To work or not to work?

Sorry you're having to go through this.  Your profile says you were in situ initially?

Sorry you're having to go through this.  Your profile says you were in situ initially?

Sorry you're having to go through this.  Your profile says you were in situ initially?

While there are many considerations and different strokes for different folks, I find work (full time) to be a welcome and pleasant distraction from my stage IV melanoma.  Of course, if things were to take a turn for the worse, I'd have to re-evaluate. 

While there are many considerations and different strokes for different folks, I find work (full time) to be a welcome and pleasant distraction from my stage IV melanoma.  Of course, if things were to take a turn for the worse, I'd have to re-evaluate. 

While there are many considerations and different strokes for different folks, I find work (full time) to be a welcome and pleasant distraction from my stage IV melanoma.  Of course, if things were to take a turn for the worse, I'd have to re-evaluate. 

Personally, I need to work – not only to support my family, but as Mat noted above I need the distraction. From your comments, it seems like you want to work so I say just do it. The last thing any of us should be doing is living in fear such that it prevents us from doing the things we want to do because of the "what ifs."

Kevin

Personally, I need to work – not only to support my family, but as Mat noted above I need the distraction. From your comments, it seems like you want to work so I say just do it. The last thing any of us should be doing is living in fear such that it prevents us from doing the things we want to do because of the "what ifs."

Kevin

Personally, I need to work – not only to support my family, but as Mat noted above I need the distraction. From your comments, it seems like you want to work so I say just do it. The last thing any of us should be doing is living in fear such that it prevents us from doing the things we want to do because of the "what ifs."

Kevin

You're right, it is ultimately your decision and what is going to help you the most. As others have said, working can be a great distraction, but not everyone wants or can handle that. I also understand not wanting to start something and then having to leave part way through- doing that (or even the thought of doing that, which for myself I veiw as "quitting" and that's something I just don't do) gives me ulcers nearly as bad as dealing with this stupid disease. I still struggle with the same question though, each time I have to start a new therapy. I know I should be a bit braver, but I hate having to leave things unfinished, contracts unfulfilled, etc.

If I could be working, I think I would. The difficulty for me is the type of work I do requires some significant physical ability. Additionally, I was diagnosed half way through my internship (a 1 year non-renewable contract) in 2011. I decided when I returned home not to go searching for work because I was starting interferon. I wanted to see how I would handle it before I made any promises to employers. Turns out I would not have been much use anyway. After that I took a couple months off to regain my physical strenght (and get married), then was looking for work again when I progressed to stage IV. I chose IL-2 first, which had me in and out of the hospital and with so many doctors appointments there was no way anyone in their right mind would hire me, then right after I finished that I progressed again and it was on to WBR and Yervoy. That doesn't appear to have worked and with new brain mets discovered in Dec I've been disqualified (for now) from clinical trials so I'm on the BRAF/MEK combo. 

All of my very frequent relapses are not intended to scare you into not working, my situation is different- I didn't work because I didn't have a job to start with and was never really stable enough to get employment in my field (and laughably am "overqualified", love that term, for lower paying jobs). I never understood that- who cares if I'm overqualified, if I can do the job and am willing to do the job for the advertised pay, why can't I be considered? Anyway, I digress… Luckily my husband's salary and help from family has kept us afloat. My husband works for a University, which happens to be the same University I got my degrees at so I have been fortunate that former professors know me well and throw me little temporary easy jobs now and then that I can fit in between everythng else. 

One of these jobs was to create a 3 week summer school course for high school students, which allowed me to mostly work from home at my own pace. It ran for the first time last summer, while I was getting WBR and Yervoy. It ran from 9am-4:30pm Mon-Fri and I was responsible for aprox 1/3 of the lecture material as well as all of the grading and writing exams. I was able to be there every day, do all of my lectures and all of the grading while recieving those treatments, and have some confidence that I could work comfortably with the combo I'm on now. My very round about point I guess is that even if you don't stay stable, the newer treatments are much easier and most people can work while they're recieving them, if they want to. So even if you progress, you likely wouldn't have to leave part way through the year, though you may have to miss occasional days for infusions, scans, or checkups. 

