... Join the Healthcare Professionals Network to read more pieces like this. Maybe you have read it already, but in case you missed it, I want you to know about a wonderful hospice in your area. -talk to the radiotologist directly What do you do when your oncologist says, “You are completely done with treatment, and I no longer need to see you anymore”? Talking about death is not easy. Copyright 2000-2019 © Cancer Survivors Network. After you’ve been diagnosed with breast cancer, your oncologist may recommend many different treatments. I replied to your post titled "Caregiver dilemma-to cry or not to cry" about Hospice for your dear sister. I don't post much to this board, but do read often. Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Hi All. As a medial culture, we shy away from mortality issues. It is a conversation that alters the doctor/patient relationship, an acknowledgement by the doctor that, despite all the advances of modern medicine, “I can do nothing more to extend your life.” However, according to ongoing research, this difficult conversation is not being had enough, and patients, clinging to false hope, are being given chemotherapy when it should have been discontinued in favor of palliative care. Prior to the visit on Monday Ron had 8000ccs of fluid removed from his abdomen. I'm an oncologist who got breast cancer. As you can see on this board some doctors are doing all chemo stage 4, some all radiation, some a mix. Case in point, in an editorial in the Journal of Supportive Oncology, [Support Oncol 2008;6:322] Paul R. Helft, MD, Associate Professor of Medicine at the Indiana University School of Medicine, wrote: “In practice, I almost never use the naked word hospice, especially when I first introduce it. visit. Please feel free to PM me if you have any questions about our experience with hospice. Mum has been to see the oncologist and Shes pleased with mum (without the chemo in her she has strength and doesn't look 'grey') They don't think its right that they should pump mum with more chemo and destroy her quality of life (in a bed and weak) so they are letting her live her 'alright' quality of life while she's well enough to go out. Every Oncologist knows this, ... (which indicates no chemo needed) but because my tumor was 1.8 cm my ONC is advising chemo. Veterinary cancer specialists help pet families make hard decisions every day. However, he can offer NO data on if more chemo will help or not. Continued 4. Sorry don't remember does your sister have a J-tube yet? If anyone in my family ever needs hospice again, they will be the ones I call. Oncologist says “No More Chemo” Discussion Board › Forums › Chemotherapy & More › Oncologist says “No More Chemo” This topic has 4 replies, 3 voices, and was last updated 9 years, 10 months ago by highsmith . The hospice is: VITAS Innovative Hospice care of california 1-866-418-4827 First-line chemotherapy included combination therapy in 84% of patients. Posted on June 24, 2016 by bookjunkie. It is not a substitute for professional medical advice. What's more, they want you to ask everything you want and need to know because that way they can help you start chemo and learn a lot about it. However, the oncologist will not entertain afatinib as she says side effects are significantly more severe than chemo, also tagrisso not approved in Ireland. They have reached the point of no return and should all retire before they are thrown in jail for deliberately provoking more cancer in their patients. Just my opinion, If fighting is what your sister really wants to do at this point, it should be the patient's decision to continue chemo. The doctor won't like it but ask: This would suggest an increased use of chemotherapy near the end of life, which was identified in this study. You may have many, some, few, or none, and each of them can happen to differing degrees. Im looking for some thoughts and help following our latest onc. There are many other hospice in the bay area, but I truly believe that this is one of the best, in my opinion, the Best!. THE ONCOLOGIST SAYS NO MORE CHEMO. There are also some links to the NIH and clinical trials. Not all cancers respond to these therapies, so they may not be a good fit for you. Second-line therapy was given to 56% of patients; 26% of patients received third-line therapy, while 10% received fourth-line therapy and 5% received fifth-line therapy or greater. She was ready to give chemo ten days back and today even when her vitals were matching the standards of chemo she decided not to go ahead with chemo. However he wrote to him and for a while he made more effort when I saw him. However, all practitioners who refer many patients to hospice do so in the belief that these programs provide the best, highest quality, and most efficient and effective means of supporting the palliative and end-of-life needs for dying patients.”, In a corresponding commentary to Dr. Helft’s editorial, Lidia Schapira, MD, Assistant Professor, Department of Medicine, Harvard Medical School, said, “Hospice by any other name remains a venue for delivery of nursing and social services for dying patients. I'm not familiar with Sanford, but first you might want to try where you are. Good luck - 33 is so young my heart breaks for your sister and your entire family. The results are telling: The researchers reported data from 10 community practices including 417 patients treated for advanced NSCLC in 2000–2003. I didn’t say that chemo isn’t effective in most cases of cancer, this ONCOLOGIST says it. Cancer Survivors Network - Comments for "THE ONCOLOGIST SAYS NO MORE CHEMO" In reply to THE ONCOLOGIST SAYS NO MORE CHEMO. I was diagnosed with breast cancer six years ago when I was 32 years old. Your sister is always free to have a second opinion, but it can only help her and all of you to have hospice on board now. Your heart is breaking and it can be hard to keep a clear head, and nice to have another listening as well. Now we really do not know where to go from here...whether to take a second opinion, what shall we do? No More Chemo. Given how much chemo batters your body around and I was stage 1 with no nodes involved I was more than comfortable with her recommendation. But the opener must be followed by a main course: clinicians must have another talk with patients to explain the details of hospice and to fully articulate and flesh out what end-of-life care entails. It has disappointed my sister who was keen to go ahead with it...alas! Chemotherapy is among the treatment options available. A study by Murillo and Koeller in The Oncologist [2006; 11:1095–1099] looked at chemotherapy given near the end of life to advanced non-small cell lung cancer (NSCLC) patients treated in the community oncology setting. Tenacity and positivity in the face of desperate clinical scenarios are vital qualities in an oncologist treating people with cancer. All rights reserved. From Rons description of his symptoms the onc. The hospice is so caring and helpful. