When Merv Griffin died on August 12, his family said on his website :

Griffin, who turned 82 on July 6th, was recently diagnosed during a routine examination with a recurrence of the prostate cancer that he had overcome more than a decade ago. Its aggressive progression to other organs was unexpected and immediate, according to his doctors at Cedars-Sinai Medical Center in Los Angeles.

The notion of a sudden fatal resurgence may mislead other men who are fighting prostate cancer.This description of Griffin as “recently diagnosed” during a “routine examination” with a recurrence of a cancer “overcome” a decade ago surprised some prostate cancer patients and alarmed others. It really doesn’t fit with the typical pattern of prostate cancer recurrence and progression. It’s not how most patients who suffer recurrence learn about it.

The statement by the Cedars-Sinai doctors may have been intended to preserve Griffin’s privacy and to assure family members that nothing more could have been done. More detail came from The National Enquirer, which reported that Griffin’s prostate cancer had spread to his bones, bladder, back and lungs. A catheter was put into his bladder to ease urination; blood was drained from his lungs.

A spokeswoman for The Griffin Group replied to a patient’s query: “1996. treated by radiation. brief episode in 1999. Reappeared as small spots on bone 2 months ago, and spread rapidly
and aggressively, and there was some chemo. . . . Merv had frequent check-ups and always came away with a clean bill of health until the day he didn’t.”

Why bury the fact that he knew years ago that his cancer had come back? “Always a clean bill of health” does not fit with what Merv’s son Tony Griffin told Larry King Live on August 23.
(full story…)

People, families and medical caregivers want improvements for those who die in hospital intensive care. In an era of increasing trust in use of home hospice many people say that they would prefer to die at home, or in a homelike setting. But a considerable number of patients with chronic, life-threatening illnesses enter hospital for acute care near the end of life and die in an intensive care unit (ICU).

Today 1 in 5 deaths in the United States takes place in the intensive care unit (ICU) or shortly after receiving intensive care, a trend that is likely to continue, according to intensive care specialists writing in a supplement to this month’s Critical Care Medicine.

More patients with severe illness are arriving at ICUs, the authors explain, and many families and patients with chronic, life-limiting diseases are opting for a trial period of intensive care. The patients have needs which traditional ICUs were not specifically designed to meet, especially needs for ongoing palliative or “comfort care.” And the families need and are asking for more information and support.

Full story:
http://www.psa-rising.com/living/end-of-life-care2-06.html

02 June, 2006
Associated Press
Doctors Say Futile Cancer Treatment Rising
By MARILYNN MARCHIONE , 06.02.2006, 07:35 PM

Doctors are reporting a disturbing rise in the number of cancer patients getting chemo and other aggressive but futile treatment in the last days of their lives.

Critics of the practice say doctors should be concentrating instead on helping these patients die with dignity and in comfort, perhaps in a hospice.

Nearly 12 percent of cancer patients who died in 1999 received chemotherapy in the last two weeks of life, a large review of Medicare records revealed. That is up from nearly 10 percent in 1993, and the percentage probably is even higher today, researchers said.

“Patients don’t like to give up,” and neither do physicians, said Dr. Roy Herbst, a cancer specialist at the University of Texas’ M.D. Anderson Cancer Center in Houston who had no role in the study.

Overly aggressive treatment gives false hope and puts people through grueling and costly ordeals when there is no chance of a cure, cancer specialists said.

“There is a time to stop,” said Dr. Craig Earle of the Dana-Farber Cancer Institute and Harvard Medical School. “It’s sometimes easier to just keep giving chemotherapy than to have a frank discussion about hospice and palliative care.”

Earle led the federally funded study and presented the findings Friday at a meeting in Atlanta of the American Society of Clinical Oncology. . . . .

However, another study presented at the cancer meeting on Friday showed the opposite problem: people not getting enough care.

A survey of nearly 700 primary care doctors in Wisconsin found that only 11 percent would refer a patient with advanced lung cancer to a cancer specialist and only 25 percent would refer a woman with advanced breast cancer.

“We also found a general lack of knowledge about the benefits of newer treatments” that can help such patients, said Dr. Timothy Wassenaar of the University of Wisconsin-Madison, who reported on the study at the cancer meeting.

“That’s horrible,” Herbst said of the unwillingness to refer such patients. He noted that newer chemotherapy treatments have extended lung cancer survival from 20 percent at one year to nearly 50 percent now.

Full story:
Doctors Say Futile Cancer Treatment Rising — Forbes.com