Palliative Chemotherapy - your thoughts?

Palliative care does not mean end of life. Palliative care means there is no cure but the disease can be controlled
As for treatment, if there are few side effects it is worth considering. However she should never be influenced by people who are not in her position. I urge her to discuss honestly with her oncologist.

RosiesMaw

My HoD was diagnosed with Pancreatic Cancer and his consultant at the Churchill offered him a trial of chemo which at the time was not necessarily mainstream therapy for soft tissue cancers.
He lived for 5 years of which I would say only the last 6 months to a year was really hard going.
Everybody is different so generalisations cannot be trusted.
Take the requisite medical advice -anecdotal evidence is not the same thing.

Try reading the words @FP

At no time have I referred to my late husband or said he had any form of cancer.

Please check your facts in future

RTFT
I spoke of my HoD - Head of Department as if you didn't know.
Careless and tactless to get this so wrong.

JaneJudge

Hospices are wonderful places and end of life care is so important, no matter what any of us think of the subject in hand. Death should be talked about more and we should be more open about it.

I agree. Not in a morbid way but to help everyone to live their lives and
come to the end of their lives in the best way possible for them.

It is summed up in this quote by Dame Cicely Saunders (founded St Christopher's Hospice in South London) who said:

" You matter because you are you and you matter to the end of your life. We will do all we can, not only to help you die peacefully but also to live until you die"

Hospices are wonderful places and end of life care is so important, no matter what any of us think of the subject in hand. Death should be talked about more and we should be more open about it.

I understand that you are married to a now retired GP FP, and will have mixed with what you now call ‘health professionals’, as a consequence, but nevertheless
these references to ‘many’ and ‘a large number’ seem to me to be an exaggeration. ‘Some’ I can accept.

I posted this on another thread but feel it is relevant here too:

Hospices provide amazing care and support for people facing end of life and making choices; patients and families are supported

I volunteer in a hospice. It is a privilege to see:

a) the change in patients when they arrive in terms of being provided with appropriate care and medication to ease pain
b) the quiet acceptance that so many come to as they come to the end of their life
c) the support that enables families to come to terms with their relatives time to come to the end of their life
d) the support that is provided so that the patient and family can prepare, and for the family after their loved one has died.

Hospice type care should be available to all. Palliative care training should be standard across the NHS

I am sorry you find it unhelpful. I have spent my whole life surrounded by health professionals and the subject has been discussed with many of them over a long period of time. No exaggeration, sadly.

‘Often’? ‘Many’? ‘A very large number of cases’? How do you define ‘often’, ‘many’ and ‘a very large number’? These are phrases that you use (may I say ‘very’?) often. You have a tendency to exaggerate in this way FP, and in this context it isn’t helpful.

RosiesMaw

^Sadly, it is often the spouse/partner or family that almost forces a patient to go through very unpleasant and futile treatment- as they can't accept the imminent loss^
Well TBH I think that’s tosh as a general rule

It may be one person’s observation, but no more than that….

I am so so sorry your OH suffered from this condition, but so glad he survived 5 years which he enjoyed sharing with you.

With pancreatic cancer, this is very rare, sadly. My friend was not the stronges of person, and was always frail. It is a shame you choose to call my comment 'tosh' in this context.

My observation comes from many professionals specialists in end of life care, family and friends, and one organisation I belong to. A very large number of cases, sadly, and over a long period of time.

OldFrill - thank you for your explanation. When I was involved with Palliative Care 25 yrs ago, it was a new concept in cancer care.

A quarter century later you can only imagine the new strides in technology/medicine, applications and treatments, new guideline that are now used in the cancer realm.

The term “palliative” still means *to ease the pain or force of, without curing.”

The term “chemotherapy” means prevention or treatment of disease with chemicals.

Coupled together it threw me, but perhaps your national health system (here too?) has incorporated the two taking it to new vistas in cancer research.
Blessings to all cancer patients.
USA Gundy

Gundy

When the term Palliative is offered, that means “end of life” care. It is the most effective, pain-free, comfort care a person can receive when ALL other options have run out.

It is not adding another long-suffering treatment in hopes of a cure - instead it is the most humane and caring form of living out your life instead of suffering. Pancreatic cancer for most people (but not always) is incurable.

I’m sorry about your friend. You can help her by reading up on palliative care and helping her understand it is a way for her to rid herself of the PAIN.

A big part of my hospital work was around the palliative care program in our Level One Trauma Center. It is never offered until all other medical options have run out. Although the word chemotherapy kind of threw me - perhaps a way of saying it will be administered via drip.
USA Gundy

Palliative chemotherapy is chemotherapy administered not as a cure but to prevent a cancer from growing and/or restricting the speed of its growth etc. It is not without side effects and as with ordinary chemotherapy people tolerate the side effects differently. Chemotherapy itself is usually very debilitating (it was much worse than my cancer and totally wiped me out for months, but did the job). A friend with a brain tumour had been having palliative chemotherapy for a couple of years, very successfully - between treatments, which were increasingly debilitating, he was able to lead a fairly normal life. But as his tumour symptoms returned he ultimately felt he was simply to tired to cope with the debilitation of the palliative chemo side effects. He turned down the offer of further treatment and faded away within weeks. The palliative chemo probably prolonged his life and improved the quality of life but it was the side effects that made him choose to quit.

