The Care of the Terminal Patient

Abstract

Virtually every physician who cares for cancer patients faces a situation which seldom confronts his colleagues in other disciplines — the patient in whom death is statistically predictable within a relatively short time frame (weeks to months) and in which case nothing can be done to alter this inevitability. While it is true that the patient with severe coronary artery disease and Class IV heart failure may be in the same category, the life span of that patient is not defined in the same way as the patient with unresectable adenocarcinoma of the lung. Moreover, much can be done to maintain the former patient in some sort of equilibrium until the actual period of dying begins, which is usually of short duration. The patient with ‘terminal’ cancer, on the other hand, has a relatively long period of dying. Both the physician and the patient perceive that there is no realistic long-term hope, although at the moment the patient may be functional, communicating, and interacting with his environment.