Mandatory Decision Making in a Cancer Journey

Game theory and cancer treatment.

I started this post with the Robert Frost poem The Road Not Taken. It was worth reading again. It's about decision making and the criteria one has available in the evaluation of choices.

That's a pretty clinical analysis of a lovely poem but I'm into clinical analysis these days. Google the title and find a more satisfying sense of the poem than what you'll get here.

For me, it was surfacing Personal Control responsibility again. For me, it was more determinative in dealing with options. But the decision making itself is likely more difficult, ironically because in most daily decisions, the stakes are so low. Not so with cancer.

However, in a life threatening disease treatment journey, like cancer or others, there are many choices to be made, most of which are far beyond your control. Even if your disease is untreatable, there are decisions that are only yours to make.

These are not optional choices where a coin flip may be just as optimal as any other means to get beyond maybe.

Getting to a decision is mandatory in disease situations. You can defer and delay and deflect for only so long. Then no decision becomes a decision.

Eventually the puck must get dropped and the game must be on. You are in a fight against your enemy, your cancer. Yes your cancer. This isn't a metaphorical game about cancer. It's your real life and its about your life or your death.

That said, I will still speak in terms of game metaphors in this post. That's because it's helpful in understanding the nature of the mandatory disease decisions.

GAME THEORY

I've recently been made aware of game theory and the two types of games, the finite and infinite. My involvement in politics drew me into game theory. My cancer has brought me back. I am aware and relatively well informed about game theory m, but far from being more than a curious learner.

So what's the difference? The finite game has an agreed to set of rules, including a common definition of what a win is. There is always an opponent who must be defeated by the end of game time.

The purpose of the infinite game is to win but what constitutes winning is keeping the game going, not just until the clock ends the game.

Elections are finite and infinite games in my mind. The finite reason is to win an election. But that’s is not to end the game. The infinite aspect is to take power to implement election policy, over the long haul, or at least until the next election. Keeping the game going past election day.

MANDATORY DECISIONS

So back to mandatory disease decisions. Like with elections, I see both games at play. Decisions in treatment selection are finite. Winning, at this stage of the game, is picking the most optimal treatment mix based on science, evidence, and other factors, like accessibility. More on that in future posts.

My treatment decision was 33 radiation sessions supplemented with 7 chemo sessions over 7 eeeks. The recent evidence is the chemo enhances the effectiveness of the radiation. No surgery.

My treatment regime is in week 5 of 7 and it's all about effective plan execution, monitoring and amending as required.

The infinite game aspect I see is coming. That will be the post-treatment follow through of monitoring the treatment effects, tracking for spread or new disease, and all the mental physical and spiritual adjustments that will be my new normal.

We spend a lot of focus on the finite of getting to the treatment “finish line.” It's a tough journey that demands focus and strength. I'm staying in that “get to the finish line” headspace until I'm there. That's a big enough and vital enough of a challenge for now.

But I'm aware that finish line is the end of one phase but the starting line of another beginning, the infinite post-treatment game phase. That is were winning means staying alive, but also with a mindset and attitude that is worthy of that life.

That's coming. But for now, i’mout to defeat this enemy through my commitment to my great treatment plan of radiation and chemo regime designed specifically for me and my cancer.