"As Cancer Patients Look To Last-Chance Therapies, Hard Conversations Are Getting Postponed" - Bob Tedeschi
A new generation of immune-boosting therapies has been hailed as nothing short of revolutionary, shrinking tumors and extending lives. When late-stage cancer patients run out of other options, some doctors are increasingly nudging them to give immunotherapy a try. But that advice is now coming with unintended consequences. Doctors who counsel immunotherapy, experts say, are postponing conversations about palliative care and end-of-life wishes with their patients — sometimes, until it’s too late. Cardinale Smith, MD, associate professor of medicine, hematology and medical oncology, geriatrics, and palliative medicine at the Icahn School of Medicine at Mount Sinai, said she has seen a handful of patients who tried immunotherapy treatments after failing chemotherapy, and who were later admitted to the hospital in poor condition. Almost all of them died there, without having been asked about where, and under what conditions, they might prefer to die. “These conversations are not occurring because of the hope that this will be the miracle treatment,” Dr. Smith said. “Unfortunately, on the part of the oncologist, treatments like immunotherapy have become our new Hail Mary.” Immunotherapies work for only around 15 to 20 percent of cancer patients who receive them.
- Cardinale Smith, MD, Associate Professor, Medicine, Hematology and Medical Oncology, Geriatrics, Palliative Medicine, Icahn School of Medicine at Mount Sinai