Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

When discussing cancer treatment, the approach matters

Michael Carbine
Patient
December 20, 2014
Share
Tweet
Share

Dr. Peterson, the radiation oncologist, gets right to the point.

“The medical center’s tumor board has concluded that your cancer is inoperable, incurable and untreatable,” he says flatly. “Any chemotherapy or radiation treatments would be palliative in nature.”

He begins explaining the reasons behind the board’s verdict, but everything he’s saying washes out. My mind stopped working as soon as I heard the words “incurable” and “palliative.” I am sliding into shock.

Dr. Peterson pauses.

“I thought you knew this,” he says hesitantly.

“Well, two weeks ago, I got a much better prognosis from Dr. Lowe, who’s a cancer surgeon,” I say. “He and I discussed my having surgery.”

Clearly unsure of what to say, Dr. Peterson quickly returns to the board’s findings, but I interrupt him.

“What would happen if I choose to decline treatment?”

“There’s no reason to be afraid of chemotherapy and radiation,” he begins.

“I’m not afraid,” I interrupt. “My main interest is quality of life, not longevity –”

“If you do nothing, you’ll be dying, and there will be no quality of life,” he cuts in quickly. “The sooner we begin chemo and radiation, the better off you’ll be.”

We continue to talk past each other, and the conversation deteriorates until we reach a dead end.

“I’m sorry,” he says finally. “I’m pretty young” — he looks to be in his thirties –” and I don’t have that much experience in dealing with messy situations like this.” His voice and face betray his discomfort.

He takes me across the hall to meet with Dr. Richards, the medical oncologist who will be coordinating my care.

ADVERTISEMENT

On Dr. Richards’ desk, I see a treatment consent form already filled out and awaiting my signature.

Without any civilities or inquiries into who I might be, how what’s happening to me is affecting me emotionally or how my values and preferences might influence my decisions, Dr. Richards unleashes a torrent of numbers about my particular kind of cancer — its prevalence (rare), nature (unusual) and existing research (there’s little in the literature). The data, expressed in a language I cannot yet understand, further numbs my brain.

Finally, he comes to the point: He plans to subject me to the most aggressive and brutal course of chemotherapy possible.

“There are possible side effects,” he cautions, “but they’re worth it because I’m going for the cure.”

“But the tumor board says that the cancer is incurable,” I say.

“Well, it’s true … a cure would be nothing short of a miracle,” he admits, his tone businesslike. Without missing a beat, he continues: “I’ll be using three chemotherapeutic agents, and the regimen will run for two months; you’ll have a mix of visits to the infusion center and use of a home infusion pump. That should shrink the tumor and buy you some time –”

For the second time in one day, I interrupt a doctor.

“My overriding concern is quality of life rather than longevity,” I say.

He regards me impassively. I can tell that he is losing interest.

“What would happen if I do nothing?” I ask.

He recommends exploring hospice care.

“Would chemo enhance the effectiveness of the treatments the radiation oncologist is proposing?” I ask.

“Yes,” he answers, but reminds me that the radiation oncologist, like himself, is recommending the most aggressive treatment in hopes of a miracle.

“Then a less brutal regimen would be to go to Lourdes,” I say facetiously.

To my astonishment, he nods. “A trip to Lourdes would be a better use of your money.”

He looks at his watch. “We can’t spend all day on this,” he announces impatiently.

In silence, he prints out a brief summary of the chemotherapy options.

“Look it over and call me when you’ve decided on one,” he says.

He stands. The meeting is over.

Disoriented, confused and enmeshed in a web of disbelief, I leave. Only later, when anger begins to temper the shock, do all the things I could and should have said come to me. I write them down but put the list aside until I can find another oncology team at a different center.

After some searching, I select a new team. And, in truth, I eventually go with the chemo and radiation regimen recommended by Drs. Peterson and Richards. But the new team helps to make the decision an entirely different experience for me.

From the first visit on, they listen closely and respond to my concerns and fears. They solicit my feedback on their recommendations and spend time explaining my options. They too talk about numbers and data and algorithms, but they also listen to my story, and I can tell by their questions and comments that they value what I’m saying.

I know that they are highly competent medical professionals. But the way in which they relate to me — as one human being to another — convinces me that they also understand the personal side of medicine, and that they will bring to my care not only the aim of curing but also the art of healing.

The trip to Lourdes can wait.

Michael Carbine is a retired health care business writer. This article was originally published in Pulse — voices from the heart of medicine, and is reprinted with permission.

Prev

MKSAP: 76-year-old woman with a headache

December 20, 2014 Kevin 0
…
Next

A day in the life of a hospitalist

December 20, 2014 Kevin 1
…

Tagged as: Oncology/Hematology

< Previous Post
MKSAP: 76-year-old woman with a headache
Next Post >
A day in the life of a hospitalist

ADVERTISEMENT

More in Patient

  • AI’s role in streamlining colorectal cancer screening [PODCAST]

    The Podcast by KevinMD
  • There’s no one to drive your patient home

    Denise Reich
  • Dying is a selfish business

    Nancie Wiseman Attwater
  • A story of a good death

    Carol Ewig
  • We are warriors: doctors and patients

    Michele Luckenbaugh
  • Patient care is not a spectator sport

    Jim Sholler
  • Most Popular

  • Past Week

    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • The health insurance crisis 2026: What Kentuckians need to know

      Susan G. Bornstein, MD, MPH | Policy
    • Physician weight loss strategy: Why willpower isn’t enough in 2026

      Archana Reddy Shrestha, MD | Physician
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • Systemic strain creates the perfect environment for medical gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • In the age of AI, what makes a physician REAL?

      Harvey Castro, MD, MBA | Physician
    • The cost of clinician absence in the boardroom: a 30-year perspective

      Christopher Mastino, MD | Physician
    • My wife wants me to retire

      Sandy Brown, MD | Physician
    • 2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid

      Arthur Lazarus, MD, MBA | Physician
    • Immigration policy and child health: a medical student’s perspective

      Adam Zbib | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • The health insurance crisis 2026: What Kentuckians need to know

      Susan G. Bornstein, MD, MPH | Policy
    • Physician weight loss strategy: Why willpower isn’t enough in 2026

      Archana Reddy Shrestha, MD | Physician
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • Systemic strain creates the perfect environment for medical gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • In the age of AI, what makes a physician REAL?

      Harvey Castro, MD, MBA | Physician
    • The cost of clinician absence in the boardroom: a 30-year perspective

      Christopher Mastino, MD | Physician
    • My wife wants me to retire

      Sandy Brown, MD | Physician
    • 2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid

      Arthur Lazarus, MD, MBA | Physician
    • Immigration policy and child health: a medical student’s perspective

      Adam Zbib | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

When discussing cancer treatment, the approach matters
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...