Cancer And Time Toxicity

For cancer patients, time is of the essence.

In my case, with incurable cancer, time feels particularly precious as it is limited. I suppose that’s the same for us all really.

But with a lifespan being cut short by cancer I therefore want to know where and how my time will be spent and I certainly don’t want to waste it bogged down in the health care system with all of its inefficiencies.

Cancer patients are robbed of time. It goes with the territory and it’s yet another toxic element we have to endure. It’s one of the biggest costs of cancer alongside financial toxicity.

With cancer, time is diffracted and re-assembled, it is fuzzy and frenzied, it is explicitly precarious and elusive, it is rethreaded and criss-crosses the past, present and future and creates it’s own dimension.

Time toxicity relates to the time spent undergoing cancer-related ‘physical contact’ medical care including travel and waiting times. Sometimes, a short outpatient appointment can easily take up half a day or more.

Let’s not forget blood tests, picking up medication, clinic visits, coordinating care, scans, home-based care and telephone appointments. It also encompasses seeking urgent care for side effects, follow-up tests and possible hospitalisation.

That’s a lot of time and “time that you don’t get back” so to speak. Add all this up and factor everything in, it’s no wonder we are exhausted.

It’s not just us though. Our partners and family members also fall victim to time toxicity as they are the people often doing all the ferrying and carrying. They lose time if not more so.

When your time is eaten away then making time for social events is also curtailed because you and your loved ones are tired.

Time is certainly consumed but how much of a patient’s additional time, in terms of survival, will be spent  interacting with the health care system? Will that actually be of benefit especially if one has a shorter lifespan predicted?

As Johnson et al (2023) note,

Many cancer treatments impose large time investments on patients and their care partners despite only modest survival benefits.

How we spend our time as a resource should be up to us and time spent in the health care system might be doing more harm than good in which “the survival benefit is dwarfed by the logistics” (Srivastava, 2022).

This said, time toxicity is tolerated as a necessary burden and by-product when a treatment offers a significant survival benefit.

The ‘system’ can help patients though and probably isn’t doing enough to ease the time burden. For example, what appointments can be done virtually, to save time for patients and consultants?

The amount of time committed to dealing with cancer is substantial and should not be underestimated in our ability to cope.

Cancer gobbles up our time and so as patients we need some honest discussions about the likely time toxicity of different treatments so we can best weigh our options.

But let us end on a high note.

Time swallows itself, burps uncertainty but also renews hope, reignites dreams, and releases potential.