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Navigating the Costs of Cancer Treatments: A Call for Compassionate End-of-Life Care

The Decision to Prioritize Quality of Life

Tom Somerville, a 62-year-old resident of Kingston, Ontario, made the profound decision to cease his cancer treatments after experiencing severe side effects from chemotherapy. Initially diagnosed with colon cancer, which later spread to his liver, Tom underwent six months of exhausting treatment. This experience, coupled with a desire to cherish his remaining time, led him to prioritize quality of life over the continuation of treatment, prompting a meaningful trip with his wife to Victoria instead of enduring further medical interventions.

A man stands with a woman holding an umbrella while on vacation in B.C.
Tom Somerville, left, and his wife, Katherine Somerville, enjoyed a vacation in Victoria while he paused cancer treatments. (Submitted by Katherine Somerville)

Advocating for Common-Sense Oncology

Dr. Christopher Booth, Tom’s oncologist, supports his decision and is part of a broader initiative advocating for “common-sense oncology.” This movement, supported by oncologists in Canada and the U.S., promotes more judicious use of end-stage cancer treatments. They emphasize the importance of honest discussions with patients about the realistic benefits of treatments, aiming to enhance both the quality and the duration of life without compromising one for the other.

A woman with long hair, seated wearing a black top and black glasses.
Not having treatment for cancer isn’t giving up, says Rachel Koven of Kingston, Ont. (Turgut Yeter/CBC)

A Shift in Perspective on Treatment and Life

The initiative encourages a reevaluation of how treatments are administered, particularly those that offer minimal benefit at the cost of significant side effects. For many patients like Tom, the realization that life’s quality outweighs the marginal extensions offered by harsh treatments has been liberating. This perspective is not about giving up but about making informed, considered decisions that align with patients’ values and desired quality of life, allowing them to spend time meaningfully with loved ones.

A man stands wearing glasses, a striped shirt, suit jacket and conference lanyard in front of a blue backdrop reading American Society of Clinical Oncology.
Dr. Bishal Gyawali wants people to ask whether a two-week improvement in survival is meaningful. (Submitted by Bishal Gyawali)
A patient receives chemotherapy treatment for breast cancer in France.
Randomized trials are meant to guide whether a physician should use a chemotherapy agent as a standard of care. (Eric Gaillard/Reuters)

Additional Insights:

The story of Tom Somerville highlights a critical aspect of cancer care — the need to balance the potential benefits of treatment against its impacts on patients’ quality of life. This approach not only respects the patient’s autonomy and informed preferences but also underscores the importance of compassionate care in oncology. By fostering open discussions about the realistic outcomes of treatment, medical professionals can better support patients and their families during one of the most challenging times of their lives, ensuring that care is both effective and empathetic.