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Cited by 280Palliative Care and End-of-Life IssuesPalliative and Oncologic CarePain Management and Opioid Use

The Role of Chemotherapy at the End of Life: “When Is Enough, Enough?”

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Harrington, Sarah Elizabeth, Smith, Thomas J.·2008·JAMA
DOI 10.1001/jama.299.22.2667PMC PMC3099412
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Abstract

Patients face difficult decisions about chemotherapy near the end of life. Such treatment might prolong survival or reduce symptoms but cause adverse effects, prevent the patient from engaging in meaningful life review and preparing for death, and preclude entry into hospice. Palliative care and oncology clinicians should be logical partners in caring for patients with serious cancers for which symptom control, medically appropriate goal setting, and communication are paramount, but some studies have shown limited cooperation. We illustrate how clinicians involved in palliative care and oncology can more effectively work together with the story of Mr L, a previously healthy 56-year-old man, who wanted to survive his lung cancer at all costs. He lived 14 months with 3 types of chemotherapy, received chemotherapy just 6 days before his death, and resisted entering hospice until his prognosis and options were explicitly communicated. Approaches to communication about prognosis and treatment options and questions that patients may want to ask are discussed.

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Research works printed but not linked: 3

  1. [41]Hayes DF. An overview of treatment for locally advanced recurrent, and metastatic breast cancer. In: Rose BF, editor. UptoDate. Waltham, MA: UpToDate; 2008. [Google Scholar]
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Authors
Harrington, S. E., & Smith, T. J.
Affiliations
Virginia Commonwealth University (US)
ORCID
Smith, Thomas J.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2008-06-11
Volume
299
Issue
22
Pages
2667
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.299.22.2667
PMC
PMC3099412
OpenAlex
W2052621119
Cited by
280
References
129
Citations by year
2026: 1 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 14 · 2021: 19 · 2020: 14 · 2019: 14 · 2018: 11 · 2017: 21 · 2016: 20 · 2015: 17 · 2014: 23 · 2013: 14 · 2012: 23
FWCI
22.19
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
  • National Institutes of Health
  • National Cancer Institute (R01CA116227)
  • U.S. National Library of Medicine (G08LM009525)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
end-of-life chemotherapy, palliative care, interprofessional collaboration, prognosis communication, treatment decision-making, lung cancer, hospice care, symptom management, goal setting, patient-clinician communication, chemotherapy side effects
MeSH terms
Antineoplastic Agents, Attitude to Death, Decision Making, Hospices, Humans, Interprofessional Relations, Lung Neoplasms, Male, Medical Oncology, Middle Aged, Palliative Care, Patient Acceptance of Health Care, Physician-Patient Relations, Prognosis, Terminally Ill

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