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Why an Oncologist Needs to be Totally Honest with "Terminal" Cancer Patients

Updated on November 18, 2015

The truth may be the best medicine

One of my relatives recently died from a very aggressive cancer that usually carries a poor prognosis.

I'm not sure she understood just how sick she was until close to the end.

First she was diagnosed. Then she had surgery to remove a tumor in her lung. Then she was given what sounded like good news - "It's only Stage II, so we can treat it."

She and her extended family were greatly relieved because they now expected the best. They trusted their doctors and they assumed all would be well, as long as she did the prescribed courses of treatment. In the United States, this is generally surgery, followed by radiation and possibly chemotherapy.

In short, this woman's physician's either weren't telling the complete truth or she didn't understand exactly what they were telling her. Since she was an intelligent woman, I'll wager the doctors weren't being entirely straight.

Apparently, she's the only cancer patient who's either in denial or being misled.

A 2012 study that appeared in The New England Journal of Medicine underscored the apparent communication breakdown between doctor and cancer patient.

This report found that most patients with a poor prognosis don't really believe it, and also don't think they're going to die from their disease.

The NEJM findings showed that either 81 percent of people with metastatic colon cancer believe that chemotherapy will cure them. And 69 percent of lung cancer patients believe the same.

The authors of the study pointed out that these patients didn't realize the treatments they received were "palliative" rather than curative. In other words, they expect the therapy will give them a fighting chance of long-term survival.

Source

A Biography of Dr. Emanuel Revici

Palliation versus cure

Apparently, my cousin's doctor's were thinking in terms of palliation rather than cure when they assured her the lung tumor was "treatable." Yes, they could offer her various treatments, some of which would make her vomit and lose her hair. But they couldn't offer her a cure, at least by conventional medical standards.

So were they lying? Yes and no. But they weren't being entirely honest.

To be fair, doctors are afraid of what will happen to someone if they are given a very poor prognosis and no treatment options. Having no hope often, in and of itself, often sends patients into a precipitous decline. This is a dilemma, especially in the United States, because the only legal treatments for cancer are surgery, radiation and chemotherapy. An oncologist may know these won't help a particular patient, but this is all he or she can suggest without risking his or her medical license.

Even if a physician knows of a good alternative cancer treatment, they aren't legally able to recommend it.

This legal restriction proved devastating in my cousin's case. Although she had the financial means to pay out of pocked for alternative medicine, or even to travel to a cancer clinic in Mexico or in Germany, two countries that permit treatments such as Sono-Photodynamic therapy and hyperthermia, she didn't even consider those options, both of which have long track records of success.

That's because she trusted her oncologists, and everything they told her.

Many cancer patients seek treatment in Tijuana

Source

Cancer Step Outside the Box

What happens when patients don't hear the truth

If patients really knew what the true success rates were for their particular type of cancer, perhaps many of them would embark upon a different approach before it's too late.

One cancer clinic in the Tijuana, Mexico area, where dozens of alternative cancer care centers exist, claims a 25 percent long-term survival rate for people who've basically been sent home to die.

Once it became clear my cousin's conventional medical treatments weren't working, and actually seemed to worsen her condition, her doctors suddenly switched gears and recommended hospice.

When a patient "goes on hospice," this is usually a point of no return. Hospice care typically involves liberal use of sedatives and pain killers. These drugs often cause excess sleepiness.

If an already weakened cancer patient begins to sleep most of the time, he or she won't be eating or drinking very much, which hastens death. So it's very easy for a patient to go from functioning fairly well to nearly comatose in a matter of days.

In my cousin's case, her cancer spread much faster than she was led to believe it would. Her pain level increased proportionately, requiring the use of heavy-duty painkillers. This set off an irreversible downward spiral that resulted in the death of a woman who, just a few months before, epitomized the saying, "Live life to the fullest."

Unfortunately, my cousin's death from lung cancer came very quickly, as this is often a very lethal and quick-killing cancer. By the time she realized conventional treatments weren't going to help her, it was too late to try anything else.

Natural Cancer Cures With a Good Track Record

Why everyone deserves to know the truth

If my cousin had known her future on earth was measured in weeks, not years, and that standard medical treatments would prove futile, this smart and strong-willed woman would have sought out alternatives. And she would have found them.

Whether these treatments would have extended her life is something we'll never know. But at least she could have tried them. I'm sure she would have tried as many of them as she could.

However, because she placed her hopes in a medical system that offers a near-zero chance of long-term survival for her particular cancer, at the stage it was diagnosed, she didn't explore anything else.

This is precisely why doctors need to level with their patients, instead of encouraging them to try treatments that may shrink their tumors a bit, but may not help them live longer.

Disclaimer

These statements have not been evaluated by the Food and Drug Administration (FDA). These products are not meant to diagnose‚ treat or cure any disease or medical condition.

