell lung cancer lived an average of 7.15 months.

Of course most people choose some form of treatment. Early stage lung cancers may be curable with treatment, and even though advanced lung cancers aren't curable, they are treatable. And it's important to keep in mind that this is statistics. Statistics are great for looking at trends, but say little about what an individual person can expect. So why did I share this information?

Sometimes treatments like chemotherapy and radiation therapy can be grueling at best. When I was going through my own cancer treatment it helped at times to consider the alternative...

But I also wanted to send out a reminder to those who have loved ones who choose to forego cancer treatments (after making an informed decision based on the best material possible,) to respect those decisions. I recently told one of my children that truly loving someone means that we would accept them and love them even when they make choices we wouldn't make. It's easy to care for someone when they agree with us. But it's much harder when we need to put our own wishes and decision making aside and accept that of another.

Why would someone choose to skip treatment?

  • Sometimes the survival "benefits" are small. For example a chemotherapy regimen may only extend life by a few weeks, and would come with negative side effects. Someone may choose to skip treatment to feel as healthy as possible with the time they have left.
  • Due to religious beliefs. Some people's faith may forbid medical treatment.
  • Skepticism about the benefits of treatment.
  • Interest in pursuing a different approach, such as prayer or alternative medicine.

As a last note, some people forego treatment because of the stigma of lung cancer (feeling that they don't deserve treatment if they smoked) or because of a lack of insurance and resources. Nobody should be denied life saving or life extending treatment due to a lack of finances. There is help available, both from non-profit programs, and via your friends and loved ones.

Source:

Wao, H. et al. Survival of patients with non-small cell lung cancer without treatment: a systematic review and meta-analysis. Systematic reviews. 2013. 2:10.

Comments
May 20, 2013 at 10:36 am
(1) Liz says:

My mom had lung cancer and decided against treatment. She was in her mid-80s and already had severe COPD. Her quality of life was not good, and she knew that treatment would ruin her short remaining time. I agreed.

Years later, I faced the same choice but made a different decision. I was much younger–mid 60s, and otherwise in perfect health. I had surgery and chemo. I still have lung cancer, but it’s being managed by a targeted therapy.I have been living with cancer for 6-7 years now, with a very good quality of life, although the 3 months after surgery were lousy, and the series of chemos were rough for a while. But right now, I have few problems and lots of joy.

August 17, 2013 at 10:38 pm
(2) matt says:

How much time did your mother have after being diagnosed? My mother was diagnosed with stage 4 lung cancer and has emphysema. The doctor says there isn’t anything they can do at this point.

September 27, 2013 at 4:49 am
(3) Marthandam says:

My Father was detected having Lung cancer ( stage 3) in November 2012 when he was 76 . He was a smoker , He underwent both chemo and Radiothertapy. His treatment was sucessfull Except for Leg pain there were no major side effects. During review in July Doctors had confirmed that his cancer has almost gone into remission.
He returned back to work and all of sudden on september 9th 2013 had a cardio vascular failure and passed away.
Separation has been difficult but the only consolation is that his end came all of a sudden and he did not suffer.
Any one who would want information which if they feel could be usefull to them may contact me on my mail. s_mathandam@yahoo.com

October 21, 2013 at 3:31 pm
(4) Marie says:

My mom was diagnosed with lung mass on September 14, 2013. She refuses to have it biopsied but it was not on a CT scan in March but is now there and is a 4.3cm mass.
She is 76, COPD with emphazema, has blockages in her neck of 75% on both sides and an aortic anurysm of a 4cm.
The doctor said from her symptoms of caughing up blood, pain and the speculated mass he was sure it is cancer. Since mom refuses to have it biopsied he can not stage it but he believes it to be stage 3 possibly 4. They sent her home on hospice.
I have took off work to care for her and have enough savings to make it 8 months. After that she will have to go to a nursing home. This is all very hard and I know with time her care will be harder. At least right now she can get to the bathroom and back to her bed.
Today she seems stronger and I wonder when the major decline will occur. The unknown is what is hard.

October 21, 2013 at 6:14 pm
(5) Anne says:

Marie, my mother is 86 and needs to have a mass 3.2 cm on her lung biopsied too. She cancelled her appointment and rescheduled for another day, but I’m not sure we should go. I’m leaving that up to her. She is having depression now, and I just don’t know what to do either. The “not knowing” what’s ahead is awful! I’m sure she will be on hospice soon. Prayers for you.

