Photo © Associated Press.
Nurses repeatedly witness the suffering of people with advanced, metastasized cancer who are undergoing chemotherapy. These drugs often seem to diminish rather than enhance the quality of the remaining weeks of their lives.
In the first article in a new AJN series on palliative care, author Marianne Matzo points to research indicating that chemotherapy in end-stage cancer does more harm than good. So what should we do when patients ask (as in this article), “Is the chemotherapy going to help me? And if it’s not, why are they offering it?”
Matzo, director of research for the Hospice and Palliative Nurses Association, discusses when such treatment is most likely to be beneficial. Noting that “quality of life at the end of life often begins with clinicians’ willingness to deal with patients’ distress in facing a life-limiting disease,” she offers suggestions about how best to initiate difficult conversations about a patient’s goals, values, and prognosis.
(This palliative care series has been developed in collaboration with the Hospice and Palliative Nurses Association.)
What I have experienced personally with family members with life limiting diagnoses are physicians who are not well educated on palliative care combined with a “we can beat this” mentality and who do not/can not/will not present realistic future to the patient and family.