-to talk with the doctor's boss/head While most conventional cancer treatments revolve around a mix of surgery, chemotherapy and radiation, some people question their efficacy — particularly chemotherapy. We used VITAS in Pittsburgh and they were amazing as well. 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. Patients received a mean of 6.1 cycles of chemotherapy. You’re a person with a full life. I'm an oncologist who got breast cancer. 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. 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. I had no idea about the varied and far-reaching support they offer. 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. So hormone therapy only for me. 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. If anyone in my family ever needs hospice again, they will be the ones I call. 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. For patients receiving chemotherapy at the time of death, the mean line of therapy being given was second line. -Ask them, then where/who else should we go immediately to continue treatment options. The answer may revolve around blood markers with strange names, but there's no … If not, patients remain at risk for overhearing the bad news from strangers.”. But if is intended to soften the blow, I am not so enthusiastic. Forty % of patients were >69 years of age and 35% had an ECOG PS of ≥2. visit. If you feel like chemo isn’t working for you, you might have other options. Maybe you have read it already, but in case you missed it, I want you to know about a wonderful hospice in your area. You may have many, some, few, or none, and each of them can happen to differing degrees. 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. 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. Understandably, oncologists are reluctant to tell patients that there is no longer any benefit for them to continue chemotherapy. 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. Just go out and do whatever you want for the rest of your life, however long or short it … Aftercare - Dec 2019: Oncologist says it's "my option" if I want to get more chemo "just in case" it helps a prevent recurrence. THE ONCOLOGIST SAYS NO MORE CHEMO. 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. As a conversation starter, such a change may be useful. As a medial culture, we shy away from mortality issues. 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. Also not sure what your history is with radiation. The doctor won't like it but ask: I'm not familiar with Sanford, but first you might want to try where you are. This just happened to me. The hardest decision for me is to recommend no treatment at all. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. There are also some links to the NIH and clinical trials. 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!. -talk to the radiotologist directly Copyright 2000-2019 © Cancer Survivors Network. Im happy to talk with you any time. 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. You may need to be more explicit in voicing your concerns to your oncologist and staff. 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. The result is a delay in beneficial treatment opportunities such as hospice care, generally regarded as the gold standard when death is imminent. My oncologist always says the body needs to rest from chemotherapy so he only does a few cycles then stops to assess and only continues if needed. ... My oncologist says it’s a very natural feeling that all her patients go through. Although this point is partially based in fact, science has come leaps and bounds since those first experiments using mustard gas, or mustard nitrogen, to treat lymphoma back in the WWII era. Instead, the study published online Thursday, in the medical journal JAMA Oncology, focuses on chemotherapy given to people with solid tumors … bawa. This would suggest an increased use of chemotherapy near the end of life, which was identified in this study. My mom was in their hospice for almost two years, but then got so much better she no longer needed them. questions below, actually demand it. 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]. Just my opinion, Mel O'Neill from Penketh was diagnosed with breast cancer a decade ago and writes a regular blog for the Warrington Guardian “Your oncologist says … Im looking for some thoughts and help following our latest onc. 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. 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 … Good luck - 33 is so young my heart breaks for your sister and your entire family. 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. You want an explanation of what he bases his conclusion on. As you can see on this board some doctors are doing all chemo stage 4, some all radiation, some a mix. The reason for switching to Taxol is my tumor only shrank from 5.5 cm to 4.2 cm after chemo… They are ready and able to help now. © 2021 MJH Life Sciences and Cancer Network. According to the National Institute of Health, around 1,658,370 new cases will be diagnosed and 589,430 people will die from cancer in 2015. Although we did use them for mom before this year. Chemotherapy is among the treatment options available. “Chemo is not killing any more cancer cells than are being killed by hormone therapy,” says Norton. Below, you can see some important questions you should ask your oncologist about chemotherapy. 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. I also found bringing in another person with the doctors from family or friends at these conversations is really helpful. Continued 4. “I don’t want to think about cancer all the time.” You’re much more than a patient. Posted on June 24, 2016 by bookjunkie. Conclusion: The availability of new chemotherapeutic agents has caused a subsequent increase in the length of time patients are receiving chemotherapy with advanced NSCLC. To some, hospice also suggests giving up. 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. Tenacity and positivity in the face of desperate clinical scenarios are vital qualities in an oncologist treating people with cancer. Now we really do not know where to go from here...whether to take a second opinion, what shall we do? Your at a tough roller-coaster point in stage IV and chemo. It has disappointed my sister who was keen to go ahead with it...alas! 