On Heartbreak in Oncology

The many successes cancer medicine has witnessed over the past 2 decades have dramatically escalated the burden of care that oncologists are expected to provide. The availability of multiple treatment lines for diseases previously approached with therapeutic nihilism coupled with significant improvements in outcomes has been a boon to all those affected by cancer. These same achievements have also dramatically increased patient and societal expectations and have impacted the burden of care while blurring the lines between previously stark transitions from active to palliative or hospice care beyond recognition. The prolongation of active treatment times for almost all disease subtypes has resulted in a significant increase in the number of clinical stress points within an oncologist-patient relationship.

There has been much written regarding optimal communication and coping strategies for patients moving from active oncologic care to full palliative care or hospice. Many resources have...