Cancer Organization Says Doctors Should Focus More On Palliative Care As Opposed To Costly Treatments
I smell a big rat!
Back in November of 2010, a federal panel ruled that mammograms are useless for women under fifty, and that women in the 50 to 74 age range should only have them every other year. Plus they said that monthly breast self-exams are also unnecessary.
Then, earlier this year, there was news that the FDA yanked its approval of the drug Avastin for treating breast cancer, supposedly because of the nasty side effects, but most likely due to the $80,000 price tag.
And now according to the American Society of Clinical Oncology, doctors need to focus more on palliative care, hospice care, and end of life options rather than spending money on treatments that would buy a person only a few more months of life at best. They’re even hawking a booklet about it.
Frankly, this all sounds very fishy to me. Advanced cancer is not a new phenomenon. But judging by the overall tone of ASCO’s press release, you would think that up until now, oncologists have been too chicken to tell their cancer patients that they’re dying,and that they’re wasting time and money by prescribing useless chemo and radiation, when they should focus more on getting these people into hospices so they can just die in comfort. At least that’s how the AP covered this story.
WASHINGTON – Patients don’t want to hear that they’re dying and doctors don’t want to tell them. But new guidance for the nation’s cancer specialists says they should be upfront and do it far sooner.
The American Society of Clinical Oncology says too often, patients aren’t told about options like comfort care or even that their chemo has become futile until the bitter end.
When people have a fatal illness it’s perfectly normal to want to fight to the bitter end, and to preserve life. The job of a doctor is to save and preserve life. Being a bean counter is not part of the Hippocratic Oath. But apparently, the ASOG thinks we’re wasting our time and money, and that we should just make these people comfortable until they hurry up and die.
To help families broach the topic, too, the group developed an easy-to-read booklet about those choices, from standard care to symptom relief, and advice about what to ask to maximize remaining time.
“This is not a 15-minute conversation, and it should not happen in the back of the ambulance on the way to the ICU at 3 in the morning,” says ASCO chief executive Dr. Allen Lichter. “When everyone is well and has their wits about them, it’s time to start the process.”
“This is a clarion call for oncologists to take the lead in curtailing the use of ineffective therapy and ensuring a focus on palliative care and relief of symptoms throughout the course of illness,” the guidance stresses.
Who is the ASCO to say what is effective and ineffective? Determining the best course of treatment is between the patient, the doctor, and the patient’s family. Also, I can guarantee you that if any of the doctors on the board of ASCO had cancer, they would fight it to the bitter end.
Anyway, moving along, the ASCO says that not enough doctors are having end of life conversations with their cancer patients.
But the oncology society says it isn’t happening enough with the very sick. Fewer than 40 percent of advanced cancer patients have what it calls a “realistic conversation” with their doctors about what to expect and their choices of care.
So are these people trying to say that cancer patients and their doctors simply don’t tel their patients they’re not improving? I find that hard to believe. After all, when they’re in the hospital being treated, isn’t it a standard procedure to tell a patient that there cancer is either in remission or not responding to treatment. Are they implying that doctors don’t tell their patients they’re dying? What’s more likely the case is that most doctors try their best to kill the cancer the cancer and save their patients, rather than just writing them off as terminal cases who should just be left to die.
The consequences: Patients increasingly are receiving aggressive chemotherapy in the last two weeks of life. They’re spending more of their last months hospitalized. They’re not told that a lot of expensive, side effect-prone therapies buy at best a few more months.
In other words, why bother spending all that money on those pesky sick people who are going to be dead in a few months anyway?
I have the feeling that the company’s CEO and senior staff are Obamacare supporters.