Sydney Yolande Barned, Internal Medicine Hospitalist at Anne Arundel Medical Center, shared on LinkedIn:
“‘Manageable’ is a word I use as a physician.
It is also a word I’ve come to question as a person living with cancer.
In medicine, ‘manageable’ often means something reasonable: a symptom isn’t life-threatening, isn’t causing organ damage, doesn’t require hospitalization, or doesn’t require us to stop an effective treatment.
But sometimes I wonder whether we move on too quickly once we decide something is manageable. Because manageable for whom, and at what cost?
A pain level of 5/10 may be medically manageable. But who wants to live with pain every day?
Diarrhea may be manageable. But what if someone plans every outing around knowing where a bathroom is?
Fatigue may be manageable because someone can still work. But what if they’re using most of their available energy to do that, and have little left for exercise, family, or enjoying the rest of their day?
I live that last example. I work. I function. I do many of the things I want and need to do. So clinically, my fatigue is ‘manageable.’
But by afternoon, fatigue and brain fog can make my brain feel like its running on go-slow. Exercise becomes much harder unless I get it done earlier in the day.
Is that manageable? Yes. Would I like it to be better? Absolutely.
Manageable should not mean we stop trying to make it better.I see this differently from the physician side now, too.I ll ask a hospitalized patient about their pain and hear, ‘7 or 8 out of 10, but thats my baseline.’
‘Baseline’ can be clinically reassuring when evaluating an acute problem. But then I catch myself: This person lives at a 7 or 8.
We cant eliminate every symptom. Medicine has limitations, and sometimes effective treatments come with unavoidable tradeoffs. But a patients adaptation to a symptom shouldn’t automatically become evidence that its burden is acceptable. We often assess symptoms as snapshots.Patients experience them longitudinally.
So maybe ‘How bad is it?’ isn’t enough.
- What have you stopped doing because of it?
- What do you plan your life around?
- What does ‘managing’ it actually cost you?
This belongs across the healthcare ecosystem – from clinicians assessing functional impact, to researchers measuring patient-reported outcomes, to drug developers thinking about long-term tolerability and ways to proactively mitigate predictable side effects.
Disease control matters. Survival matters enormously. But as treatments allow people to live longer, we also have to ask:
What is the experience of the life were helping people live?
A side effect can be medically manageable and still be life-altering.
We shouldn’t confuse a patients ability to endure something with evidence that we have done enough.”
To which Amy Moore, Director of the Patient Engagement and Advocacy at Summit Therapeutics, Inc., added:
“Important perspective from Dr. Sydney Yolande Barned, physician and lung cancer survivor, regarding that loaded word ‘manageable.’
Manageable for whom? The doctor or the patient?
Worth the read.”
You can also read:
Supportive Care Is Not an Extra: Why It Belongs at the Center of Cancer Treatment 2026
