on January 29th, 2015 No Comments
This 9-minute video report from Al Jazeera America’s “America Tonight” offers an intimate glimpse into the lives of veterans suffering from advanced cancer, as they discuss end-of-life issues with their care providers at the Veterans Affairs Palo Alto Health Care System.
More than 200 late-stage cancer patients are participating in this Stanford-designed pilot study. Its goal is to improve the quality of life of these patients, while simultaneously reducing the costs of 11th-hour treatments that might not offer life-extending or life-enhancing benefits.
The driving force behind this study is Manali Patel, MD, a young Stanford oncologist who designed the plan with three others during her fellowship year at the Stanford Clinical Excellence Research Center, called CERC. The Center’s mission includes tests of its innovative care concepts at diverse U.S. health-care sites, in order evaluate and refine them prior to advocating widespread adoption.
The video focuses on one of three major components of the new CERC-designed approach to cancer care. The first is earlier patient counseling and shared decision-making about treatment options, well before a patient is on the brink of death, when emotions overwhelm the decision-making skills of patients, families and clinicians.
These difficult discussions don’t happen as often as they should, as I wrote in a 2012 Stanford Medicine magazine article on topic:
According to a recent study, end-of-life discussions typically take place only 33 days before death. With Patel’s proposed cancer care model, patients would be thoroughly briefed on the survival odds and side effects before being rushed off to surgery or chemotherapy. Many months before the family is gathered around a loved one’s deathbed, a person’s final wishes – resuscitation, feeding tubes, assisted breathing and whether a person wants to die at home – would be well-informed and documented.
Other pilot sites tests are in the process of implementing various components of the new approach. Last week Patel provided an update on these new cancer-care pilots:
- The VA Palo Alto Health Care System has almost finished its target study enrollment of 210 patients and data analysis will soon begin.
- CareMore Care Centers in Southern California have completed patient enrollment and data analysis has begun.
- In March 2015, a pilot will be launched at St. Jude Heritage Medical Group in Southern California.
- In May 2015, pilot tests will be launched in partnership with Unite Here Health in both Atlantic City, New Jersey, and Chicago.
And finally, an update on the cancer patients featured in the video: former Army police officer Rafael Arias, who chose to skip a final round of chemotherapy, recently passed away peacefully at his home. Timothy Blumberg is still in remission.
Previously: Uncommon hero: A young oncologist fights for more humane cancer care, TV spot features a more humane approach to late-stage cancer care, “Stop skipping dessert:” A Stanford neurosurgeon and cancer patient discusses facing terminal illness
Video courtesy of Al Jazzera America