Early palliative care in cancer

An interesting interview has been published on Medscape (http://www.medscape.com/viewarticle/849081?nlid=86464_485&src=wnl_edit_medp_honc&uac=147469ST&spon=7&impID=789946&faf=1)

There has been an interesting study showing that early supportive care instead of chemotherapy in not operable lung cancers might prolong survival. The study has shown that in addition to that the life quality is greatly improved in supportive care arm and also the cost for healthcare is significantly lower – including end of life care. The prolongation in survival in supportive care arm exceeded most of the new cancer drugs applied in lung cancer. The go home message is that not giving chemo in many progressive cancers is indeed better in many patients that giving chemotherapy.

Excellent example of this was my grandfather and his lung cancer. Due to the position of the cancer, age and metastases he was directed into palliative care. No chemo. He actually outlived all other patients diagnosed at that time and his appearance for workup of his head metastases was a big surprise for all the stuff. The doctors at the ward though he was long dead. As far as I can remember he was diagnosed in 2000 and died in 2004.

On the other had I know a patient M (age 50). He has been diagnosed with lung cancer as I was starting at MUV – 2005. He was disqualified from operation due to the location of tumor that penetrated walls of great vessels – it was just impossible to touch it. The first oncologist told him to say farewell to the family. The second improvised and ordered a chemo which was much stronger that any indication. Then he underwent standard chemo.

He still lives. The tumor is still there. 10 years later he started to believe that it might have been some mistake. He recently underwent a biopsy – which again has shown lung cancer.

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