This is an informational article and not intended as medical advice or advocacy of certain treatment options. People with health concerns should discuss them with a trusted medical professional. I am not a medical professional and cannot give medical advice.

Disclosure

I am a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

Do you believe oncologists should be totally honest with their patients?

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  • Ericdierker profile image

    Eric Dierker 4 years ago from Spring Valley, CA. U.S.A.

    I think your "medical advice" was spot on. If a poor patient is only getting advice and information from their doctor, they need to go elsewhere. Having good bedside manor and being a great oncologist are not mutually exclusive but pretty darn close. Can you even imagine a doctor spending that much time on that very complicated specialty being much of a people person -- I do not think so.

    I do question your "legal opinion". A Doctor discussing alternative treatments is not breaking any ethical, medical or legislative laws. Someone is outright lying about that. Can they prescribe banned or unaproved treatments? No. Can they, inform about them and discuss them and lead to more education about them, certainly.

    My doctors were different than your cousins. It was more like "Eric you are going to die soon, however we can give this hail Mary a try to you will be miserably suffering for 6 months or so before you die". What the doctors did not know is that I do not do suffering, and I do not do dying.

    Keep on this friend, you are doing great work

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi Eric,

    Thanks for weighing in. I appreciate your comments.

    Oncologists, in general, do not steer patients in the direction of alternative medicine. A lot of them view these different approaches with a fair amount of hostility. On one forum I read of an oncologist telling a woman, off the record, to try Essiac tea. I have no way of verifying whether or not this information is true.

    Oncologists can certainly discuss alternatives, but they don't often do so in a positive manner, from what I'm hearing. But they can't recommend an alternative approach over chemotherapy or they'd be setting themselves up for trouble.

    It must be a very tough field to work in.

  • Ericdierker profile image

    Eric Dierker 4 years ago from Spring Valley, CA. U.S.A.

    True that, it must be real tough. I still drop in on mine some 15+ years later and give him a hard time about being such a nerd ;-) They should get to see the good they do. Although in my case some might argue.

    It is fair to understand that these doctors treat disease not patients. They are to be warriors and not handholders. This is why it is paramount to have good support people and to read the good works of good folks like you. I will never tire of thanking you.

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Eric, that is so kind. Thank you.

  • Marcy Goodfleisch profile image

    Marcy Goodfleisch 4 years ago from Planet Earth

    An absolutely great hub - and so important. I firmly believe patients need to have the same information their doctors do, especially when dealing with oncology. There can come a time when the decisions are crucial and can greatly impact how a person's last few months will be spent. Voted up and shared.

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi Marcy,

    Thank you for the nice words. It is very important that patients have exactly the same information as their doctors, because their lives are on the line. Someone with a fast-moving cancer cannot afford to do treatments that aren't going to help. With any luck, and the appropriate treatments, their last months can be many years from now.

  • Carola Finch profile image

    Carola Finch 4 years ago from Ontario, Canada

    I feel fortunate as a cancer patient to have an oncologist who is honest about me. I had a suspicous MRI that showed a mass in my back. My ocologist told me that it could be bone cancer, which is terminal and untreatable. Since I was on chemo for breast cancer anyway, they did another MRI in six months, that showed it was what I suspected - scar tissue from an old back injury. That was two years ago and my prognosis is good. It feels good to have confidence that my oncologist will be honest with me, even if fears prove to be unfounded. Thanks for sharing this story and dealing with this important issue.

  • bac2basics profile image

    Anne 4 years ago from Spain

    Hi.

    My husband was diagnosed with lung cancer shortly after we relocated to Spain. He was offered and started a course of chemo and radiotherapy. We were told this was palliative care not curative and it would improve his quality of life and give him more time, but of course we didn´t know how much more time. I thought maybe another 5 years, my husband thought another 10 years, we were both wrong. He underwent treatment for 7 or 8 months and the cancer shrunk and yes he did begin to feel better once the terrible effects of the treatment stopped, but just 2 months later he had a seizure and was rushed into hospital again and it was found that the cancer had metastasized and he had a tumor in his brain. He was offered treatment for this which he also accepted and afterwards was told that the mega dose of radiation he had directly into this brain tumour had gone very well, but it was clear to me that it hadn´t worked and the cancer was spreading fast. Eventually his own oncologist told me to prepare myself as things were looking really bad, and when my husband came back into the room ( he had gone to be weighed) he asked what was going on and what would happen if the next 3 courses of chemo didn´t work. At this point the doctor had to tell him that if no progress was made treatment would be stopped and when my husband asked what then, he was told that the end would come quickly. As it turned out he only managed one further shot of chemo and died shortly afterwards.

    I know doctors have to offer hope to cancer patients and their loved one´s, it´s all we had to hang on to and a positive attitude is necessary in order to suffer the consequences of the treatments, which are horrendous. After saying that, if patients knew that no matter what treatment was offered it would only give them a few more months, and most of that suffering the side effects of treatment , would they actually opt to put themselves through it all, possibly yes, possibly no.

