GIST Cancer – When is Enough Enough? by Jodi Merry

An August 19 article of The New York Times was published about the treatment of cancer and knowing when there are no more options. Doctors and patients alike find themselves asking the question “When is enough, enough?” Doctors have the difficult task of telling a patient that there is nothing else that can be done for them. They don’t want to take away the last bit of hope that a patient has, and many patients would do “anything to live just one more day.” Many patients will not give up and give in to hospice care because they “fear that they will be left alone,” meaning they would lose their priority status with their doctors and caregivers.

Doctors talk to their patients early on about their disease management plan, discussing all of their options, including the decision to allow hospice care to take over. A patient could think more clearly about their options in the earlier stages of their disease process rather than when they’re grasping for each and every extra day of life. Patients need to be made aware that they shouldn’t feel “abandoned” by starting hospice, and that hospice could provide comfort and support to both them and their family in the end of life stages. Studies have shown that aggressive therapy at the end stages of disease only “hastens the process” of death. Whereas without treatment, a patient could be comfortable and have greater quantity and quality of time to spend with family and friends. However, some patients are afraid to die and will continue treatment even when it isn’t doing any good.

Again, doctors find it difficult to tell a patient “enough is enough”, for fear that they are robbing that patient of hope. The article even goes so far as to say that doctors may even be looking at their own livelihood, in that the cost of treatment is what keeps them in business. One would certainly hope this is not the case, and I, as a cancer patient myself, don’t believe it is. From personal experience, I have found doctors in this field of medicine to be very compassionate and they have always kept my best interests in mind.

So, when is enough, enough? Should treatment cease even when a patient is willing to continue? A patient’s autonomy must be respected by the doctor, and defended under all circumstances. Ultimately, the patient is always in the driver’s seat when it comes to disease management.