Treatment Options (Missional Cancer, Part 3)

The treatment for my thyroid cancer was done before I even knew I had the disease.  The thyroid and all the cancer was surgically removed from my body.  I need to take thyroid hormones for the rest of my life, but I’m well.  If the cancer had been bigger or not as contained, I would have required more treatment (with radioactive iodine).  Whenever one is faced with cancer, there are choices.  In my case, the choices were relatively easy to make, but they weren’t without risk.

After returning from a “Turn-around Church” conference with Bill Easum near his home in Port Aransas, TX, I gave my session a report — the results of a massive assessment of the congregation including the prognosis of  a “healthy” turn-around in both discipleship and mission.  “It’s just like we’ve been to the doctor, the diagnosis is in, and the test shows we have cancer,” I told them.  “Now we have a choice to make about what kind of treatment, if any, we want to choose.”

All of the possible treatments, I believe, fall into one of three basic paths: 1) radical treatment with the possibility of a cure; 2) treatment that may or may not cure the illness, but will prolong life for a time; 3) palliative care that makes the inevitable death as comfortable and “faithful” as possible.  And, of course, there’s always the option of doing nothing.  Depending on the type of cancer or illness, one or more of the paths may not be an option.

It’s important that we realize any of the available options can be “faithful” options.  For a congregation, it’s up to the congregation to decide when faced with the reality, which treatment option is best for them.  It should be done prayerfully, and considering the advice and leadership of the pastor and the presbytery.  But it is the responsibility of the congregation to discern, to pray, and to live faithfully into the new future story they choose.

1) Radical Treatment

Radical Treatment in the church is sometimes called “congregational transformation.”  It requires a great deal of energy, a willingness to take risks and to make life altering changes; and the “cure” may, in fact, kill us.  Radical treatment of cancer may require every penny we have, an amputation, or a total change in lifestyle.  These are radical changes.  In the church it may mean selling a building and moving to a new location, and that would require all of the energy and missional conviction of starting a new church.  It may mean inviting immigrant faith communities into the fellowship of the congregation and transforming from a racially homogeneous congregation to a multi-cultural church.  It will undoubtedly mean having to give up something that many of your members hold dear, often the building, an style of music, etc.  Congregations choosing this option need to realize that transformation isn’t only about the congregation’s building or structure, but it effects every member and participant in the community.  Congregational transformation begins with personal transformation, so it requires individual commitments to grow spiritually, to change habits, to take on new responsibilities, etc.  But, if willing, the congregation could experience a resurrection that is beyond their imagination.

Radical treatment like this is a viable option when the patient has the financial resources, the mental stamina and hope, and is otherwise relatively healthy.  For a congregation transformation is a faithful option when there is a spiritual readiness to surrender personal preferences for the well-being of the kingdom, significant financial resources from the congregation, highly committed and dedicated leaders ready to devote a great deal of energy and time to the transformation of the congregation, and an otherwise healthy congregational system (not a high-conflict congregation for instance).  It’s also important to note that a decision to proceed with this kind of radical treatment does not guarantee a cure.  As much as we have anecdotes of congregations successfully turning around or transforming … we cannot “plan” it or even “do” it.  God is the “cure” giver and God is the one who brings new life.  We can only prepare the soil and surrender ourselves to God’s Spirit and see what God will do with us.

2) Treatment to Prolong Life

There are times when the diagnosis or the health of the patient calls for a treatment that probably won’t “cure” the cancer, but it will significantly increase both the length and quality of life.  In the Future Story Project that my colleague, Mary Marcotte, and I developed in the Presbytery of New Covenant, we described this option as the “Path to Faithful Renewal.”  This treatment option allows the congregation to develop a “new normal” so to speak.  Instead of working to become a congregation of  300 members with a full Sunday School and youth group, for instance, it may mean coming to a new understanding of what a healthy and vital small church looks like.  How do the 55 members of the congregation who are here be a  spiritually alive missional faith community?

This option frequently involves new forms of pastoral leadership, possibly including one or more elders seeking to be commissioned as a lay pastor.  It may mean a change in the place of worship: selling the building, sharing space with another congregation, meeting in homes, etc.  It always means focussing on the spiritual development of the members and being attentive to the mission, vision, and call of the congregation.

For congregations who don’t have the spiritual energy or the leadership or financial resources to attempt the radical treatment above, this option allows the congregation to focus on the spiritual health of its members.  In time, a “renewed” congregation may decide the time is right to try something radically different, or that the time is right to change to treatment option 3, palliative care.

3) Paliative Care (or Hospice)

Individuals and families are often faced with making the very difficult decision of choosing hospice care for themselves or a loved one.  Most everyone I know who has chosen the care of a hospice have been blessed by the experience, even though the loss is painful.  There are times when acknowledging an impending death becomes the most courageous thing we can do.  The same is true for a congregation.

When a church lacks the leadership, financial resources, and, most of all, the energy for options 1 or 2, it may be time to make the courageous decision to request dissolution of the congregation.  When done faithfully, the path to dissolution can be one of celebration, close community, healing and reconciliation and a time of great hope.

Every one of these options can be  a huge step of faith.  Every one of them can be a story of resurrection.  Most everyone I know who has been through a struggle with cancer, or some other significant illness, says that coming through it has changed them for the better.  When we face a major obstacle in our lives, we may say we only want to go back to the way it was … but we know that isn’t going to happen.  The cure, no matter what, is going to change us not merely restore us.

If you want help with your congregation in facing reality or making a choice of “paths” or “treatments” please call for help.  No one should make these kinds of decisions on their own.  Your presbytery should have the resources and tools available to help your congregation make a faithful decision about its future.

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