PALLIATIVE CARE II
One of the initiatives that I have been working on for my practice over the last six months is to develop an ongoing palliative care program. I am really excited about some of the things that we are putting in place for our patients. Palliative care is the treatment of patients who are having symptoms due to a terminal illness. My hope is that through these new initiatives in our practice that we will begin the process of palliative care much earlier in our patients. The patients who are diagnosed with advanced lung cancer, metastatic breast cancer or other ultimately terminal cancers probably should see a palliative care specialist early in their treatment. This is what our program is striving for. By bringing palliative care specialists into our practice to see our patients, I am hopeful that a transition between active treatment and palliative care and hospice will be made smoother. The stopping of treatment for advanced cancer is a very scary thing for the patients. Many physicians have difficulty discussing the subject of stopping therapy. One concern that I have today is the high degree of patients who received chemotherapy within two weeks of their lives. In many studies this was 10-20%. These patients are obviously not benefitting from this chemotherapy as their condition is such that the chemotherapy is likely doing more harm than good. It is our duty as medical oncologists to do a better job explaining to our patients the risks and the benefits from our therapies. As the patient's disease progress and they go on second and third-line therapies, a patient should know that the benefit or the chances of benefit from our chemotherapy become very, very small. The risks of increased side effects become increasingly large. I am hopeful that the new palliative care initiative that is going on in our practice will make this transition both smoother and hopefully earlier in a patient's disease course.
One of the partners that we have partnered with in our palliative care program is the Center for Practical Bioethics, which is here in
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My neighbor had some type of IV going into her skull for breast cancer that had metastasized to her brain. She told me she was not ready to go and would do anything it took so she was getting chemotherapy through the IV. I am not a physician but I clearly thought it was doing her more harm than good. We lost her last March and I think about her in her last days often. I hope this catches on with other oncologists because I think it is not only benifical to the patient but to the family as well. thanks for your blog.
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This entry reminds me of when I was a kid growing up in Kansas. My grandfather used to say "When life give you lemons, make lemonade". But he was a hopeless drunk who never made much sense so I never paid much attention to him. Have a great day!
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