Drs Hope Rugo, Mike Rabow, and Reshma Mahtani discuss an interdisciplinary approach in toxicity monitoring, symptom management, and pain control to optimize patient care in metastatic breast cancer.
Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit.Hello. Welcome to our discussion about sequencing and monitoring for toxicity, symptom management, pain control, and when care should focus primarily on palliation rather than aggressive treatments.
I think that the biggest opportunity is for us to be able to link the care that we want to provide and that we're able to provide with the goals that people have.are so important, because it's really only when we know what the goal is that we can construct treatments and treatment regimens that make sense for everybody involved that we think are both efficacious and desired..
I think it's also important to be very upfront when we're having a conversation about goals of care in treating metastatic disease. It's a careful balance between, like you said, taking away that hope, but also giving them aof where they are in their disease process. It happens with time and with trust that develops. I think that's what's so special about the relationship between the medical oncologists and our patients.
The advice I routinely give patients who are open to hearing it is that it's usually later than we think. It's later than we think because sometimes people might have literally less time than we thought that they did. They might die or develop liver metastases or other complications that become very serious very quickly. It's often later than we think because people lose sometimes their ability to enjoy their life as deeply and as fully as they would like to.
I think it's very useful to use communication signposts to help people identify that you're saying something very important around goals-of-care discussions. It might be something like, Mr So-and-so or Ms So-and-so, I think we're in a different place now. Let that comment sink in, so people either understand what you're talking about because they just had their scans and it showed progression, or they can ask what you're referring to in particular.
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