Think about what makes you happy- if you enjoy your job or would welcome a distraction, go for it. You can't live your life always asking "what if?". At some point we need to throw caution to the wind and give it a shot. If it works, great, if not, it will be dissapointing, but not the end of the world (no matter how much our brains tell us it might be).

Good luck

You're right, it is ultimately your decision and what is going to help you the most. As others have said, working can be a great distraction, but not everyone wants or can handle that. I also understand not wanting to start something and then having to leave part way through- doing that (or even the thought of doing that, which for myself I veiw as "quitting" and that's something I just don't do) gives me ulcers nearly as bad as dealing with this stupid disease. I still struggle with the same question though, each time I have to start a new therapy. I know I should be a bit braver, but I hate having to leave things unfinished, contracts unfulfilled, etc.

If I could be working, I think I would. The difficulty for me is the type of work I do requires some significant physical ability. Additionally, I was diagnosed half way through my internship (a 1 year non-renewable contract) in 2011. I decided when I returned home not to go searching for work because I was starting interferon. I wanted to see how I would handle it before I made any promises to employers. Turns out I would not have been much use anyway. After that I took a couple months off to regain my physical strenght (and get married), then was looking for work again when I progressed to stage IV. I chose IL-2 first, which had me in and out of the hospital and with so many doctors appointments there was no way anyone in their right mind would hire me, then right after I finished that I progressed again and it was on to WBR and Yervoy. That doesn't appear to have worked and with new brain mets discovered in Dec I've been disqualified (for now) from clinical trials so I'm on the BRAF/MEK combo. 

All of my very frequent relapses are not intended to scare you into not working, my situation is different- I didn't work because I didn't have a job to start with and was never really stable enough to get employment in my field (and laughably am "overqualified", love that term, for lower paying jobs). I never understood that- who cares if I'm overqualified, if I can do the job and am willing to do the job for the advertised pay, why can't I be considered? Anyway, I digress… Luckily my husband's salary and help from family has kept us afloat. My husband works for a University, which happens to be the same University I got my degrees at so I have been fortunate that former professors know me well and throw me little temporary easy jobs now and then that I can fit in between everythng else. 

One of these jobs was to create a 3 week summer school course for high school students, which allowed me to mostly work from home at my own pace. It ran for the first time last summer, while I was getting WBR and Yervoy. It ran from 9am-4:30pm Mon-Fri and I was responsible for aprox 1/3 of the lecture material as well as all of the grading and writing exams. I was able to be there every day, do all of my lectures and all of the grading while recieving those treatments, and have some confidence that I could work comfortably with the combo I'm on now. My very round about point I guess is that even if you don't stay stable, the newer treatments are much easier and most people can work while they're recieving them, if they want to. So even if you progress, you likely wouldn't have to leave part way through the year, though you may have to miss occasional days for infusions, scans, or checkups. 

Think about what makes you happy- if you enjoy your job or would welcome a distraction, go for it. You can't live your life always asking "what if?". At some point we need to throw caution to the wind and give it a shot. If it works, great, if not, it will be dissapointing, but not the end of the world (no matter how much our brains tell us it might be).

Good luck

You're right, it is ultimately your decision and what is going to help you the most. As others have said, working can be a great distraction, but not everyone wants or can handle that. I also understand not wanting to start something and then having to leave part way through- doing that (or even the thought of doing that, which for myself I veiw as "quitting" and that's something I just don't do) gives me ulcers nearly as bad as dealing with this stupid disease. I still struggle with the same question though, each time I have to start a new therapy. I know I should be a bit braver, but I hate having to leave things unfinished, contracts unfulfilled, etc.

