Little Discussion by Cancer Physicians of End-of-Life Care
Many prefer to wait until patients show symptoms, or treatments have been exhausted
TUESDAY, Jan. 12 (HealthDay News) -- Many physicians are not willing to discuss prognosis and end-of-life issues with terminally ill cancer patients, preferring to wait until they show symptoms or have exhausted all treatments, according to a study published online Jan. 11 in Cancer.
Nancy L. Keating, M.D., of Harvard Medical School in Boston, and colleagues conducted a nationwide survey of 4,074 physicians caring for cancer patients regarding the timing of discussion of end-of-life issues with terminally ill patients.
The researchers found that 65 percent of physicians would discuss prognosis with asymptomatic patients with four to six months to live. Only 44 percent would discuss do-not-resuscitate status, 26 percent would discuss hospice, and 21 percent would discuss preferred site of death immediately, but most preferred to wait until the patient developed symptoms or no further treatment was possible. Cancer surgeons and oncologists were more willing to discuss prognosis, while non-cancer specialists were more willing to discuss end-of-life issues.
"In conclusion, despite guidelines recommending discussion of prognosis, do-not-resuscitate status, hospice, and preferred site of death with terminally ill patients while they are still feeling well, our findings suggest that different types of physicians have very different views regarding the appropriate timing of these discussions," Keating and colleagues write.