The People's Perspective on Medicine

Show 1097: What Can Be Done to Help When the Prognosis Is Poor

Even when a person has been diagnosed with an incurable disease, doctors can provide palliative care to help the patient live better as well as longer.
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What Can Be Done to Help When the Prognosis Is Poor

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Although lifespans have been increasing, so has the burden of chronic disease. When a person is diagnosed with a serious illness such as cancer, cirrhosis, kidney disease, heart failure or Parkinson’s, medical science may not have a cure. But doctors shouldn’t say, there’s nothing more we can do. Instead, they should ask, how can we help this patient live better, if not longer? That is the goal of palliative care.

What Is Palliative Care?

Many people imagine that palliative care is strictly for the very end of life. But they are underestimating its usefulness in so many other situations. Helping patients focus on what is most important to them can help them live better, whether their prognosis is for a few months or for a number of years. When expected life span is limited, it may make sense for doctors to discontinue drugs that are intended to help keep patients healthy in the long run and to maintain the medicines that help people feel better, including pain medications.

What Should Patients Ask After the Diagnosis?

Many people presented with a frightening diagnosis want to know how long they can expect to live, as well as what symptoms to anticipate. Dr. Pantilat urges patients to ask questions about this, and to be as explicit as possible. Patients may also need to ask for help achieving their most important goals, such as attending a child’s wedding. If doctors are asked explicitly, they may be able to indicate which goals are unrealistic and which might be reached through modifying current plans.

This Week’s Guest:

Steven Pantilat, MD, is professor of medicine in the department of medicine at the University of California, San Francisco. He is the Kates-Burnard and Hellman Distinguished Professor in Palliative Care and the founding director of the UCSF Palliative Care Program. In 2007, this program received a Circle of Life Award in recognition of excellence and innovation from the American Hospital Association.

His book is Life After the Diagnosis: Expert Advice on Living Well with Serious Illness for Patients and Their Caregivers. His website is www.lifeafterthediagnosis.com

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I wish doctors would stop looking at how old we are,
Being 60, 70, 80 or 90 does not matter we still want to live.
Just help us with whatever problem we have and be POSITIVE
with your “have a good day” exit.

Please mention that often – perhaps always – the complete cost of hospice care for people over 65 is paid by Medicare.

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