October 21, 2013 at 7:23 pm
(6) Marie says:

Anne I will pray for you and you mom as well. I know her decision will be hard for both of you.

October 28, 2013 at 10:28 pm
(7) Marie says:

Matt how is your mom doing? I have been praying for you both.
Liz I am very glad you are doing well with treatment and pray this finds you well.
Marthandam sorry about your dad and I am continuing to pray for you.
Anne did your mom go for her biopsy? I am praying daily for you both.
My mom is hanging in there no changes just about the same.

November 10, 2013 at 4:03 pm
(8) Debrah Harrison says:

My mum has just been diagnosed with lung and liver cancer. This is in final stages as she has been given just 4/6weeks. She lost her husband last June and she had sudden weight loss and had no energy. We took her many times to her gp expressing our concerns. Unfortunately, she had a fall and also low blood pressure. She was admitted to Hospital where they diagnosed after a few days. Her heart is too weak to undergo an op and she would probably die under treatment. She is having no treatment and we are taking her home to care for her.She is in her 80′s and is very weak, I wonder what her life expectancy really is?

November 10, 2013 at 11:47 pm
(9) Marie says:

Debrah;
I am praying for you and your mom. I hope you have signed up for hospice. They are a wonderful help and it is covered by Medicare. They have a book called Gone From My Sight that can really give you good clues about where your mom is at each stage.

November 11, 2013 at 5:35 pm
(10) Jackie says:

Oh people what an awful situation we are all in. I losyt my dad exactly 2 years ago today with Lung cancer, and now im losing mum too, we are caring for her at home as we did dad too, I have 2 siblings so we share the care between us. Dad died just 10 weeks after diagnosis, but mum is so very different she was diagnosed in April this year, she was told there was no treat ment availabe to her, she as serious COPD too, we have palliative care at home for her. I truely believe that every case of cancer is different and nobdy can say the life expectancy of someone is this position. Mum is getting weaker by the day and sleeps for the majority of the time, I pray for everyone with this vile deasease and their families, its takes its toll on everyone xxx

November 11, 2013 at 7:53 pm
(11) OverwhelmedinMO says:

My grandmother was recently told she has breast cancer and today a chest x-ray showed a mass in her lungs as well. We are waiting for the pet scan rather than doing a CT because of how hard all these tests are on the kidneys. That is tomorrow. I lost my mom last December to kidney failure from diabetes so this has been particularly hard to take.

I honestly don’t know what to do from here. I am taking her to appointments and talking to the doctors but, I just can’t believe it. She has COPD and although we were going to do the surgery are rethinking the plan now that the diagnosis is more grim. I just feel very lost.

November 11, 2013 at 9:58 pm
(12) San says:

My heart goes out to everyone….my mom was just recently diagnosed with lung cancer….Now we worry about doing a biopsy or Media stinoscopy …which is less invasive…she’s 82 never smoked never drank always took care of herself…..this is so overwhelming…I just don’t understand…..we will pray for all

November 12, 2013 at 8:07 am
(13) Marie says:

Jackie, OverwhelmedinMo and San I will add each of you to my prayer list. My mom is hanging in there and I understand all too well the emotional rollercoster we all are on.

November 12, 2013 at 10:31 am
(14) DB says:

No one has mentioned the mental stress of the patient. It is real, knowing that your life is coming to an end and not wanting to burde n your family. Suggestion, music that the patient has always enjoyed is very soothing.

November 12, 2013 at 2:50 pm
(15) Marie says:

Good point DB. Anne said her mom was going through some depression. I believe each person in that situation does. I know with mom she has gone through all the stages of greif from shock to acceptance. She deals with it in her own way and has made it clear to us she doesn’t want to discuss it openly. She does better watching the food network or HGTV.

November 17, 2013 at 4:59 pm
(16) Heidi Hughart says:

My mom has been diagnosed with lung cancer. She is 86 years old and in poor health. She had TB as a teen. I don’t know the exact kind of cancer she has, she doesn’t ask the doctor questions she just does what ever they “recommend”. She is recuperating from a fall which resulted in 3 cracked ribs. This took a toll on her and I am really questioning the wisdom of doing surgery on her but realize this is her decision to make. I don’t know if the doctor is recommending chemo or radiation after surgery. What is the recovery process after lung surgery.? They are removing 2 lobes.

