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End-of-Life Treatment Has Important Nuances

Maurie Markman, MD
Published: Sunday, Oct 13, 2019
Maurie Markman, MD, editor in chief, is president of Medicine and Science at Cancer Treatment Centers of America and clinical professor of medicine, Drexel University College of Medicine, Seattle Cancer Care Alliance

Maurie Markman, MD

A most thoughtful commentary published in a recent edition of The New York Times highlights the critically relevant issue of end-of-life care in the oncology arena.1 The author, Jane Brody, personal health columnist for The Times, poignantly recalls that when her husband was “nearing death from lung cancer,” she “authorized radiation treatments in hopes he could attend a concert of the theater songs he had written.” Later, she regretted having done this. “After he died, I realized how much my goal tormented his last weeks with treatments he didn’t want,” she wrote, concluding, “I now realize that how people spend their remaining days should be a personal decision based on sound medical advice and free from other people’s influences.”1

The article includes comments from others regarding the potential lack of utility of chemotherapy near the end of life and the observation that “too often, people with incurable cancers pursue therapy beyond any hope of benefit except perhaps to the pockets of Big Pharma.” Note that individual patients and their families might reasonably take exception to “beyond any hope of benefit.”

However, it is the final short paragraph of this likely widely read personal opinion piece that forms the basis of my commentary here. Brody makes the rational statement that “sometimes…chemotherapy or radiation is offered to patients near the end of life to alleviate debilitating symptoms.”

Unfortunately, and surprisingly, Brody finishes with this: “But the goal of such palliative therapy should be made clear to patients lest it give them false hopes for a cure.”

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