Too much?
We always thought when a patient could withstand chemotherapy (both physically- and with no illness that would impede the function), we should provide these chemicals. As a last ditch effort to save the patient and improve the quality of life. (Just so you know, I didn’t abide that sentiment. I demanded they stop this ridiculous effort for my dad some 30 years ago; with the combination of leukemia, lymphoma, and sarcoma, it was clear that there was no cocktail that would work for all three- and any treatment would render the other diseases worse.)
But, now there’s new research. Drs. H Prigerson, Y, Bao, M. Shah, ME Paulk, MC Reid, D Berlin, and K. Maciejewski (all of Weill-Cornell), T LeBlanc (Duke) , B Schneider (Michigan), M Garrido (VA and Mt. Sinai NY) , K Adelson (Yale), and A Neugut (Columbia), have published the results of their study on terminally ill cancer patients. The results from the multi-center, multiyear study were published under the title Chemotherapy Use, Performance Status, and Quality of Life at the End of Life in JAMA Oncology. 
.
In a nutshell, there is a vast difference between a patient’s quality of life- and the patient’s quality of life when near death. Not only did those patients with moderate to poor response to chemotherapy not entertain better qualities of life near death, but those whose reception to chemotherapy was pretty good before death actually suffered more near death from additional treatment.
The patients were recruited for the study from 2002 to 2008, and a total of 939 were eligible, but only 661 included in this study. (The others simply were not interested or negatively inclined to further experimentation in their lives.) 384 died during the observation period; these were the younger, unmarried, uninsured, less educated, and non-white, with worse performance via the drugs, than those who survived the therapies.
These results pose significant problems for cancer-treating physicians. After all, the only reasons to provide chemotherapy (which is expensive, time-consuming, and with considerable side-effects) are to extend patient lives or make their lives better. These research results destroy these two premises, as the patient is nearing the end of life- unless the patient is ambulatory (which, to be honest, is rarely ever when s/he is near death.)
Having survived cancer and knowing my body, I would know if my body is responding to treatment. All of the data in the world could not uphold a vital decision that I would make in my final days of life. In the end, I am the master of my own decisions and I would know when I’ve had enough. The important questions of, “if and when,” could only be left up to me, regardless of how much a drugs probability is to work. It is my hope to honor my life by knowing when enough is enough. Nice blog!
Tami Principe recently posted..Welcome
First, so glad to hear your recovery was secured, Tami…
And, I certainly agree with you about who makes what decisions!
Thanks for the visit and the comment.