November 18, 2013 at 5:52 am
(17) Marie says:

Heidi;
I don’t believe an MD ever posts to this website. I will be praying for you and your mom as I do the other families who have posted here.

November 18, 2013 at 3:25 pm
(18) lungcancerguide says:

Heidi – The recovery with removing 2 lobes is significant. Here is an article that talks about some possible complications and the prognosis of a lobectomy: http://lungcancer.about.com/od/treatmentoflungcancer/a/lobectomycomplications.htm More important than age is the general health someone is in. We can’t give advise, but from what you have written here I would highly recommend a second or even third opinion before going through with surgery. Your mother’s oncologist would be a good person to discuss this with, since surgeons tend to focus on what they do best — namely, surgery. It’s more important than ever for your mother to know what type of lung cancer she has. If she has non-small cell lung cancer it’s important that she be tested for genetic markers. In some cases (such as ALK) there are treatments available for lung cancer that can improve quality of life significantly with few side effects. That said, a recent article said only 60% of doctors are checking for them. I will be praying for you as well. Dr. Lynne

December 3, 2013 at 9:47 pm
(19) Marie says:

Mom passed on December 2, 2013 at 4:20. I will contine to pray for each one who left a post here. This will be my last post here. Thank you and God bless you all

December 4, 2013 at 5:23 pm
(20) lungcancer says:

I am so sorry for your loss Marie. Thank you for supporting others here even as you were facing such struggles and grief yourself. You will remain in my prayers. God bless you, Dr. Lynne

December 13, 2013 at 10:52 am
(21) nancy says:

My mom (age 89) just had a CT scan because of a”spot’ on her lung. Scan “looks suspicious” according to GP. My mom is a lifelong smoker but had no symptoms until a cough which coincidentally(?) started after a cold and is now better and a weight loss of about 5 pounds. (She’s only 105 or so now.) She does NOT want chemo or radiation or surgery. She is even resisting a biopsy. I think she just doesn’t want to know for sure. She says the mass is about 2 inches but I think she means 2 centimeters. Discovered initially when she had an x-ray a couple months ago. And since there had been no previous x-rays, I’m not sure when this developed or how much it has grown. I’m not sure how to advise her.

December 21, 2013 at 10:45 pm
(22) Mickeyd says:

Marie … God Bless You. You were a GOD-send here, did you know this?

January 10, 2014 at 3:27 am
(23) Dayna says:

I’m so sorry for what everyone is going through.. I feel like I swallowed a rock. My ability to smile without tears is obvious especially to my kids. I have teenagers and a toddler that is so attached to their grandma. My mom is an amazing woman who prides herself in taking measures herself. She wants to make the decisions as it pertains to her choice of treatments. I agree with her. She is stage 3 non small cell. She has had the chemo 1 year ago. She was diagnosed exactly 2 years ago.
Yesterday, we just found out that e Pet scan is questionable for 2 areas of node involvement . We are scheduled for brain MRI.
I would really like to now what the benefits are of knowing how bad he cancer is. If she’s going to die soon anyway, why make life so unpleasant while we’re still able to enjoy it? She’s 73.. Still young but expectancy is 1 year at this point even with painful treatment that will stop her from enjoying life. she may even hit a depression fighting for inevitable outcome. My grandmother, her mom died at 88 from the same cancer. It was a horrible death. My mom was so devastated by her suffering. I wish I could think of a way to suggest to her to stop searching for an answer she will not want to hear.. And live her remaining year not knowing what and when will happen. Silently,in my heart, I pray for a quick heart attack in the night while she’s asleep .Am I wrong to feel this way? I feel guilty if I don’t push her for treatments. You see, I am also a doctor who sees the practical side of things , and I adore my mother with whom I am still connected to by an invisible ombilical cord. I just don’t want her to suffer psychologically and / or physically.
It’s a grueling way to die, not being able to swallow, or breathe,
My brother, whis a physician as well thinks that she hour now everything .. I want to shelter her from too much information and too few treatments of quality to hose from.
I truly believe “Ignorance Is Bliss” in this incurable lung cancer .