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. So when your oncologist says it’s “up to you” whether or not to undergo more treatment for cancer, say no. -Ask them, then where/who else should we go immediately to continue treatment options. Also not sure what your history is with radiation. Our family has used them for two family members. bawa. Patients received a mean of 6.1 cycles of chemotherapy. Further exacerbating the initiation of honest discussion about end-of-life issues is a semantic dilemma, choosing the proper terms and language oftentimes becomes an emotional chess game of avoidance. This may be routine to them, but it isn't to you. They also have a website. Prayers for your sister and all of you, Cancer is the second leading cause of death in the United States. This just happened to me. Chemotherapy was given within 1 month and 2 weeks of death to 43% and 20% of patients, respectively. I also found bringing in another person with the doctors from family or friends at these conversations is really helpful. ... My oncologist says it’s a very natural feeling that all her patients go through. We used VITAS in Pittsburgh and they were amazing as well. And a study presented at the most recent meeting of the American Society of Clinical Oncology showed for the first time that a chemotherapy-free … Your at a tough roller-coaster point in stage IV and chemo. Lisha. Don't think that your oncologist doesn't want you to ask them something. If not, patients remain at risk for overhearing the bad news from strangers.”. As the saying goes, “Hindsight is 20/20.” When I finished chemo in February 2011, I knew a lot more than when I walked in for my first infusion 4 months earlier. Although we did use them for mom before this year. Look here for more on this important topic: interviews and podcasts with today’s leaders in palliative and end-of-life care…, Journal of Supportive Oncology, [Support Oncol 2008;6:322]. The dilemma is increasing and the oncologist from Stanford has refused chemo for my sister, 33, with EC stage four. Fox News and many others have published the news about this undesirable effect of helping to create cancer stem cells—cells researchers say are particularly adept at generating new tumors and are especially resistant to treatment. Understandably, oncologists are reluctant to tell patients that there is no longer any benefit for them to continue chemotherapy. The hardest decision for me is to recommend no treatment at all. The reason for switching to Taxol is my tumor only shrank from 5.5 cm to 4.2 cm after chemo… Conclusion: The availability of new chemotherapeutic agents has caused a subsequent increase in the length of time patients are receiving chemotherapy with advanced NSCLC. For my mother in law last year and then for my dear mom this year. If the cancer stays as it is he does not give you more ( poison). © 2021 MJH Life Sciences and Cancer Network. You may need to be more explicit in voicing your concerns to your oncologist and staff. They are ready and able to help now. Some people imagine a place where you go to die; others believe it to be the last step, the final stage, the end. Posts: 40 Joined: Sep 2012 Sep 12, 2012 - 12:59 am. My oncologist recommended NOT having chemo given the less than 1% difference it made to survival rate. For me, the hardest part is not making such end-of-life decisions or discussing the pros and cons of treating a beloved pet for cancer. I had no idea about the varied and far-reaching support they offer. Claims That Chemo Is "Poison" A moderate percentage of no-chemo proponents used the chemo-is-mustard-gas rationale for refusal. Also, you might want to take a look at an article on our new site from the Mayo Clinic it may give you some helpful background - http://www.esophagealcancerfighters.com/?page_id=41 "When enough is enough - Stoping Cancer Treatment when the time is right" - it really talks about the process of deciding on treatment and what to do if you want to stop treatment and your doctor doesn't or if you want to continue treatment and your doctor doesn't. You’re a person with a full life. Unfortunately, oncologist does not take any alternative opinions from me as my Mum’s advocate. Forty % of patients were >69 years of age and 35% had an ECOG PS of ≥2. When my husband learned he had advanced lung cancer, he didn’t even want to speak to an oncologist about chemotherapy.He saw no point in treatment that could not cure him and might make him feel worse. © 2021 MJH Life Sciences™ and Cancer Network. Studies also suggest that the struggle to engage in honest, goal-oriented conversation when curative or maintenance therapy is no longer clinically feasible, is partly driven by the patient’s wish to ‘try anything at all’ in order to extend life. Dr. Moss confirms this and claims that the greatest breakthrough in the objective study of chemotherapy came from a biostatistician at the University of Heidelberg, Dr. Ulrich Abel. If changing the name to a more inclusive term, such as hospice home nursing program, makes it easier to introduce the topic, I am in favor of such a modification. But so is honesty, given out in the proper doses on a patient-by-patient basis. To some, hospice also suggests giving up. Understandably, oncologists are reluctant to tell patients that there is no longer any benefit for them to continue chemotherapy. So many folks wait till the very end to bring hospice in. But if is intended to soften the blow, I am not so enthusiastic. For oncologists it is a dreaded and often inevitable outcome. And the data supports it as well. Even though you’re happy to leave chemo side effects behind, you strangely felt safe and cocooned while undergoing treatment. The answer may revolve around blood markers with strange names, but there's no … The content on this site is for informational purposes only. Just my opinion, There is currently no evidence to suggest a benefit to delaying chemo in light of Covid-19 risks, the group says, although there may be cases in which … It is a conversation that alters the doctor/patient relationship, an acknowledgement by the doctor that, despite all the advances of modern medicine, “I can do nothing more to extend your life.” All rights reserved. The result is a delay in beneficial treatment opportunities such as hospice care, generally regarded as the gold standard when death is imminent. 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