None of us like to deal with the reality of dying from cancer.  We read about the success stories–patients who beat the odds and live much longer than expected.

But at some point, many doctors and their patients face the reality of imminent death.  This article I found on, deals with this reality and ways to avoid unnecessary and expensive tests often given to terminal patients:

Terminal Cancer Patients Too Often Get Routine Cancer Screenings

The Gray Sheet. 2010 Oct 13, D Filmore

Patients with advanced-stage cancer are too often undergoing unnecessary cancer screenings, oncologists conclude in a study in the Oct. 13 Journal of the American Medical Association.

Efforts should be taken to reduce screening rates in this population to remove waste from the Medicare system, the team from the Memorial Sloan-Kettering Cancer Center and the Dana-Farber Cancer Institute assert.

In particular, the researchers looked at rates of mammograms, Papanicolaou testing, prostate specific antigen screening and colonoscopy/sigmoidoscopy in patients with cancers associated with a median survival of less than two years.

Based on an analysis of a matched registry cohort of about 87,000 Medicare patients diagnosed with advanced cancer from 1998 to 2005 and about 87,000 cancer-free Medicare patients during the same period, the team identified screening rates in advanced disease patients that were 35% to 55% of the rates observed in cancer-free patients.

That is entirely too high, the researchers suggest, given that there is no “meaningful likelihood of proving benefit” in patients with terminal disease.

“In the extreme situation of patients with advanced cancer, screening will lead to over diagnosis (detection of a cancer which, if not found by active search, would not affect survival) in virtually all cases when a new malignancy is found,” they write. “In addition, patients may be subject to unnecessary risk due to subsequent testing, biopsies and psychological distress.”

Read more by going to:  Terminal Cancer Patients Too Often Get Routine Cancer Screenings

This doesn’t apply to patients like me who are undergoing successful treatment and expected to live a number of years.  We are talking about relapsed and refractory patients who have run out of options and are expected to live one year or less.  Might they live longer?  Of course!  But the chances of a second cancer causing the patient’s death are very slight.  And even if this was the case, would a rational patient and/or caregiver decide to treat the newly found cancer?  Probably not. 

Reality bites!  All we can do is live one day at a time and–for today–try to feel good and keep smiling!

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