Doctors have a responsibility to outline options. Patients make the final decision.

As an oncologist, I want to provide the best treatment for everyone. That should mean the best chance at a long-lasting remission, if not cure. Whatever that might take. Surgery, chemotherapy, radiation therapy — a dark tunnel that I hope patients will enter and then exit, with the sun shining on the other side. But, every now and then, I have a patient who chooses not to pursue the regimen that I think will bring them the best chances. Such was the case with Jean*. I met Jean as a second opinion — referred to me for discussion about next steps. She was 90 years old, though looked 30 years younger. She lived by herself and was very much independent. She had been married, but her husband had died of a heart condition decades earlier. She had raised three children, and was now a proud grandmother and great-grandmother. She had been doing well until eight months earlier when she developed a cough. When it progressed to involve severe shortness of breath she had made her way to walk-in clinic and was told she had a large fluid build-up around her lung — a pleural effusion. A tap followed, which showed cancer, and then a CT scan, which showed a mass in her ovary and abdominal tumors: carcinomatosis. By then she could barely walk due to the shortness of breath. Primary chemotherapy followed, and after three months she had recovered back to her usual self-independent and asymptomatic. Her doctors had told her she required surgery to treat the cancer, and then more ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs