Doctors urged to speak sooner with advanced-cancer patients

    [An earlier version of this story misspelled Marcin Chwistek’s name.  This is the corrected version.]

    Fewer than 40 percent of advanced-cancer patients have a candid and realistic discussion about the prognosis with their doctor.

    The American Society of Clinical Oncology now recommends that the medical community start conversations sooner about what choices are available.

    Joseph Straton of Penn Wissahickon Hospice said the new recommendations are right on target. Often physicians focus on beating the cancer, he said, but when treatments aren’t working, there needs to be another plan.

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    “We just tell them about the treatment, what they could get, and we might tell them about the benefits of the treatment,” he said. “But we might not tell them what some of the downsides of the treatment are and how the treatment itself may get in the way of their quality of life.”

    There is some evidence that adding care to treatment early on to ease symptoms not only increases quality of life for patients. They might even live longer.

    Marcin Chwistek is with Fox Chase Cancer Center’s Pain and Palliative Care Program. He said, traditionally, doctors treat the disease and not the person with the disease.

    “Not necessarily a lot of attention has been paid to what their priorities are,” he said. “Do they understand their prognosis? Do they know how much time they have left? Do they understand their options for treatment all of those things?”

    Both doctors agree aggressive treatments to beat the cancer shouldn’t be ruled out. It should be the patient’s choice, they said. But when dealing with an incurable cancer, they said information should be provided for the patient to make the best decision.

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