Weekend in D.C
I was in Washington D.C. this last weekend at a conference on palliative care. It brought people from all over the country to talk about the end of life care that occurs in this country. I general this country does a poor job taking care of people in the final months and days of their lives. We spend a huge amount of resources (and money) in the last year of a person’s life. The economics of dying in this country are in bad shape. As the general economy worsens the money we spend on any part of the health care system is going to be looked at very closely. In oncology we have to do a better job of facing these facts. We must use our resources as wisely as possible.
I had a man in my practice that has lung cancer. His cancer was initially localized and was treated with radiation and chemotherapy. He did well for over a year but unfortunately in cancer reoccurred. Additional chemotherapy was given with only minimal response. His overall health also declined. His most recent CAT scan showed that the cancer was growing again. I talked to him at length that additional chemotherapy would have little chance of helping his situation. It would likely make matters only worse and weaken him further. I explained that honestly that hospice care was in his best interest and that this is all that I would recommend to him.
He is now getting chemotherapy from at an oncologist in another part of town. This situation doesn’t make me angry at the patient but I must question the decision of the oncologist now treating this patient. At some point the only reasonable action is to not to proceed with additional chemotherapy. This patient, the patient’s new oncologist and this country must begin to understand this.
I pray that this man has a good response to this new therapy and that when the time comes that he will be able to except that further treatment won’t be helpful.
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