Between 2014 and 2019, investigators examined shifts in end-of-life care for patients with terminal cancer amid growing knowledge regarding hospice, palliative care, and end-of-life planning (EOLP). Contrary to predictions, the prevalence of aggressive treatment until death remained unchanged. This research avoided analyzing decision-making but suggested that both physician and patient influences led to persistent treatment trends.
The management philosophies of physicians are shaped by their training and experiences, possibly leading them to favor intensive treatments over discussions about EOLP. Senior oncologists may be unaware of or reluctant to adopt contemporary hospice practices, even in light of the American Society of Clinical Oncology’s guidelines recommending prompt conversations regarding EOLP and the cessation of ineffective aggressive treatments.
Transmitting information to patients effectively necessitates multiple interactions due to the overwhelming impact of a cancer diagnosis. Patients gain from carefully spaced, comprehensible information sessions that cover treatment alternatives, prognosis, pertinent research, EOLP, and integrative strategies like psychotherapy or medical assistance in dying where permissible.
Palliative care, essential for alleviating treatment-related side effects, is not universally accessible. Patients should actively seek facilities that provide comprehensive care, including hospice services, without exhausting their active treatment options, as brief hospice stays may limit their advantages.
Obstacles for patients include equating remission with a cure and the enduring “war on cancer” mentality. Advertisements for medications further exacerbate unrealistic hopes and may influence decisions against EOLP or hospice. Emotional and cultural narratives frequently prioritize treatment continuation over hospice approval, although contemporary practices and Medicare guidelines require that treatment be relinquished to access hospice services.
Critically, achieving a peaceful death is possible without suffering from unnecessary pain or hospitalizations unless specifically chosen. Striking a balance between realistic information and empathetic care can empower informed choices that align with patients’ end-of-life aspirations.