January 10, 2014 at 10:16 am
(24) lungcancer says:

Danya – My heart goes out to you. I agree that sometimes ignorance is bliss — and as doctors it is so hard for us to see people reach out for every treatment possible and suffer — when we have seen that often those treatments rob people of comfort and joy at the end without really making a difference. I’m thankful that the new targeted therapies for EGFR and ALK mutations have fewer side effects for those living with advanced lung cancer — but that’s the minority. My heart goes out to you because I watched my dad in a similar situation. Ultimately I had to bite my tongue and respect his wishes, even though he chose a different route than I would have. You will be in my thoughts and prayers. Dr. Lynne

January 20, 2014 at 11:19 pm
(25) Bev says:

Getting very scared. The lady I’m taking care of has been like a mother to me the past 10 years. In Aug 2012 her husband past at age 83, in Nov 2012 she find of she had nsclc. In Dec 2012 they started radiation and chemo ( the light dose they can) . Drs said she couldn’t handle it. They wanted her to do 9 weeks she only did 3 weeks. She wouldnt go back. They check her in April and told us it has shrunk. In June she started hurt in her left shoulder and down her arm. She will not go back to the Drs. For the last 4 or 5 months her mind is not right, forgetting things, not unstanding things in the past 2 weeks the pain is getting bad. She has pain meds but will not take them. She tells other her cancer is gone and I think she think it is. I’m all she has. No kids just me. Request and all say it up to her to stop treatment. And I unstand that, but I’m scared. Dr say in Nov2012 it might be stage 2b or 3a. It been 14 month when we find out, 13 months from last chemo and rad. The pain in her arm in going down to her elbow and hand. She love to crochet and now she is forgetting how. What can you tell me about what’s to come. Do I need to get ready for something to happen? All she eats is a cookies or 2 and a bit of peanut butter a day for the last year. Yes she still smoke about 2 pack a day. Can it spread with tumor is shrunk? Is pancoast tumor what can be the reason for the pain? Can someone tell me something please?

January 26, 2014 at 10:28 pm
(26) Sarina says:

It saddens me to tears reading all the above comments. My father too has lung cancer diagnosed in Aug 2013. His consultant wants to start chemo but my father doesn’t want to have treatment. I respect his wishes but am do scared. Will he suffer without treatment and what will his symptoms be? Should he go through with it to see if it shrinks the tumour? Questions I cannot answer. He is 80 and has a mass of 7cm, has COPD, has been a smoker for nearly 60 years and is still smoking. He is in amazing spirit, joking and looking at the bright side of life and although has other health issues he’s doing ok at the moment. I’m scared that chemo will finish him off due to his age too. I’m sorry for all of you that are seeing loved ones suffer and sorry for those of you that have lost loved ones. I’m glad I found this forum. I think I needed it at 3.27 am…

January 30, 2014 at 4:24 pm
(27) Kellie Hanley says:

After reading all of these I have a lot of these same feelings for my mom who is only 56 with stage 4 lung cancer. She’s been doing treatments. Brain surgery in December another pet scan this week and results today. They found a new spot in the bone in her back. Her body will not tolerate iv chemo anymore so she gone try pill form. She’s losing ability to talk and use her right hand. The dr are increasing steroid treatment in hopes that the difficulty she’s having is due to swelling in the brain. I really don’t want my mom to stop trying but I also don’t want to see her have the side effects from treatment. Now she could develope a rash on face and diarrhea. I just wonder if letting nature take its course would be a better quality of life. Prayers to all!

January 30, 2014 at 5:46 pm
(28) lungcancer says:

Kellie – You are asking the million dollar question, and one that far too many families have to face. On top of that the answer is different for everyone. I will keep your family in my prayers. For now, here is an article that addresses things to think about when you are weighing the quality of life your mother has with and without treatment. On another note, people who develop a rash on targeted therapies such as Tarceva seem to respond better to the drug than those people who don’t develop a rash. <a href=”http://lungcancer.about.com/od/endoflifeissues/fl/When-Should-You-Stop-Cancer-Treatment.htm”>When Should You Stop Cancer Treatment?</a>

February 6, 2014 at 10:35 pm
(29) clare says:

My dad was just diagnosed w/ stage 3 lung cancer. He will next b going for a biopsy . Myself n mom n siblings r beside ourselves. My dad was always the person I felt closest too who cud read my emotions and supplied me w the most tenderness n affection. I always considered myself a “daddy’s little girl”. My heart is shattered .I look at pictures I have of him esp ones of just us dancing and laughing at my wedding. He is 82 n has copd n emphysema w some dementia. I love my dad w my whole heart …please say prayers for him. I m trying to b positive n strong but am finding it so hard.

