Right time for ‘end-of-life’ talk

The vast majority of patients with incurable lung or colorectal cancer talk with a physician about their options for care at the end of life, but often not until late in the course of their illness, according to a new study by Harvard-affiliated Dana-Farber Cancer Institute investigators published in the Feb. 7 issue of the Annals of Internal Medicine. The researchers found that such belated conversations tend to occur under particularly stressful conditions — when patients have been admitted to a hospital for acute care. And the doctor who shares in the end-of-life care talk is often a hospital physician rather than an oncologist who has treated the patient for much of his or her illness. Together, these circumstances may deprive patients of the opportunity for extended reflection and deliberation that would have been possible months earlier, when the conversation also could have occurred under less trying and hectic conditions, the authors...

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