I’m caught up in the current chatter of the cost of cancer care.
How it’s related to treatment, how oncologists are handling the pressure of cost and treatment, and is there a better place to direct the care when treatment is no longer a potential life extender. There are probably many other layers that go into this discussion too.
How about the pressure it puts on a doctor? If the cancer has spread, does the doctor continue treatment or is this the time to take those dollars and put them to good use with palliative care or even hospice?
Does a doctor feel like a failure when the only real “next step” is treating the symptoms and not the disease? At some point, taking the pain away could be even more important than treating the disease. Cancer hurts, especially advanced cancer.
If a patient is lucky enough to be treated by a multi-disciplinary team, odds are the pain team is there to respond quickly. If there is no multi-disciplinary group, it’s important for the care-giver to advocate for the patient and ask for a pain specialist or a palliative care expert in the case of advanced disease.
I’m not sure oncologists are programmed to stop treatment. It’s not their fault, their patients aren’t programmed to quit either. So maybe both sides of this discussion need a little re-wiring. There are a lot of dollars up for grabs here and a lot of lives on the line too.
Maybe we all need a little palliative care on this topic.
June 5, 2012 @ 2:14 pm
One thing is for certain, palliative care is an option that could well be available even before treatment stops. Personally, there were times when it was hard to care & feed myself during chemotherapy, and palliative care (not only for the terminally ill) would have been a boost in terms of support. I realize this article is about when to stop funding one option and start funding another, but just wanted to point out that often times patients need that palliative support during treatment, and it can go unaddressed.
Catherine
http://Www.FacingCancer.ca
June 4, 2012 @ 7:32 pm
There are lots of opinions about treating or not treating patients with advanced cancer. As I’ve stated before and believe, the majority of us, patients, know when it is time for palliative care, hospice, pain management, etc. Yes there are those who want treatment regardless of the cost or prognosis. But do we need to have a very broad brush and state unequivocally that once you’ve reached Stage IV just go quietly into the night, cease all treatment, etc. I don’t think so. I know too many who are doing OK with Stage IV and I do know one miracle young man who would have been dealt a death sentence by the illustrious committee of oncologist who deemed that PSA’s are no longer necessary. My oncologist did his best for the young man in spite of the way he looked (tumors sticking out through the skin in his chest and neck)…put him in the hospital and on chemo and he is now cancer free for the last 10 years.
It comes down to us…the patients and caregivers….to find an oncologist who will truly try to help us even when things don’t look so good….to continue to try something new or different but to try until it becomes obvious that cancer is winning the fight.
This conversation is not going away. The costs are staggering for treatment but I’m not sure that they must be that way. I stopped taking the drug I’ve been on for 8 years because my insurance would no longer cover it and it cost $20,000 per year for me out of pocket to continue it. Until I have another recurrence, I cannot qualify for any type of treatment that would possibly prevent the recurrence….no sense to me…but that is the way it is in the cancerworld…..fight the beast, the bureaucrats and sometimes the doctors just to try to live. Great system, huh!