Anti-cancer therapies including chemotherapy, molecular target therapy, and radiotherapy for outpatients become standard treatments for patients with advanced cancer because less toxic anti-cancer drugs and better supportive drugs to reduce side-effects have been developed. In the most advanced cancer patients, the purpose of anti-cancer therapy is both improving survival and maintenance of quality of life. Treatments for outpatients with advanced cancer have the advantage of continuing work or relaxing with the family compared with inpatient treatment. On the other hand, they also provide patients disadvantages such as delay of discovery of adverse events.
Recently, the project of ‘advanced care planning’ (ACP) has been developed in the field of cancer patient care. ACP is the process by which patients, in conjunction with their physicians and loved ones, establish goals and preferences for future care and codify these preferences. To make better ACP, we should give patients sufficient and enough information about end-of-life care or prognosis. End-of-life care discussion between patients and their physician should be set up if the patients have incurable cancer and a life expectancy of <1 year according to NCCN recommendation. However, it is a hard task for us if patients have good performance status and are receiving chemotherapy.
Here, I show my experiences about end-of-life care discussion, and try to clarify a considerable best way to do for cancer patients receiving chemotherapy.