1. Health
Lynne Eldridge MD

With Metastatic Lung Cancer Hospice is an Underused Gift

By May 28, 2009

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Hospice can be a tremendous gift for those with metastatic lung cancer and their loved ones, but a new study suggests that many people are not even offered the package. Something that saddened me deeply, having generously received what hospice has to offer caregivers and their loved ones more than once.

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This study looked at over 1500 patients diagnosed with stage 4 lung cancer to see if their physicians had discussed hospice with them within 4 to 7 months of their diagnosis. Only half of the patients said the topic was addressed, and this was the case even for those with the most severe pain.

Why?

Part of the reason is a lack of understanding about what hospice really means. Hospice is not a place, it is a philosophy. Many people have hospice care in their own homes. And hospice doesn’t mean “giving up.” Most treatments for stage 4 lung cancer are designed to improve quality of life rather than offer a cure – something that fits with the hospice philosophy.

But what if nobody knows exactly how long you will live? To enter hospice, a physician needs to estimate that you have a life-expectancy of less than 6 months. What happens if you live longer? Absolutely nothing. If your physician still believes you have less than 6 months to live, hospice is renewed. If you are expected to live longer – wonderful.

My grandmother lived with me during her last years with cancer and I’m not sure what I would have done without hospice. The difference? Before hospice, I did the lifting, the driving, and the managing. Once hospice was on board, I sat back as a hospital bed was delivered, oxygen brought in, a home health care nurse managed her treatment, and a social worker coordinated the whole thing. We could have the chaplain visit whenever we wished, and home health care aids to help with her cares. Her medications were delivered to the door, and I was given a supply kit of additional medications. If her pain was not controlled or she developed anxiety or nausea, a quick phone call to hospice could direct me to something in that kit to remedy the problem. When muscles in her arms tightened so it was hard to feed herself, they sent a physical therapist to my home that day to restore her function. And it was all free. It breaks my heart reading the statistics on how many lung cancer patients forego adequate pain treatment because of the cost.

Oh – Grandma did live more than 6 months. We simply renewed her hospice for another 6 months. What if a miracle cure had been developed? We would have simply cancelled hospice and gone for the cure.

I have known so many people who were only able to benefit from hospice the last few days or weeks of their lives. Learning about hospice doesn't mean the time is right for you now, but can help you know when you or your loved one may wish to discuss this with your doctor.

Further Reading:

Photo: istockphoto.com

Source:

Huskamp, H. et al. Discussions With Physicians About Hospice Among Patients With Metastatic Lung Cancer. Archives of Internal Medicine. 2009. 169(10):954-962.

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