February 9, 2014 at 7:47 pm
(30) Sara Wood says:

My father is a non smoker and has just been diagnosed with lung cancer a week ago and almost immediately began chemo (there was no mass for them to remove and he’s had symptoms such a a chronic cough for years).

The doctors have given him a really good prognosis where he’s talking about possibly living 10-20 years. They haven’t staged it yet and I don’t know what form it is but I’ve been reading a lot of statistics and info on the web and the survival rates even at 3 years are so low for so many even those who get treatment is there really any hope at all or is this something they falsely promise for some reason? I’m desperately trying to find the possibility of him being around for years and years to come but the internet isn’t helping me in my quest… Is there anyone out there who’s survived longer than 5 years and can share your story?

February 14, 2014 at 9:49 pm
(31) buddhist student says:

I’m sorry everyone here has been suffering. My dad has been fighting various forms of cancer for 5 years. He was just diagnosed with a mass in his right lung. (He already had part of his left lung removed.) But my post isn’t about him. It’s about my mom. She suffered for 5 years with COPD and emphysema. We were called to the hospital in July of 2013, and were told she was going to die. She didn’t. But she continued to get sicker and sicker. I live far away and visited every month or so for a weekend. She realized she was never going to get better and so did I. She was still smoking 3 cigarettes a day and feeling guilty about them. I told her that life had to be worth living. In December she was back in the hospital. I flew up for Christmas and she checked herself out of the hospital against medical advice. She died three days later. I was glad she was at home. I was glad I was able to make her last days comfortable and I was glad that she had her faculties. She ended up dying in my arms. Sometimes people just have to go on. It isn’t easy, but it is the natural way of life.

March 3, 2014 at 9:48 am
(32) Kyle says:

And some people may not seek treatment because life, to them, is the dark cloud that looms over them, not death.

March 11, 2014 at 4:48 pm
(33) karen says:

Hello to all,

My Dad was diagnosed with stage 4 lung cancer in Jan 14, he has decided on NO treatment as, we lost my Mom in Sept of 09 from the same diagnosis, however, my Dad had a stroke in 2005 which left him disabled in a few ways and one of them was his ability to talk… He never complained even when he could talk, therefore, I don’t know when he is in REAL pain and what KIND of pain he is in….. I have NOT called Hospice yet, because I feel that he is NOT there yet….. Can anyone shed some light on this, it seems to be that his right side from his collar bone to the bottom of his rib on the right side of his body is in PAIN…. Right now all his Dr. gave him was Tramodol and I know that is not that strong, however, I know that Hospice will keep him drugged like my Mom and I don’t want that at this stage??????

Please Help!!!!

Thanks, Karen :)

March 29, 2014 at 8:48 am
(34) laurelie says:

MY HEART GOES OUT TO ALL THE FAMILY WHO IS CARING FOR THERE LOVE ONES AT HOME ,,,,,,, I TO IS CARING FOR MY HUBBY HE IS 67 AND LOST 65 LBS SINCE NOV, 2 HE NOW IS 100 LBS AND HE HAS C,O,P,D AND EMPHAMZA AND LUNG CANCER THE LARGE TUMOR COVERS HIS LEFT LUNGS AND THE OTHER TUMOR IS COVING ALL OF HIS KIDNEYS ,,, LM 59 AND I TRY TO GET HIM TO TAKE TREATMENT BUT HE SAID NO , SO I TOLD HIM I WILL KEEP HIM HOME WITH US AND DO I CAN TO MAKE HIM COMFORABLE, HIS PAIN IS TERRIBLE , BUT I GIVE HIM BACK RUBS AND HELP HIM IN ANYWAY I CAN ,,,,, NOT READY TO LOSE HIM YET WE WILL BE MARRIED 35 YEARS IN JUNE AND BEEN TOGETHER 40 YEARS , LOVE HIM DEARLY TAKE CARE , PRAYERS ARE WITH YOU AND YOUR FAMILY

