I’ve written a couple of posts lately about how much things cost ranging from Botox to Lupron to high school year books. My last post was short, a bit flip, and on the humorous side. Shortly after I wrote it, I read this amazing post on Not Down or Out. I complimented Cheryl on her post and much to my surprise, she said it had been partially prompted by my “what things cost”-themed posts!

I’m not saying that I’m never deep because I know that’s not true. But I threw off those posts about costs and didn’t really think about them that deeply. So I started thinking about costs a bit more, relating them to my own cancer experience as well as of those about which I’ve read.

Breast cancer treatment costs a lot. We lose things we would have preferred to keep such as money, time, a sense of safety, taking our health for granted, relationships, a brain that works properly, and last but not least, body parts. We gain things we’d rather not have like nausea, fatigue, weight, neuropathy, hot flashes, aches and pains, and grief. Everybody’s experience is a bit different and for each individual, the experience can change over time.

Putting aside the fact in our lives as tainted test tubes, we don’t know for sure whether each ache or pain or other side effect is really due to cancer treatment. (Okay, I know some of them are pretty obvious, but generally speaking, we don’t always know.) But we do know our current day to day experience and what we like and don’t like about it. And a good number of things that we know about are costs of having cancer and having been treated for cancer.

What we don’t know are the costs of the roads we have not taken. Those of us who had surgery for DCIS will never know if left untreated, whether it would have become invasive or not. And those of use with early stage invasive cancer, don’t know what our outcomes would be if we’d foregone all or a portion of treatment. Finally, those of us with metastatic disease will never know if we chose the right balance between strategies to extend life verses those that preserve quality of life.

Instead, we must make decisions based on our understanding of research on assessment and treatment of our particular diseases, our other risk and protective factors, our personalities, what is important to each of us, and what is not important to each of us. And we must try to make well-reasoned decisions, accounting for all of these factors, while under incredible life stress. Not to mention the fact that we all have people who love us and depend on us. There are costs to family members and friends. As my friend Nancy says, “This disease has tentacles.”

And how many assessment and treatment decisions have each of us made in our experience with cancer? Tons, right? This means there are many paths not traveled. To really understand the costs of our decisions, we would need to be able to live many lives, each based on a different set of decisions.

We’ll never really know because each of us have just one life to live. I often write about my own decisions, “I made the best decisions I could based on the information I had at the time.” It may sound kind of nerdy but it frees me from a good deal of “what if” kind of thinking. I try not to dwell on the costs of the roads I didn’t take. I will never know what they are and to do so would have me walking in circles instead of pursuing the path I chose.