The very worst thing my husband had to cope with was when he was told there was no further treatment whatsoever for his cancer and he was facing death within two years. Had he been offered anything that might prolong those two years he would have not hesitated to grab it. He had fought the cancer and metastasis for ten years. He never gave up but it killed him in 6 months. It's an entirely personal decision and it's one that you are lucky if you have the option, or any option. Choice itself is a positive.

Sadly, it is often the spouse/partner or family that almost forces a patient to go through very unpleasant and futile treatment- as they can't accept the imminent loss
Well TBH I think that’s tosh as a general rule

It may be one person’s observation, but no more than that….

RosiesMaw, you’re right, everybody is different and generalisations can’t be trusted.
sadly it’s often the spouse/partner or family that almost forces the very unpleasant and futile treatment -they can’t accept the imminent loss
I’m unaware of any research that supports this statement.
If I’m to reflect on my own experience of bereavement/end of life decisions, I didn’t follow the path being criticised, neither did any of my loved ones or close friends
]I would welcome assisted suicide. I accept not everyone agrees with me and that there are spiritual/ethical/medical issues involved. I wouldn’t want anyone to feel fear of `judgement in this complex area of life

My HoD was diagnosed with Pancreatic Cancer and his consultant at the Churchill offered him a trial of chemo which at the time was not necessarily mainstream therapy for soft tissue cancers.
He lived for 5 years of which I would say only the last 6 months to a year was really hard going.
Everybody is different so generalisations cannot be trusted.
Take the requisite medical advice -anecdotal evidence is not the same thing.

Sadly, it is often the spouse/partner or family that almost forces a patient to go through very unpleasant and futile treatment- as they can't accept the imminent loss. My friend's OH, also an old school friend and very well off- insisted on taking her all over the country ot the most expensive specialists in the most expensive hospitals- totally against her wishes- and despite her doctors saying there was nothing to be gained.

Fleurpepper I so agree with you and Georgesgran you are right that with some cancers it can help people to survive a lot longer. My view is that with Pancreatic Cancer the average prognosis is 6 months and I sincerely dont think it should be offered to patients with no hope - I think it is inhuman and they should be encouraged to enjoy their last months with good pain relief.

I’m not an expert ^Gundy* but here in the UK there’s a vast difference between Palliative Care and Palliative Chemo as my DH’s Consultant was most emphatic to explain. Palliative Care is end of life care, but Palliative Chemo can go on for years and is about quality of life and how to extend it.

It’s definitely a person choice. Many year ago my father had stomach cancer and given about 9 months to live. He started on som palliative chemo but after a couple of sessions gave up. His feeling was that it made him feel very ill so he discontinued treatment. He ate what he wanted, when he wanted and continued to be as active as possible until the day he died.

I admired him for making this decision. As it happened he buried many hatchets in the last 3 months of his life.

gangy5

Have any of you come across this and what are your thoughts on this? I have a friend at the mo who has pancreatic cancer and has had this treatment offered to her. From personal experience I don't feel it is ever appropriate in this situation and is simply adding to the pain already being suffered.

I totally agree. My best ever friend died of pancreatic cancer, aged 52- 6 months after being diagnosed. Instead of quietly spening her last few months doing things she wanted to do and see the few people she wanted to spend her precious time with- she went through lots of treatments that had no chance to work and made her last few months a misery.

Diggingdoris - Cancer is indeed tricky, chancey, risky scary and a total crapshoot (as they say). Some are lucky, some pin their hopes to what the medics say, some are not lucky in the end.

I’ve had cancer - now seven yrs free. But I told my family if it ever comes back I am not going for treatment. I know personally (from within my married family) that chemo can be so wretched that taking the treatment is worse than living with the cancer. My MIL died in the end of treatment because it just ravaged her. There was no quality of life towards her end.

I’m so sorry about your father.

It is a very individual decision but I remember my dad saying that had he known he only had 6 months he would have refused the chemo as those months were awful for him. But the drs had said he might live five years, so he took the treatment. How wrong they were. So sad. Miss him every day.

Many thanks to all who have contributed to this thread, I'm sure we are now more informed about the subject and it may help us to make a difficult decision at some time.

When the term Palliative is offered, that means “end of life” care. It is the most effective, pain-free, comfort care a person can receive when ALL other options have run out.

It is not adding another long-suffering treatment in hopes of a cure - instead it is the most humane and caring form of living out your life instead of suffering. Pancreatic cancer for most people (but not always) is incurable.

I’m sorry about your friend. You can help her by reading up on palliative care and helping her understand it is a way for her to rid herself of the PAIN.

A big part of my hospital work was around the palliative care program in our Level One Trauma Center. It is never offered until all other medical options have run out. Although the word chemotherapy kind of threw me - perhaps a way of saying it will be administered via drip.
USA Gundy