Archives for February 17, 2010

oncRN: fyi

i have yet to meet a patient who wants treatment.

patients want an outcome.

big difference.

via oncRN: fyi.


I had a patient with an inoperable tumor recently, who’d been getting chemo and radiation for this same tumor for 4 years, while it progressively got bigger and bigger, all nicely documented in the electronic notes.

And, when I advised a hospice admission I was rebuffed.  “The oncologist says we might be admitted to an experimental treatment at MD Anderson”.

I understood their desire to have hope (however misplaced), and wanted to throttle an Oncologist.  We’re talking about a bone invading tumor the size of a soccer ball.  Which has responded to exactly nothing, in  years.  At what point is treatment not only pointless, but counterproductive?

(Old doctor joke: when the nephrologist goes to the morgue to give the last dialysis, they’re surprised to find a note in the empty coffin “gone to chemo”).

We all want to live forever.  None of us will.  Don’t give up when the treatment can give a positive outcome; don’t waste your days chasing treatment when the outcome is more treatment…

thanks to Musings of a Dinosaur for the idea, and OncRN for the insight.