An oncologist talks about the existential crisis of cancer
“For all our progress, we still die, and most of us have an awkward relationship with that reality.”
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In an editorial recently published in the Journal of Oncology Practice, Timothy Gilligan, MD, medical oncologist and co-Director of the Cleveland Clinic Center for Excellence in Healthcare Communication, argues that oncology care is more than the discoveries and treatments that enable longer and better living for patients with cancer. “Cancer is a human drama,” he says, “an existential crisis for patients, their loved ones, and the healthcare team who cares for them and for one another.” Exciting science does not enable oncologists to understand and play an appropriate role in that drama, he argues, and end-of-life communications training is absolutely essential to oncology practice.
In sharing a loved one’s story, he writes:
“Lost in the excitement about cancer genomics, signal transduction pathways, and a focus on controlling the cancer at all costs, the life-prolonging and quality-of-life benefits of palliative medicine had been completely overlooked. I found myself heartbroken over my and others’ inability to help her to get beyond her anger at being struck down years before she had expected. She lived fiercely, and finding a way to come to terms with her fate escaped her despite all the obvious interventions. Her husband reflected that he wished they had foregone all treatment, all the hours spent driving back and forth to the hospital, sitting in the waiting room, and undergoing tests and procedures. It had been 2 years with no quality of life, he said, yet he was not sure she would have felt the same way; her life after starting treatment was miserable, but she wanted to live as long as she could. Acceptance of death was out of the question.”
Read the full story of Dr. Gilligan’s family cancer drama, his analysis of communication training for physicians, and his goals for patients at the end of their care journeys here.
Photo Credit: ©Russell Lee
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