Healthcare Professionals Blog

Last month the American Society for Clinical Oncology (ASCO) published a statement in the online version of the Journal of Clinical Oncology, entitled, “Toward Individualized Care of Patients with Advanced Cancer” (http://jco.ascopubs.org/content/early/2011/01/24/JCO.2010.33.1744.full.pdf+html) It reads almost as if one of the staff of Closure had written it.
ASCO suggests a radical change to the way cancer care is delivered.  The change begins with candid conversation about the person’s diagnosis and prognosis soon after the discovery of the cancer, when enough time remains to make clear-headed decisions.  It continues with offering palliative care to enhance the quality of life right from the start, even while providing the best curative treatments available.  It includes allowing the patient to weigh in on the goals and the course of treatment at every point, to change her mind, to opt out, or to seek alternatives.  It concludes with offering hospice care when curative options run out, while there is still time to die in peace and dignity.

As far as we have come in medicine we have not defeated death.  Death is neither a medical error nor a failure of will by the doctor or the patient.  We can postpone it but not eliminate it.  We can anticipate it – but more often we try to avoid or deny it.  When we cannot sidestep, and must face death, we often panic.

To every intern asked to “get a code status” for a patient he or she has never met, to every doctor who has been asked by the family of a dying patient, “What should we do?” and not known how to answer, and to every nurse or therapist who has felt helpless in the face of a dying patient’s pain, we dedicate www.closure.org for Health Professionals.

Here you will find guidance for having the difficult conversations so that your patients and their families say what they really need to say – and so that you really hear them.  You will learn tools for giving comfort when you cannot give cure – and to increase comfort while you are trying to cure.  You will acquire strategies for setting goals and making decisions as a part of a team with your patient so that you can honor his wishes, whether those wishes are for a peaceful, quiet death or for a determined battle to survive in the face of overwhelming odds.  You will learn not to wait until it is too late.

The Closure Web site offers hope – hope that while we wish long, healthy lives to everyone, the final chapters of those lives can be filled with peace and fulfillment, rather than pain and suffering.  Join us and learn what you can do for your patients.

Since our Web site is new, we are interested in hearing your thoughts and ideas so that we can better enhance your online experience. Have a suggestion for a topic you think we need to cover? Do you know of some additional resources we could use? Let us know your thoughts by responding to this blog post.

The Closure Team