If I could be working, I think I would. The difficulty for me is the type of work I do requires some significant physical ability. Additionally, I was diagnosed half way through my internship (a 1 year non-renewable contract) in 2011. I decided when I returned home not to go searching for work because I was starting interferon. I wanted to see how I would handle it before I made any promises to employers. Turns out I would not have been much use anyway. After that I took a couple months off to regain my physical strenght (and get married), then was looking for work again when I progressed to stage IV. I chose IL-2 first, which had me in and out of the hospital and with so many doctors appointments there was no way anyone in their right mind would hire me, then right after I finished that I progressed again and it was on to WBR and Yervoy. That doesn't appear to have worked and with new brain mets discovered in Dec I've been disqualified (for now) from clinical trials so I'm on the BRAF/MEK combo. 

All of my very frequent relapses are not intended to scare you into not working, my situation is different- I didn't work because I didn't have a job to start with and was never really stable enough to get employment in my field (and laughably am "overqualified", love that term, for lower paying jobs). I never understood that- who cares if I'm overqualified, if I can do the job and am willing to do the job for the advertised pay, why can't I be considered? Anyway, I digress… Luckily my husband's salary and help from family has kept us afloat. My husband works for a University, which happens to be the same University I got my degrees at so I have been fortunate that former professors know me well and throw me little temporary easy jobs now and then that I can fit in between everythng else. 

One of these jobs was to create a 3 week summer school course for high school students, which allowed me to mostly work from home at my own pace. It ran for the first time last summer, while I was getting WBR and Yervoy. It ran from 9am-4:30pm Mon-Fri and I was responsible for aprox 1/3 of the lecture material as well as all of the grading and writing exams. I was able to be there every day, do all of my lectures and all of the grading while recieving those treatments, and have some confidence that I could work comfortably with the combo I'm on now. My very round about point I guess is that even if you don't stay stable, the newer treatments are much easier and most people can work while they're recieving them, if they want to. So even if you progress, you likely wouldn't have to leave part way through the year, though you may have to miss occasional days for infusions, scans, or checkups. 

Think about what makes you happy- if you enjoy your job or would welcome a distraction, go for it. You can't live your life always asking "what if?". At some point we need to throw caution to the wind and give it a shot. If it works, great, if not, it will be dissapointing, but not the end of the world (no matter how much our brains tell us it might be).

Good luck

Hey Maureen,

It is a lot to think about isn't it?  Like the other posters noted…it is a very personal question with no right or wrong answers.  I think you have to weigh what you feel is the best way to spend your time.  After all…that's what life is, isn't it?  Spending our time…somehow….for however long we are here.  Then, there are the other issues…How do you feel?  Are you physically and mentally strong enough to do your job?  Can you get off when you need to for never ending doc appointments and treatments?  And…esp in your case….are you ok with leaving your job should you have to do that after your return?  I know that as a teacher, that could be pretty tricky for you.  Anyhow…I've had to face all these questions myself.  I took 6 months off work as a pediatric nurse practitioner to have lung surgery and my brain zapped.  Thankfully my bosses were cool with that and allowed me to return when I was ready.  My schedule was already set at: 3, 12 hour shifts a week.  That allowed me to join an anti-PD1 trial in Tampa, to which I traveled from Chattanoogs every other week for 6 months and then every 3 months for 2 additional years.  Had my work schedule not allowed the trip then I would not have been able to work.  I guess I figure, if being an NP and taking care of kids is what I do and part of who I am, then…I want to keep doing it…at least for now.  Recently someone posted a link to an op ed in the New York Times ("How long have I got left?"  By Paul Kalanithi).  It was written by a surgeon who returned to work after having been off for about 8 months after his diagnosis and treatment of metastatic cancer.  He shares his thoughts, that given your question, you might find interesting.

I wish you the best with whatever you decide. I'm sure you will decide what is best for you!

