QUESTION: Having had many oral cancers - I'm quite disfigured and eat and speak with difficulty.
I'm now facing an operation that may leave me unable to speak or eat. Should I go ahead with it or bow out as gracefully as possible with a few months of possibly reasonable quality of life?
I and my family - my daughter donated one of her kidneys to me four years ago - are happy and fulfilled, but I dread this operation. I so want to be there for my family, to see grandchildren and to help my husband in his old age (as he has helped me over the years). What do you think?
Yours sincerely, Ghislaine
ANSWER: I naturally feel very hesitant offering any kind of opinion on a problem like yours, Ghislaine.
It sounds so overwhelmingly horrible and frightening - and also appears, as far you are concerned, to be a matter of life or death - that I feel presumptuous even commenting on the situation. It is a very personal choice and needs not only your views but also your family's taken into account.
However, you've asked, so here goes. Personally, I would probably have wanted to draw the curtains - if you'll excuse the euphemism - even before the last operation, the results of which you're living with now.
The prospect of talking and eating with difficulty fills with me with dread; life is grisly enough without being unable to be fluent or get pleasure from eating.
And yet, here you are, clearly happy and fulfilled and coping remarkably well. So who's to say you wouldn't come to terms with the result of the next operation and somehow manage to pull through? Because of your personality - optimistic and, it seems a stranger to depression - perhaps you wouldn't find the situation unbearable, and you'd still be able to make a huge contribution to your family's lives.
Also, have you thought that you're anticipating a dismal future that may not actually come to fruition? Could it be that the doctors have outlined the worst case scenario? They often do this to cover themselves against their patients blaming them when things turn out much worse than expected.
It could be that when the surgeons start operating they find there is much less cancer than they had thought (or, of course, there may be much more). And let's say the results are as bad as they say, if not worse? You sound so game, I feel that you'd be up for anything.
But as you're dealing with unknowns, my tentative advice to you would be to have the operation and then, after six months, see how the land lies.
If life is bearable - and it may well be more than bearable - then you will just continue living as bravely and happily as you can. And if it's intolerable, and life is a total misery, then you can start making other plans.
It might help you to ask your surgeon to put you in touch with other people who have had the same operation, so that you can find out how they are coping. You could even ask them whether they feel they would have preferred to have died, or to live in the state they are now. You will only get subjective answers, but I'm sure you would discover some interesting insights.
I think it's extremely sensible of you to start anticipating the outcome of this operation now. And it's important to include your whole family in all your thoughts and anxieties, because only then will they be able to come to terms with any future plans you might make.
The Independent