Doctors 'are withholding treatment from dying cancer patients because they think it is futile to continue'
By Sophie Borland
Doctors are withholding treatment from dying cancer patients because they do not think it worthwhile, a report warns.
They are refusing to send them to intensive care or offer life extending drugs as they believe such measures are ‘futile’.
In some cases, patients have been put on the controversial Liverpool Care Pathway - where fluids and food are withdrawn - rather than on life support machines.
A report by the Royal College of Physicians today warns that the hospital care for some terminally-ill cancer patients is inadequate.
It blames a lack of communication between GPs, nurses, cancer specialists and doctors in A&E for causing delays in treatment that can result in unnecessary suffering.
But it also warns that some doctors are too fatalistic and refuse to provide life-extending drugs or even help patients with their breathing as they believe it pointless.
In one case a 56-year-old man who had only just been diagnosed with lung cancer was put on the Liverpool Care Pathway after doctors realised the illness was terminal.
Initially cancer specialists had wanted to put him on a life support machine as part of his lung had collapsed and he was struggling to breathe.
But they were overruled by doctors working on intensive care who ‘felt the patient would not benefit.’
Instead he was put on the Liverpool Care Pathway and died shortly afterwards.
Another patient with terminal kidney cancer had initially been on sunatib, a drug which can extend life for several months.
Although he had been responding well to the treatment, doctors decided to stop it when he suddenly had a flare-up of symptoms including pain and sickness.
They said he was unable to make the decision himself as he was confused and delirious - he died four days later.
The report states: ‘There are concerns that sometimes an unnecessarily nihilistic approach to management may be adopted, particularly where the patient has evidence of secondary spread from the cancer and assumptions about futility of active treatment are made.
It also warns that cancer patients are being put to the back of the queue for x-rays and told by staff ‘A&E patients come first.’
Others who have developed serious infections as a result of their chemotherapy have had to wait 15 hours for hospital staff to administer antibiotics.
And some terminally ill patients were being admitted to hospital unnecessarily right at the end of their life because doctors had not given them enough pain relief.
Some may end up dying in hospital against their wishes rather than at home.
Professor Sir Mike Richards, the Government’s National Cancer Director said: ‘People with cancer often develop new and acute problems which require an urgent response, either as a consequence of their cancer illness or the treatment itself.
In a forward to the report, he added: ‘This will be compounded by the increased incidence of cancer in older people and associated comorbidities.
‘Yet patients and their carers may be unprepared for such situations and when they do seek help, there is still more to be done to improve their experience and avoid fragmented care.’
Eve Richardson, chief executive of the National Council for Palliative Care and of the Dying Matters Coalition said: ‘We only have one chance to get end of life care right, which is why it is concerning that many people who are dying are being needlessly admitted to hospital against their wishes, causing unnecessary distress and discomfort.
‘Routinely involving people who may be approaching the end of their life in discussions about the care and support they would like to receive - before it is too late - is essential and must be a priority for all health and care staff.’
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