Celeste

Hey Maureen,

It is a lot to think about isn't it?  Like the other posters noted…it is a very personal question with no right or wrong answers.  I think you have to weigh what you feel is the best way to spend your time.  After all…that's what life is, isn't it?  Spending our time…somehow….for however long we are here.  Then, there are the other issues…How do you feel?  Are you physically and mentally strong enough to do your job?  Can you get off when you need to for never ending doc appointments and treatments?  And…esp in your case….are you ok with leaving your job should you have to do that after your return?  I know that as a teacher, that could be pretty tricky for you.  Anyhow…I've had to face all these questions myself.  I took 6 months off work as a pediatric nurse practitioner to have lung surgery and my brain zapped.  Thankfully my bosses were cool with that and allowed me to return when I was ready.  My schedule was already set at: 3, 12 hour shifts a week.  That allowed me to join an anti-PD1 trial in Tampa, to which I traveled from Chattanoogs every other week for 6 months and then every 3 months for 2 additional years.  Had my work schedule not allowed the trip then I would not have been able to work.  I guess I figure, if being an NP and taking care of kids is what I do and part of who I am, then…I want to keep doing it…at least for now.  Recently someone posted a link to an op ed in the New York Times ("How long have I got left?"  By Paul Kalanithi).  It was written by a surgeon who returned to work after having been off for about 8 months after his diagnosis and treatment of metastatic cancer.  He shares his thoughts, that given your question, you might find interesting.

I wish you the best with whatever you decide. I'm sure you will decide what is best for you!

Celeste

Hey Maureen,

It is a lot to think about isn't it?  Like the other posters noted…it is a very personal question with no right or wrong answers.  I think you have to weigh what you feel is the best way to spend your time.  After all…that's what life is, isn't it?  Spending our time…somehow….for however long we are here.  Then, there are the other issues…How do you feel?  Are you physically and mentally strong enough to do your job?  Can you get off when you need to for never ending doc appointments and treatments?  And…esp in your case….are you ok with leaving your job should you have to do that after your return?  I know that as a teacher, that could be pretty tricky for you.  Anyhow…I've had to face all these questions myself.  I took 6 months off work as a pediatric nurse practitioner to have lung surgery and my brain zapped.  Thankfully my bosses were cool with that and allowed me to return when I was ready.  My schedule was already set at: 3, 12 hour shifts a week.  That allowed me to join an anti-PD1 trial in Tampa, to which I traveled from Chattanoogs every other week for 6 months and then every 3 months for 2 additional years.  Had my work schedule not allowed the trip then I would not have been able to work.  I guess I figure, if being an NP and taking care of kids is what I do and part of who I am, then…I want to keep doing it…at least for now.  Recently someone posted a link to an op ed in the New York Times ("How long have I got left?"  By Paul Kalanithi).  It was written by a surgeon who returned to work after having been off for about 8 months after his diagnosis and treatment of metastatic cancer.  He shares his thoughts, that given your question, you might find interesting.

I wish you the best with whatever you decide. I'm sure you will decide what is best for you!

Celeste

I really know how you feel!!  I am in a dilemma myself considering going back to work or not.  I know I had good reason to be off work when I was on interferon which I was able to tolerate for 12 treatments.  I returned to work when feeling better and I felt maybe this much interferon nipped this nasty disease by the bud after I had a radical lymphectomy with one node revealing metatasis.  Low and behold when I had a pet scan, it spread to other lymph nodes between my trachea and esophagus.  I am now on a clinical trial with yervoy and not knowing what side effects I would have I decided to go on special leave.  I will be going for my third treatment next week and actually having few side effects.  I decided to wait until my treatments are completed and after I receive results from my pet scan April 9th because I too did not want to start working and then find out I have to go through another course of action.  I think what type of job has a lot with deciding to stay home or not.  I probably would  be at work if I had a job where I was just in one place.  I am a caseworker and I travel every other day to different places, like personal care homes, hospitals, nursing facilities and homes in the community.  I just did not want to over exert myself and be stressed to keep up with my job.  April 9th will be a big day for me and I will just have to wait and see.  If you want to connect with me through my e-mail you can regarding your decision.  It is hard to keep a continuous monolog in this site, I've found.  my e-mail is [email protected]

