Last month the American Society for Clinical Oncology (ASCO) published a statement in the online version of the Journal of Clinical Oncology, entitled, “Toward Individualized Care of Patients with Advanced Cancer”. It reads almost as if one of the staff of Closure had written it.
ASCO suggests a radical change to the way cancer care is delivered. The change begins with candid conversation about the person’s diagnosis and prognosis soon after the discovery of the cancer, when enough time remains to make clear-headed decisions. It continues with offering palliative care to enhance the quality of life right from the start, even while providing the best curative treatments available. It includes allowing the patient to weigh in on the goals and the course of treatment at every point, to change her mind, to opt out, or to seek alternatives. It concludes with offering hospice care when curative options run out, while there is still time to die in peace and dignity.
The best part is that this is not an experiment or a theory; it is ASCO’s vision for how every patient with cancer in the US will soon be cared for.
It is also our vision. Closure is dedicated to the idea that every person, whether ill with cancer or some other affliction, be fully informed about diagnosis, prognosis, options for curative treatment, and options for comfort, and prepared to make thoughtful decisions about death and dying that serve his goals and values. It is the idea that healthcare is not just about living longer – it is about living well, right up to the last moment. For some that means experimental chemo or surgery, for others it means morphine, hospice care, and dying at home. For everyone, it means dying with as few regrets as possible about the way the death occurred.
Hopefully the leaders of other specialty societies are listening so that ASCO’s model can soon become the model for all life-limiting chronic diseases – kidney failure, ALS, dementia, or congestive heart failure. Every patient deserves that level of care and consideration.