March 31, 2014 at 4:13 am
(35) Fattum says:

My dad was diagnosed with non small cell lung cancer in July 2013, which is now stage 4.
He is 80 yrs old and has not undergone any treatment except for radiotherapy thaat too for a blood he was having in his chest. He is much better than before and can walk with support. I am with him 24/7 to take care of him.
The cancer hasn’t spread any part of the body. His hypertension and suger is in control. No cardiac problems, his chest is clear and is absolutely fine expect, of course, the disease.
But he always feels he is very very sick and psychologically he feels he is very weak. He was and now is more impatient and has no control over his anger. He shouts for no reason and has a very short temper, which sometimes get on other people’s nerves.
I am 22 and too suffering from ovarian cyst myself and with severe lower back pain due to some hormonal problems.
Sometimes it is hard for me as I am at my brothers place far away from my mum as she cannot travel herself.
Needs lots of advises and prayers to cope up in this situation.

April 2, 2014 at 3:22 am
(36) Sheilah B says:

I’d been suffering from a respiratory infection for about a month and half. Though it’s mostly over, I have still been having coughing fits. Today I noticed that the pain in my neck, shortness of breath and pain in the chest have magnified considerably. (thought that the cervical fusion was possibly disassembling) I have health insurance but am actually to poor to pay the deduct. & copay. But the symptoms were enough like heart issues too I had to find out. I’m told after a ct scan that I’ve got swollen lymp nodes, and there’s a black mass on my lung below the swollen nodes. The ER cannot order a biopsy. I don’t even want to pursue it. I’ve smoked many years, usually under a pack a day. I’ve suffered through poverty my whole life. I managed to put together enough money to own outright my own condo when I retired. I live in a Red state, so though I earn only a few hundred over acceptance for public assistance I don’t qualify for Medicaid, and if I did, the state would put a lien on my home. For that matter, so can health providers. I don’t know too many who have gone through lung cancer or cancer of any sort to have lived through it. Most of them poor like me. Those who pursued treatment had nothing to rob their children of and could ‘afford’ to accept the help. Those who accepted their fate didn’t seem to die any sooner than those who fought. Tonight I’m praising GOD for the warning. That way, I will have my will drawn and my home sorted out for my girls when the time comes. Wish me luck and peace. I don’t want to die but I am going to eventually anyway. I don’t know if it’s cancer or lingering infection. But this isn’t utopia here by a long shot. I’m not really going to miss this place where matters are made harder for so many for so little reason. I hope mankind learns to get over themselves. Esp the 1-2% terrorizing the rest of the planet.

April 19, 2014 at 12:47 pm
(37) Praful says:

Hello Everyone,

God bless you all and your loved one.

My father is diagnosed with Lung Cancer 3B stage. He is 69. He gone through 1st chemo on 2nd april 2014. He is feeling ok now. Blood coughing stopped. Haemoglobin increase. Seems everything ok till now.

Doctor is saying this is not curable, So I am planning to give one more chemo and then stop the chemo. and look for some alternative treatment, I need your expert suggestion on this?

Is anybody know about Hemp Oil. (Rick Simpson Hemp Oil ). I am planning to try this as well. Also B17 tablet. Will these treatment help my father ???

April 21, 2014 at 6:06 pm
(38) Peggy says:

Where do I start? My Mom had adenocarcinoma of both lungs in 2006. She had two wedge resections and chemo. She has been cancer free until now. We found out 2 weeks ago that she had a 2.5cm mass in her right lung. Today we found out that is has spread to the lymph nodes, right scapula, and spine. I’m devastated.

My mom is a retired nurse and is 71 years old. She is way too young! I pray for her recovery, but as a nurse, I am also realistic. But I will never give up hope and she says she will go down fighting. I will be right there beside her.

April 22, 2014 at 5:22 pm
(39) lungcancer says:

Peggy – My heart goes out to you. It can be so hard to know where to start and we can feel so helpless, especially when we know what we do as medical professionals. It sounds like you are starting in exactly the right place – right there beside her.

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