I really know how you feel!!  I am in a dilemma myself considering going back to work or not.  I know I had good reason to be off work when I was on interferon which I was able to tolerate for 12 treatments.  I returned to work when feeling better and I felt maybe this much interferon nipped this nasty disease by the bud after I had a radical lymphectomy with one node revealing metatasis.  Low and behold when I had a pet scan, it spread to other lymph nodes between my trachea and esophagus.  I am now on a clinical trial with yervoy and not knowing what side effects I would have I decided to go on special leave.  I will be going for my third treatment next week and actually having few side effects.  I decided to wait until my treatments are completed and after I receive results from my pet scan April 9th because I too did not want to start working and then find out I have to go through another course of action.  I think what type of job has a lot with deciding to stay home or not.  I probably would  be at work if I had a job where I was just in one place.  I am a caseworker and I travel every other day to different places, like personal care homes, hospitals, nursing facilities and homes in the community.  I just did not want to over exert myself and be stressed to keep up with my job.  April 9th will be a big day for me and I will just have to wait and see.  If you want to connect with me through my e-mail you can regarding your decision.  It is hard to keep a continuous monolog in this site, I've found.  my e-mail is [email protected]

I really know how you feel!!  I am in a dilemma myself considering going back to work or not.  I know I had good reason to be off work when I was on interferon which I was able to tolerate for 12 treatments.  I returned to work when feeling better and I felt maybe this much interferon nipped this nasty disease by the bud after I had a radical lymphectomy with one node revealing metatasis.  Low and behold when I had a pet scan, it spread to other lymph nodes between my trachea and esophagus.  I am now on a clinical trial with yervoy and not knowing what side effects I would have I decided to go on special leave.  I will be going for my third treatment next week and actually having few side effects.  I decided to wait until my treatments are completed and after I receive results from my pet scan April 9th because I too did not want to start working and then find out I have to go through another course of action.  I think what type of job has a lot with deciding to stay home or not.  I probably would  be at work if I had a job where I was just in one place.  I am a caseworker and I travel every other day to different places, like personal care homes, hospitals, nursing facilities and homes in the community.  I just did not want to over exert myself and be stressed to keep up with my job.  April 9th will be a big day for me and I will just have to wait and see.  If you want to connect with me through my e-mail you can regarding your decision.  It is hard to keep a continuous monolog in this site, I've found.  my e-mail is [email protected]

Here is the deal with me.

DX'D 1987 Stage III Melanoma

Following surgery, I went back to work.

Nine years later, I was DX'D Stage IV.

Back and forth between treatments and surgeries.  My work resume became quite sketchy.

I soon realized that "jobs" were not in my future.  So I once again struck out on my own…..and started a business, based upon my own merits……………..not my health.

I have never looked back, and I will be damned if I apolgize for my health to ANY employer ever again.

I still work, still have melanoma; but it is on My terms.

1987-2014=27 years MY way.

…and melanoma can STILL kiss my shiny white butt.

Yeah, it was and IS personal.

Charlie S

Here is the deal with me.

DX'D 1987 Stage III Melanoma

Following surgery, I went back to work.

Nine years later, I was DX'D Stage IV.

Back and forth between treatments and surgeries.  My work resume became quite sketchy.

I soon realized that "jobs" were not in my future.  So I once again struck out on my own…..and started a business, based upon my own merits……………..not my health.

I have never looked back, and I will be damned if I apolgize for my health to ANY employer ever again.

I still work, still have melanoma; but it is on My terms.

1987-2014=27 years MY way.

…and melanoma can STILL kiss my shiny white butt.

Yeah, it was and IS personal.

Charlie S

Here is the deal with me.

