When To Stop Disease Treatment

The medical world operates in a “fix it” paradigm, which is a wonderful thing in most cases. However, we’ve found that the model lacks the wisdom of a long-term, bigger-picture approach when treating terminal or chronic health conditions. 

If patients aren’t careful, they wind up pursuing treatments they would never have in the beginning or participating in treatments that diminish their quality of life in irreversible and regrettable ways.

Things To Consider Before You Stop Disease Treatment That Prolongs Life

Deciding when to stop disease treatment isn’t easy, but it often frees patients and families to enjoy the highest quality and most meaningful life they have left. There are several things patients and families need to consider before stopping treatment. 

Quality of life vs quantity of days left

The question of quality over quantity is something we ponder hundreds, if not thousands, of times in a lifetime. When it comes to treatments that prolong life, quality vs. quantity is the primary consideration.  We highly recommend that everyone – terminal illness/disease or not – ponder deep, big questions about their End-of-Life Plan. Your answers become the guideposts for which treatments you choose – and for how long – when presented with a terminal diagnosis. Questions include things like:

• What does quality of life mean to you? 
• What kind of life do you not want to live? 
• How many times (if any) do you want to be resuscitated? 
• How long would you want to be on a feeding tube or life support (if at all?)
• Where do you want to spend the end of your life (hospital? Home? Hospice house?)

These are all earnest questions, but they should be asked as early in the treatment phase as possible.  The answers will help to shape your decisions around when to stop treatment. Comfort and quality of life trump the number of days you have left if you’re spending them unconscious, unable to do things you enjoy, without the ability to taste/enjoy good food, in physical discomfort/pain, or separate from the ones you love.

How Many Times (And How Long) Have You Pursued Treatment?

The American Board of Internal Medicine (ABIM) started an organization called Choosing Wisely in 2012 to promote conversations between clinicians and patients – helping patients choose care that aligns with their ultimate goals, values, and end-of-life preferences.  Some of the basic questions used to guide patient/clinician conversations are around whether the treatment option(s)are:

• Supported by evidence
• Not duplicative of other tests or procedures already received
• Free from harm
• Truly necessary

And, when it comes to cancer treatments, they state “If you have had three different treatments and your cancer has grown or spread, more treatment usually will not help you feel better or increase your chance of living longer. Instead, more treatment could cause serious side effects that shorten your life and reduce the quality of the time you have left.” That wisdom applies to many treatments used to prolong life for patients with a terminal illness or disease. Choose wisely, and be brave enough to say “enough” when the prognosis won’t improve. 

How much are you suffering from the treatment?

Sometimes, the suffering from the treatment doesn’t make sense for the disease’s prognosis. It’s one thing to suffer for a short time because studies show you’ll gain months or years of health and strength again. It’s another to hear a doctor admit that your days are numbered even with treatment. The pull to do anything to live longer is strong, but at what cost? Weigh the suffering from the treatment with the suffering from the disease. In many cases, patients decide they’d rather be in less pain and enjoy life more for a shorter time than suffer indefinitely from treatments that mean most of their time is spent in bed, feeling unwell, or in physicians’ offices.

Have doctors or nurses mentioned hospice?

As we mentioned, our healthcare system is better at trying to fix something than acknowledging when something can’t be fixed anymore. Unfortunately, this inability of many doctors to be straightforward in hard ways keeps patients on a treatment autopia track they wouldn’t have chosen if they knew where it would lead. If your doctor or nurse has mentioned hospice, pay attention. That is a sign that treatments aren’t going to make you better, or they feel your quality of life will diminish from here on out. It means care providers feel you’ll benefit more from hospice services than treatments. Plus, hospice services bring everything you need – including medical support and equipment – wherever you want.

Is pursuing treatment an excuse to avoid the reality to stop disease treatment?

Are you suffering through treatments because you haven’t been able to face the reality of a terminal diagnosis? The fear of suffering and death is so powerful that people will voluntarily choose suffering and treatment instead. However, a terminal diagnosis doesn’t go away. So, avoiding your fears, anxieties, or concerns around the end of your life only builds up – rather than diminishes – if you ultimately know treatments aren’t saving you. Hospice and palliative care teams are here to support you. With our services, you can take advantage of palliative comfort care while pursuing current treatment plans. In addition, you’ll have access to physicians, nurses, social workers, therapists, spiritual counselors, and others who can help you through your decisions about whether or not to stop treatment. This support provides tremendous relief to our clients and their families, helping them to make decisions that come from their truest desires – rather than fear.

Stopping Treatment For A Terminal Disease

Are you beginning to feel like enough is enough for your disease treatment plan? Are you interested in learning more about what it would mean to stop disease treatment and pursue the highest quality of life for the time you have left? If so, Hospice of the Golden Isles is here to support you. Contact us to schedule a consultation. We are committed to providing peace of mind, and invaluable support, for those facing end-of-life decisions.