Part of the challenge in oncology is the balance between hope and reality, and that is probably the most important thing to strive for for patients living with metastatic disease. Often times, the important conversations relate to treatment options, goals of care, and patient preferences (i.e., how frequent the visits to the doctor and for […]

Part of the challenge in oncology is the balance between hope and reality, and that is probably the most important thing to strive for for patients living with metastatic disease. Often times, the important conversations relate to treatment options, goals of care, and patient preferences (i.e., how frequent the visits to the doctor and for infusions, side effect profiles, and the important events in their lives which they do not want to miss). Yet, some of the most important are also the ones I struggle with the most.
This was the case with Laynie*. She and I met when she was diagnosed with ovarian cancer. I had hoped to cure her of her advanced disease, and given that she had no evidence of disease at the completion of her primary surgery, I had every reason to offer that. Unfortunately, she had relapsed only six months after treatment ended. We had talked then about the incurable nature of recurrent ovarian cancer and that our goals would need to change to more realistic ones – control of cancer and prevention of symptoms. I hoped that with the current options of treatment, she could continue to live and thrive, despite recurrent disease.
Sure enough, a year later she was still okay – on treatment with stable disease and no evidence of progression. She was still working and still enjoying her grandchildren. At the look of her, one would not have guessed she had recurrent ovarian cancer, except that her treatment had taken her once flowing blonde hair.
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