DX'D 1987 Stage III Melanoma

Following surgery, I went back to work.

Nine years later, I was DX'D Stage IV.

Back and forth between treatments and surgeries.  My work resume became quite sketchy.

I soon realized that "jobs" were not in my future.  So I once again struck out on my own…..and started a business, based upon my own merits……………..not my health.

I have never looked back, and I will be damned if I apolgize for my health to ANY employer ever again.

I still work, still have melanoma; but it is on My terms.

1987-2014=27 years MY way.

…and melanoma can STILL kiss my shiny white butt.

Yeah, it was and IS personal.

Charlie S

It's a difficult choice to make.

When I was first diagnosed in 1989 as a stage I at age 24, I couldn't imagine not working.

But time and perspective changes so when I was diagnosed again in 2005 as a stage IV, I really started to question whether or not I wanted to fight cancer and work full-time as a high school English teacher and coach.

I did return to work after successful surgeries and chemotherapy but cut back on my extra jobs- no more coaching. But when another brain lesion appeared in 2007 and I had to undergo a craniotomy, I knew that that was the sign that I needed to confidently say, No more. 

And so I went on disability retirement. In that time I have had 3 grandchildren arrive, been able to help a sister diagnosed with MS, and had peace-filled days with my husband and family. I have also been NED since deciding to live a life with less stress. Sometimes I feel guilty and think I should be working, but I know what I've been through and I know I can't go back.

I am beyond grateful that I have the choice when so many others don't. 

Best to you as you make this tough decision.

Best of health to you as well.

Karen

It's a difficult choice to make.

When I was first diagnosed in 1989 as a stage I at age 24, I couldn't imagine not working.

But time and perspective changes so when I was diagnosed again in 2005 as a stage IV, I really started to question whether or not I wanted to fight cancer and work full-time as a high school English teacher and coach.

I did return to work after successful surgeries and chemotherapy but cut back on my extra jobs- no more coaching. But when another brain lesion appeared in 2007 and I had to undergo a craniotomy, I knew that that was the sign that I needed to confidently say, No more. 

And so I went on disability retirement. In that time I have had 3 grandchildren arrive, been able to help a sister diagnosed with MS, and had peace-filled days with my husband and family. I have also been NED since deciding to live a life with less stress. Sometimes I feel guilty and think I should be working, but I know what I've been through and I know I can't go back.

I am beyond grateful that I have the choice when so many others don't. 

Best to you as you make this tough decision.

Best of health to you as well.

Karen

It's a difficult choice to make.

When I was first diagnosed in 1989 as a stage I at age 24, I couldn't imagine not working.

But time and perspective changes so when I was diagnosed again in 2005 as a stage IV, I really started to question whether or not I wanted to fight cancer and work full-time as a high school English teacher and coach.

I did return to work after successful surgeries and chemotherapy but cut back on my extra jobs- no more coaching. But when another brain lesion appeared in 2007 and I had to undergo a craniotomy, I knew that that was the sign that I needed to confidently say, No more. 

And so I went on disability retirement. In that time I have had 3 grandchildren arrive, been able to help a sister diagnosed with MS, and had peace-filled days with my husband and family. I have also been NED since deciding to live a life with less stress. Sometimes I feel guilty and think I should be working, but I know what I've been through and I know I can't go back.

I am beyond grateful that I have the choice when so many others don't. 

Best to you as you make this tough decision.

Best of health to you as well.