    It´s a difficult decision from both sides, hard for a doctor to take away all hope and hard for a patient to ask all the questions about treatment, outcome and life expectancy. All I know from seeing what my husband suffered is that should I develop lung cancer or any cancer I would want to know the bottom line before embarking on a treatment that wasn´t going to do me any good.

    I have voted this hub as useful and interesting and would like to thank you for writing it. Cancer and it´s treatments do need to be got out of the closet and given an airing, and I do agree that if life expectancy is only weeks or a few months and not years, then the patient does need to know.

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi bac2basics,

    I am so sorry to hear about the loss of your husband. Lung cancer is terrible. I've now lost three relatives to this disease. When my grandfather was dying of lung cancer, the doctors were talking like the radiation could cure him.

    Although I don't know much about medical care in Spain, it sounds as if your husband had the best standard medical care has to offer and it was probably better than what he would have received in the United States.

    Patients need to know the truth, so they have the option of declining treatment, or looking for an alternative.

    Thank you for reading and for your input.

  • Carola Finch profile image

    Carola Finch 4 years ago from Ontario, Canada

    Up here in Canada, it has been my experience as a cancer patient that though the oncologists don't recommond alternative treatment, they do accept the fact that patients are going to seek it anyway. They encourage patients to let them know what alterative treatments they are taking so that there are no problems with their medication. I was surprised though when both my family doctor and my oncologist put me on course of vitamns. Patients do have the absolute right to know everything and manage their treatment, especially if they have a limited time left.

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi Carola,

    It sounds like health care in Canada is much farther along than in the United States. Could it have something to do with the fact that there is maybe less profiteering up there, since you have a different health system? I've never heard of cancer patients in the United States being given vitamins. One person I know going through chemo was told, in no uncertain terms, to avoid all vitamins and supplements because it would interfere with the chemo.

    Canada is also the land of Rene Caisse and Gaston Naessens, both of whom had much success treating cancer with a different approach.

    Thank you for visiting and for commenting.

  • Carola Finch profile image

    Carola Finch 4 years ago from Ontario, Canada

    Thanks, ologsinquito. I am thankful we have public healthcare coverage up here in Canada, because cancer is so expensive to treat. They are not progressive enough to supply the vitamins - I have to buy them.for myself, but at least they recommend them. I think it is good for patients to educate themselves about alternative treatments. I took herbal remedies during my treatment without adverse effects - actually, most of the time my bloodwork is excellent! I consider them to be food. Love doctors - they saved my life, but they are not exactly open to new ideas. Just look at cases like Sister Kenny. In the beginning of his insulin research, Dr. Banting (a Canadian!) was rejected because he was not trained as a specialist in diabetes. I saw a film recently about the introduction of the drug herceptin (a life-saving treatment for breast cancer), and the doctor had a lot of resistance because the pharacutical company was afraid of being sued. Cried buckets through it - that doctor's persistance helped save my life. Thank you for writing about this issue.

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi Carola,

    I'm happy you're doing so well and that you suffered no adverse effects from the treatments. At least your doctors recommended vitamins.

    Thanks again for visiting.

  • hawaiianodysseus profile image

    Hawaiian Odysseus 4 years ago from Southeast Washington state

    I agree with you about the need to be honest with the patient and the patient's family, and so I won't belabor that point. What is a shame, however, and may even border on criminal intent, is how the AMA pooh-poohs natural remedies for cancer because of the impact that would have on financially lucrative pharmaceutical contracts. 'Nuff said! I'm sorry that your relatives had to experience this travesty. Aloha, my friend!

    Joe

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi Joe,

    I am very sorry as well my relatives, and so many other people, have had to live and die under these circumstances. It is criminal that people are discouraged from trying treatments that can possibly help them, especially when conventional treatments clearly aren't working.

  • bell du jour profile image

    bell du jour 4 years ago from Ireland

    Hi ologsinquito, I agree that all cancer patients should be told the absolute truth, otherwise how can they decide whether they want treatment or not? I think the reason the medical profession try to soften the blow is to encourage all patients to have some treatment, if someone is told that is will only prolong their life and not cure them they may decide to not have any treatment at all. The thing is that it is their right to decide - and by not giving them all the information the doctors are effectively taking away their right to choose. Very good hub - voted up and interesting.

    Bell

  • ologsinquito profile image
    Author

    ologsinquito 4 years ago from USA

    Hi Bell,

    Thank you for visiting and for commenting. I do think the doctors may want to soften the blow and give people "hope" by offering them chemo. But even if this treatment does prolong their life, and that's a big if, it may only be for a very short time. Yes, they are taking people choices away, because it may then be too late to try alternative medicine, or the patient may be so sick they don't even want to try.

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