End-of-Life Choice, Palliative Care and Counseling

Jane Brody: A time for treatment to endby Sonja

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For a great many cancer patients, the time may come to think long and hard about whether to continue treatment. They need to engage in an extensive discussion with their doctor and their family about their goals and about the benefits of treatment.

New York Times Columnist and Compassion & Choices “Dignity and Choices” Symposium Presenter Jane Brody has an outstanding piece on this topic:

Thirty years ago Forbes Hill of Brooklyn, N.Y., learned he had prostate cancer. At age 50, with a young wife and a fear of the common side effects of treatment — incontinence and impotence — he chose what oncologists call “watchful waiting.” For 12 years, Hill was fine. Then in 1990 his PSA count, a measure of cancer activity, began to rise, and he had radiation therapy. That dropped the count to near zero.

In 2000, with the count up again, he chose hormone therapy, which worked for a while. A few years ago, with his PSA level going through the roof, he learned that the cancer had spread to his bones and liver. It was time for chemotherapy. Hill said he knew it could not cure him but might slow the cancer’s progress and prolong his life.

Brody’s article highlights the importance of empowering patients to drive their own end-of-life care decisions. As Compassion & Choices continues to advocate moving from profit-centered to patient-centered health care, it’s more important than ever for providers and patients to have these conversations together.

Read Jane Brody’s article here.