Karen

This is an interesting topic and one that I am grappling with as well. Given that you are stage IV you will be fast tracked for Social Security Disability and will likely see automatic approval within a few weeks. That really isn't enough money to cover bills in most areas of the USA but helps. The next question is do you have private or group disability indurance as well?  Ask yourself if you automobile insurance and you were in an accident that caused some extensive and expensive damage to you car would even consider not  putting a claim in. You absolutely should consult a reputable disability attorney for advice on how to proceed. If you have medical issues resulting from the disease or from the treatment then you have a decision to make regarding your direction. I had primary sites on my skin that metastized to my lung which was surgically resected and then to my brain. The brain tumor was treated with SRS but I had a reoccurance at the same spot 18 mos later and had surgical resection and SRS again. Physically feel fine currently but attention, focus and memory issues, some rage moments, etc. Clearly not the same person I was prior to this and clearly not able to do my same level of output as before. Although I remain optimistic I can beat this I am not foolish enough to think that truly has a high probability long term. On my deathbed I am confident I won't be thinking about how many more deals I did, how many more late night business dinners I hosted and how much I made. I do however think I'll reflect back on the quality time I spent with my beautiful bride, my 15 year old son and 13 year old daughter. If you have a honest claim, the economics work and you can afford not to work it comes down to a personal decision. If you have real health issues impacting your ability to perform at work there shouldn't be any guilt about making the decision not to do it if that's your inclination. You can always go back to work, you can't go back to living if you are dead. 

This is an interesting topic and one that I am grappling with as well. Given that you are stage IV you will be fast tracked for Social Security Disability and will likely see automatic approval within a few weeks. That really isn't enough money to cover bills in most areas of the USA but helps. The next question is do you have private or group disability indurance as well?  Ask yourself if you automobile insurance and you were in an accident that caused some extensive and expensive damage to you car would even consider not  putting a claim in. You absolutely should consult a reputable disability attorney for advice on how to proceed. If you have medical issues resulting from the disease or from the treatment then you have a decision to make regarding your direction. I had primary sites on my skin that metastized to my lung which was surgically resected and then to my brain. The brain tumor was treated with SRS but I had a reoccurance at the same spot 18 mos later and had surgical resection and SRS again. Physically feel fine currently but attention, focus and memory issues, some rage moments, etc. Clearly not the same person I was prior to this and clearly not able to do my same level of output as before. Although I remain optimistic I can beat this I am not foolish enough to think that truly has a high probability long term. On my deathbed I am confident I won't be thinking about how many more deals I did, how many more late night business dinners I hosted and how much I made. I do however think I'll reflect back on the quality time I spent with my beautiful bride, my 15 year old son and 13 year old daughter. If you have a honest claim, the economics work and you can afford not to work it comes down to a personal decision. If you have real health issues impacting your ability to perform at work there shouldn't be any guilt about making the decision not to do it if that's your inclination. You can always go back to work, you can't go back to living if you are dead. 

This is an interesting topic and one that I am grappling with as well. Given that you are stage IV you will be fast tracked for Social Security Disability and will likely see automatic approval within a few weeks. That really isn't enough money to cover bills in most areas of the USA but helps. The next question is do you have private or group disability indurance as well?  Ask yourself if you automobile insurance and you were in an accident that caused some extensive and expensive damage to you car would even consider not  putting a claim in. You absolutely should consult a reputable disability attorney for advice on how to proceed. If you have medical issues resulting from the disease or from the treatment then you have a decision to make regarding your direction. I had primary sites on my skin that metastized to my lung which was surgically resected and then to my brain. The brain tumor was treated with SRS but I had a reoccurance at the same spot 18 mos later and had surgical resection and SRS again. Physically feel fine currently but attention, focus and memory issues, some rage moments, etc. Clearly not the same person I was prior to this and clearly not able to do my same level of output as before. Although I remain optimistic I can beat this I am not foolish enough to think that truly has a high probability long term. On my deathbed I am confident I won't be thinking about how many more deals I did, how many more late night business dinners I hosted and how much I made. I do however think I'll reflect back on the quality time I spent with my beautiful bride, my 15 year old son and 13 year old daughter. If you have a honest claim, the economics work and you can afford not to work it comes down to a personal decision. If you have real health issues impacting your ability to perform at work there shouldn't be any guilt about making the decision not to do it if that's your inclination. You can always go back to work, you can't go back to living if you are dead.