Covid-19 gives cancer patients more options for end of life care
A recent report of a zoom interview in America, with a cancer doctor and nurse, raises an interesting discussion. They recount how the Covid-19 pandemic has forced patients and their doctors to consider the risks and benefits of continuing with, or starting on yet another course of cancer treatment. These patients had lost their usual support networks and ongoing treatment plans and were discouraged from accessing the hospitals because of their vulnerability if infected with Covid-19.
The cancer specialists point out that doctors have been taught to treat the disease — so as long as there’s a treatment they give another treatment. But for some patients with advanced disease, those treatments can make them very ill, so they might be choosing longevity over quality of life.
Now, in the midst of Covid -19, advanced cancer patients are given the opportunity for discussion of palliative/hospice care, previously crowded out in favour of continuing less and less effective treatment.
Across the world, these dilemmas are encouraging cancer specialists to initiate discussions of palliative care (in preference to further cancer treatment) with patients who have advanced disease, and to do so more clearly than before.
One reason why such conversations have often been avoided is that the concept of palliative/hospice care is generally misunderstood. Patients think ‘you’re giving up on me, you’ve abandoned me’. But palliative/hospice care is all about preserving quality of life and letting them have time with family and time to fulfil those elements of experiencing a good and peaceful death.
Report 5.6.20 from Kate Johnson on Medscape ( Medscape.com) an American website providing access to medical information for clinicians. She interviewed Lillie Shockney, a twice breast cancer survivor, who is professor of surgery at Johns Hopkins School of Medicine in Baltimore and former administrative director of a cancer survivorship programme, and Brenda Nevidjon, chief executive officer at the Oncology Nursing Society.