10 responses to “Improving end-of-life care for patients with advanced cancer”

  1. I agree with the approach discussed, however, when you live in a community with no cancer agency it can often be difficult to get a clear sense of prognosis and initiating this discussion w/o a clear sense of this can be hard, especially if the family is not ready.

  2. I definitely agree with providing good supportive care during active oncology treatments. I would caution that the increased survival seen in the Temel study needs to be duplicated in other studies before we can really assess the effect of early palliative care on overall survival.

  3. Good article. Working in hospital now this approach seems to make much more sense

  4. Family docs need to take a more directive role earlier in the course of terminal disease so that patients do not feel compelled to persue what is often futile oncology treatment that diminishes quality EOL care.

  5. I completely agree with the above statement, even though it seems self evident

  6. today i was faced with a patient with inoperable pancreatic cancer who i had already started on fentanyl patches, domperidome, referred to palliative care and who will receive a celiac plexus block within the next few days and heart breakingly she tells me she hope to retire at 65. she is 62 I don’t want to keep hitting her with the reality of her imminent death

  7. very useful advice there is nosubstitue for truthful facts hopefully the patient will appreciate this approach

  8. While families often try to shield their loved ones regarding terminal diagnoses, I find that once communication is initiated, patients can actively engage in end-of-life decisions. I fully support the views expressed here.

  9. Although late in joining here, I do agree that GP’s need to always bring up earlier than later a discussion/clarification of limits to aggressive oncology therapy in anyone at the stage of advanced cancer. They must be supported in their decision to cease and desist with the realistic preparation for their “personal affairs.” Even if they hope for longer time and therapy which the GP will need to support if they so wish, the reminders of the limits possible should continue to be broached.

  10. Many GPs don’t have the training in palliative care to feel confident in dealing with end of life discussions. There must be more CME available for primary physicians.

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