Thank you for focusing on the long-term effects of cancer treatments ("Improving the Care of Cancer Survivors," March).

Those diagnosed with cancer become unwilling members of a huge subculture. Cancer patients get highly toxic drugs and are sent home to endure the sequelae. Unless the adverse effects are severe enough to merit a hospital stay, health care providers don't see them, but friends and family members do. Sometimes the sequelae lead patients to question the original decision to undergo certain treatments. After the period of treatment, the patient is very alert for any signs that the treatment wasn't successful or that disease has recurred. Patients may feel that to complain would make them appear ungrateful for the life-sustaining technologies.

Our language for cancer is full of connotations of battle and struggle. We call individuals with cancer "survivors." But many of us are wary of the implications of such terminology. If one is not successful in defeating the disease, is she a failure? Patients make extremely personal decisions about what interventions they are willing to endure. Are we as willing to support those patients who refuse treatments?

Bonnie Faherty, PhD, APRN-BC, CM

Northridge, CA