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Cancer Care Chronicles
April 2016

Practicing Hope

Author Affiliations
  • 1Oregon Health & Science University, Knight Cancer Institute, Community Hematology Oncology, Astoria
  • 2Columbia Memorial Hospital/Oregon Health & Science University Cancer Care Center, Astoria
JAMA Oncol. 2016;2(4):431-432. doi:10.1001/jamaoncol.2015.6413

An unexpected email from my brother-in-law awaited me that morning. His brother Stephen, in his 50s, had been diagnosed seemingly overnight with pancreatic adenocarcinoma, metastatic to the liver and lungs. They had seen one oncologist already, he wrote, and were going to the academic center the next day. Subsequent events unfolded rapidly. An emergent biliary stent was needed. He didn’t improve. He was not a candidate for clinical trials. Hospice was recommended. From long-distance, via phone and email conversations, I witnessed them seek out 3 different medical oncology opinions. The family all understood that the cancer was incurable, but said to me they “were just looking for some hope.” I hesitated in what to say to them, how much of the oncologist should I bring to the conversation, how much the supportive relative.