Navigation Links
Cancer Doctors Urge Earlier End-of-Life Care Talks

By Serena Gordon
HealthDay Reporter

TUESDAY, Jan. 25 (HealthDay News) -- People with advanced cancer should be told what end-of-life care choices are available earlier in the course of their disease, a new policy statement from the American Society of Clinical Oncology recommends.

Unfortunately, these options are sometimes presented only days before death, reports the statement, published in the Jan. 24 issue of the Journal of Clinical Oncology.

"There's a growing body of evidence that we can and should do a better job communicating with our patients with advanced cancer," said statement author Dr. Jeffrey M. Peppercorn, an associate professor of medicine at Duke University Medical Center in Durham, N.C. "There's no one-size-fits-all approach to cancer care, but patients need to be empowered. They need to know that there are options, in most cases, for disease-directed therapy, palliative therapy directed at symptom management and clinical research trials."

Currently, the authors of the statement estimate that fewer than four in 10 cancer patients are having these types of candid discussions about all of their treatment options. What's worse is that these conversations might not be taking place until days or weeks before a patient's death.

However, these conversations should happen much earlier in the course of the cancer, according to Peppercorn. And, he added, there's some evidence that by adding supportive or palliative care to disease-directed therapies, not only is quality of life improved for patients, but they might even live longer.

Peppercorn said that "these conversations are very difficult. It's much easier for a doctor to look ahead and be optimistic when delivering treatment, but the delivery of high-quality palliative care is more difficult. We're hoping that statements, such as this one from ASCO, empower patients and doctors."

The main recommendations from the new statement include:

  • Quality of life needs to be a priority at all stages of advanced cancer care.
  • Doctors should talk with their patients about their prognosis and treatment options soon after the initial diagnosis of advanced cancer.
  • Patients should be offered the opportunity to participate in clinical trials.

Peppercorn said it's also important for doctors to understand what their patients hope to get from each treatment and what their fears are. Doctors also need to make a patient's prognosis clear, including if there are uncertainties about the prognosis.

One potential barrier to these types of in-depth conversations is time, according to the statement. But, Peppercorn said that this doesn't necessarily have to occur as one big discussion. "The depth of the conversation, how much information is provided at once and details about what will occur need to be individualized for each patient," he noted.

The statement also recommends that insurers cover the cost of advanced cancer care planning discussions, including talking about palliative care options.

"I certainly agree with this approach and the recommendations from this statement," said Dr. Steven Libutti, director of the Montefiore-Einstein Center for Cancer Care in New York City.

"The trick is reading whether or not the patient and the patient's family are ready to have these conversations. When you first sit down to discuss end-of-life care, patients and their families are rarely ready to hear that there are few options, so it's important to have these conversations in a staged way. And, I think a lot of doctors have trouble letting go, and with the idea that they can't fix it. The patient is often the one that comes to terms with the reality the quickest. The physician and the family often lag behind," said Libutti.

He added that these conversations are often a difficult balancing act. "You don't want to give false hope, but you also don't want to take away all hope, because hope is an important component in the battle."

If you have advanced cancer, and your doctor hasn't initiated this type of forthright talk about what's to come, Peppercorn said you should ask your doctor what your options are.

More information

Learn more about palliative care from the American Society of Clinical Oncologists.

SOURCES: Jeffrey M. Peppercorn, M.D., M.P.H., associate professor, medicine, Duke University Medical Center, Durham, N.C.; Steven Libutti, M.D., director, Montefiore-Einstein Center for Cancer Care, New York City; Jan. 24, 2011, Journal of Clinical Oncology

Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Enhancing arrest of cell growth to treat cancer in mice
2. Paxil Blocks Tamoxifen, Lowers Survival Odds Against Breast Cancer
3. The National Coalition for Cancer Survivorship Joins the Commission on Cancer
4. Low forms of cyclin E reduce breast cancer drugs effectiveness
5. Racial disparities persist in the diagnosis of advanced breast cancer and colon cancer in the U.S.
6. Soft drinks may increase risk of pancreatic cancer
7. UH Case Medical Center researchers publish promising findings for advanced cervical cancer
8. Genes Play Role in Prognosis With Non-Small Cell Lung Cancers
9. Single gene mutation induces endometrial cancer
10. Certain genetic profiles associated with recurrence-free survival for non-small cell lung cancer
11. Molecular pathways linked to sex, age affect outcomes in lung cancer
Post Your Comments:
Related Image:
Cancer Doctors Urge Earlier End-of-Life Care Talks
(Date:10/13/2017)... ... October 13, 2017 , ... The American Board of Family Medicine's (ABFM) Board ... Chief Executive Officer, succeeding Dr. James C. Puffer upon his retirement. Dr. Newton will ... Dr. Puffer’s retirement at the end of 2018. Upon assuming the role of President ...
(Date:10/13/2017)... ... October 13, 2017 , ... Southern ... and Jennifer Huggins, PharmD ’17, along with clinical associate professor Janice Frueh, ... cardiovascular diseases during the 15th Annual Women’s Health Conference. The SIU School ...
(Date:10/13/2017)... ... October 13, 2017 , ... Many families have long-term ... long-term care insurance companies have a waiver for care if the client has a ... when the family pays for care, is often waived, so the benefits from their ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Global Healthcare ... scenic Alexandria Park in Milford, NJ. This free event, sponsored by Global Healthcare ... activity. The fun run is geared towards children of all ages; it is ...
(Date:10/13/2017)... ... 13, 2017 , ... Coveros, a leader in agile coaching ... contract by the Center for Medicare and Medicaid Services (CMS). The Enterprise Agile ... of Agile methodologies in a consistent and high value manner across CMS programs. ...
Breaking Medicine News(10 mins):
(Date:9/18/2017)... KALAMAZOO, Mich. , Sept. 18, 2017 /PRNewswire/ ... and OptiMed Specialty Pharmacy of Kalamazoo, Mich. ... a strategic hub service that expedites and streamlines patient ... spirometer, Spiro PD 2.0, and wellness management services.  ... a medical device used to measure lung function for ...
(Date:9/13/2017)...   OrthoAtlanta has been named the official orthopedic ... (AFHC) for the 2018 College Football Playoff (CFP) National Championship ... Stadium in Atlanta, Georgia . OrthoAtlanta is ... campaign, participating in many activities leading up to, and including ... ...
(Date:9/12/2017)...  Consumer reviews on the independent review site Consumer Affairs ... company for hearing aids, ranking it higher than Miracle Ear ... ... For Hearing Aids ... online store that provides high performance, state-of-the-art, German-engineered hearing aids directly ...
Breaking Medicine Technology: