Oncology: Have you seen this patient today?

Mrs. James* is an 85-year-old female who was diagnosed with colon cancerthree years ago. She underwent definitive treatment with surgical resection followed by adjuvant chemotherapy. Over the past two plus years, Mrs. James has had regular follow up visits with her doctor for physical examinations, surveillance CT scans and blood tests including tumor marker.

The patient was doing well until the past three months when she started to experience worsening RUQ abdominal pain, significant weight loss,increased fatigue and generalized weakness. Medical evaluation including CT scans and lab work revealed colon cancer recurrence with metastatic disease to the liver and lung. The risk and benefit of chemotherapy was explained to Mrs. James and her family. The patient elected not to undergo any additional colon cancer therapy.

Hospice can play a pivotal role in optimizing the quality of life in cancer patients, such as Mrs. James, who are not candidates for treatment or have elected not to receive cancer directed treatment. Although patients like this are not receiving treatment for their cancer, hospice services are available to manage the issues caused by the cancer.  It not only manages the physical symptoms and pain associated with the disease, it also provides amultidisciplinary and collaborative approach that addresses the psychosocial and spiritual needs of the patient and the family. The patient and family can also benefit by eliminating, or minimizing, visits to the ER, which causes additional stress.

Hospice can help keep Mrs. James at home.

*This is a composite example. Real patient information has not been included.