Medical opinion: Treating symptoms can improve quality of life

Editor's note: Board-certified specialists from a panel of Yuma-area physicians provide to-the-point answers to questions submitted by Sun readers. The answers are only the opinions of the answering physicians, and are not meant to be a substitute for medical consultation or physician care. Submit questions by e-mail to medicalopinion@ yahoo.com or via regular mail at Yuma County Medical Society, P.O. Box 4476, Yuma 85366.

Q — I have cancer and my doctor does not understand how difficult it is for me to get along day to day. I feel like I am dying and my doctor is not being honest with me. How can I get help?
 
A — I am so sorry you are feeling so poorly. Many people suffer from serious chronic illness, and have a lot of burden managing from day to day. What are you experiencing? Are you having a lot of pain, or shortness of breath? Are you tired and can’t manage your day to day activities? Are you feeling sad and depressed? Are you having nausea, or diarrhea, or constipation?
 
All of these symptoms can be treated, regardless of the diagnosis. For many patients, quality of life becomes poor, but treatment of symptoms can improve quality of life and your ability to manage from day to day.
 
Doctors are often uncomfortable talking about dying or a patient’s declining condition. This is even more true when you have known the doctor for a long time. Doctors are afraid you will become upset, and the bad news will worsen your health status. However, in my experience, most patients and families want to know the truth even when it is difficult, so they can take care of business and make sure family members are provided for. Even if the bad news makes you upset in the beginning, most people are able to adjust and are grateful to know what is happening.
 
If your cancer is getting worse, and you are not able to tolerate your treatment, or if there is no more cancer treatment that would benefit you, you might benefit from hospice care. Hospice care is care directed at managing your symptoms and improving your quality of life, when you have a life-limiting illness like cancer in its later stages. Hospice care is also for people with other serious illnesses like heart failure, severe strokes, COPD or chronic lung disease, Alzheimer’s disease or dementia in its last stages, or other serious diseases.
 
Medicare sets rules for hospice, and requires that the doctor believe you will not live longer than six months. Of course, it is very difficult to know when someone has only six months to live. Some people actually improve when their pain and other symptoms are managed, so they can live longer than expected. But if you become more ill as the time goes by, hospice professionals will help your family to care for you at home, and provide expert advice on how to manage symptoms and problems that a lot of people experience near the end of their lives.
 
It is important for you to think about what is most important to you, then talk to your doctor and ask direct questions. Tell your doctor what symptoms you are experiencing, and how you are feeling, and how your symptoms could be treated.
 
If the doctor says the treatment will not give you much benefit, or if there is no more cancer treatment available for you, ask your doctor whether you should be evaluated for hospice care. You may also call the hospice directly. If there is more than one hospice where you live, you can call each one to ask about the services and benefits they can provide for you.
 
No matter what you decide to do, remember that many symptoms can be treated, including pain, shortness of breath, nausea, constipation, and many others. Your quality of life is important, and you do not have to suffer alone.


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Jeanne Elnadry, M.D., is the medical director for Hospice of Yuma, Yuma’s only nonprofit hospice.