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June 16, 2008An AP story is reporting, “Many people do not get … straight talk” about cancer “from doctors, who often think they are doing patients a favor by keeping hope alive.”
The study, presented at an American Society of Clinical Oncology conference, reports that oncologists who believe this “are wrong.”
Lead author Dr. Alexi Wright, of the Dana-Farber Cancer Institute in Boston, and colleagues, examined “what happens to patients if they are, or are not asked, what kind of care they’d like to receive if they were dying.”
This study is the first to look at what happens to patients if they are or are not asked what kind of care they’d like to receive if they were dying, said the researchers from the Dana-Farber Cancer Institute in Boston.
The researchers recruited and interviewed “603 people in Massachusetts, New Hampshire, Connecticut, and Texas,” who “had failed chemotherapy for advanced cancer, and had life expectancies of less than a year.”
The authors found that “[o]f the 323 who have died so far, those who had end-of-life talks were three times less likely to spend their final week in intensive care, four times less likely to be on breathing machines, and six times less likely to be resuscitated.”
Notably, just “seven percent of all patients in the study developed depression.”
My Take?
Honesty is ALWAYS the best policy. However, it’s not necessarily the easliest policy.
When I tell people that with terminal cancer that the cancer is advanced and the therapies are not working and that there are no or limited good medical options left to try – it does NOT mean there is nothing else to do.
There’s hospice care, spiritual care, and preparation not only for death, but to leave a legacy and a heritage with friends and loved ones.
When a study like this shows that only one-third of terminally ill cancer patients say their doctors had discussed end-of-life care – then my profession has failed cancer patients.
The study showed that patients who had these talks were no more likely to become depressed than those who did not. Furthermore, they were less likely to spend their final days in hospitals, tethered to machines. They avoided costly, futile care. And they and their loved ones were more at peace after they died.