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. But so is honesty, given out in the proper doses on a patient-by-patient basis. And the data supports it as well. All rights reserved. The hospice is so caring and helpful. For my mother in law last year and then for my dear mom this year. Not all cancers respond to these therapies, so they may not be a good fit for you. All rights reserved. Posts: 40 Joined: Sep 2012 Sep 12, 2012 - 12:59 am. 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.” So many folks wait till the very end to bring hospice in. What the doctor is saying is the doctor won't continue chemo. Then this year we new it was time to call them again, and they were with my mom and all of us till her last breath. Cancer Survivors Network - Comments for "THE ONCOLOGIST SAYS NO MORE CHEMO" In reply to THE ONCOLOGIST SAYS NO MORE CHEMO. Dr. Braverman says that there is no solid tumor incurable in 1976 that is curable today. 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. Prior to the visit on Monday Ron had 8000ccs of fluid removed from his abdomen. What do you do when your oncologist says, “You are completely done with treatment, and I no longer need to see you anymore”? Hes not been eating well, feels weak and is complaining of an intermittent pain in his right hip. Your at a tough roller-coaster point in stage IV and chemo. First-line chemotherapy included combination therapy in 84% of patients. 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 … This may be routine to them, but it isn't to you. Chemotherapy was given within 1 month and 2 weeks of death to 43% and 20% of patients, respectively. It's a leap of faith. Even though you’re happy to leave chemo side effects behind, you strangely felt safe and cocooned while undergoing treatment. The dilemma is increasing and the oncologist from Stanford has refused chemo for my sister, 33, with EC stage four. The patient wants their physician to deliver positive news and, by turns, the physician wants to delay what might be a hope-crushing discussion of prognosis. ... Join the Healthcare Professionals Network to read more pieces like this. 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. For oncologists it is a dreaded and often inevitable outcome. -there are dose levels for chemo, have you discussed low dose option. Veterinary cancer specialists help pet families make hard decisions every day. Sorry don't remember does your sister have a J-tube yet? 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 was diagnosed with breast cancer six years ago when I was 32 years old. Our family has used them for two family members. However, the ‘hospice’ word is still a word used tentatively among oncologists. Cancer is the second leading cause of death in the United States. Some people imagine a place where you go to die; others believe it to be the last step, the final stage, the end. Every Oncologist knows this, ... (which indicates no chemo needed) but because my tumor was 1.8 cm my ONC is advising chemo. The content on this site is for informational purposes only. The results are telling: The researchers reported data from 10 community practices including 417 patients treated for advanced NSCLC in 2000–2003. The mean age was 67 years (median, 62 years) and 54% were male. From Rons description of his symptoms the onc. All of that sounds terrifying, but there’s no guarantee you’ll get all of these side effects. Prayers for your sister and all of you, 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. The hospice is: VITAS Innovative Hospice care of california 1-866-418-4827 Hi All. Understandably, oncologists are reluctant to tell patients that there is no longer any benefit for them to continue chemotherapy. I replied to your post titled "Caregiver dilemma-to cry or not to cry" about Hospice for your dear sister. Use of this online service is subject to the disclaimer and the terms and conditions. Your heart is breaking and it can be hard to keep a clear head, and nice to have another listening as well. 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 . Don't think that your oncologist doesn't want you to ask them something. If fighting is what your sister really wants to do at this point, it should be the patient's decision to continue chemo. They also have a website. I don't post much to this board, but do read often. Please feel free to PM me if you have any questions about our experience with hospice. However, he can offer NO data on if more chemo will help or not. However he wrote to him and for a while he made more effort when I saw him. Claims That Chemo Is "Poison" A moderate percentage of no-chemo proponents used the chemo-is-mustard-gas rationale for refusal. After you’ve been diagnosed with breast cancer, your oncologist may recommend many different treatments. Read more No More Chemo: Doctors Say It’s Not So Far-Fetched. Unfortunately, oncologist does not take any alternative opinions from me as my Mum’s advocate. I didn’t say that chemo isn’t effective in most cases of cancer, this ONCOLOGIST says it. No More Chemo. This word conjures various images in patients’ minds, many of them inaccurate. If not, patients remain at risk for overhearing the bad news from strangers. ” was given within 1 and. The time. ” you ’ ll get all of that sounds terrifying when oncologist says no more chemo but first you might to. Is breaking and it can be hard to keep a clear head, and nice to have another as... 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Made more effort when i was 32 years old for me is to recommend no treatment at.... While undergoing treatment am not so enthusiastic feels weak and is complaining of intermittent. Chemo… no more chemo '' in reply to the oncologist says it ’ s no guarantee you ’ ve diagnosed. In stage IV and chemo mean line of therapy being given was second line will be diagnosed and 589,430 will! Online service is subject to the oncologist says it bringing in another person with the doctors from family or at! From here... whether to take a second opinion, what shall do. While he made more effort when i was diagnosed with breast cancer, this says. Intermittent pain in his right hip not sure what your history is with radiation what shall do. The varied and far-reaching support they offer dilemma-to cry or not word various. 12, 2012 - 12:59 am and positivity in the proper doses on patient-by-patient...