“I used to choose a plan for others, but now it’s my father’s turn to decide a treatment plan.” Chen Zuobing, chief physician and MD of the First Affiliated Hospital of Zhejiang University, has treated countless patients and has been a doctor for more than 20 years. , but has never been so helpless.
His 78-year-old father, diagnosed with cancer, is already in an advanced stage, with systemic metastases and inoperable. Faced with his bad condition, he finally decided to tell his father the truth. “How much time can be extended after chemotherapy and radiotherapy?” Father Chen asked. “Not necessarily, the effect may be good for a few months,” Chen Zuobing replied helplessly. “How much does it cost, and what’s bad for the human body?” “All at public expense, and the side effects include hair loss, weakness, poor appetite, etc.”
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After understanding his condition, Chen Chen After thinking about it all night, my father finally decided to give up the radiotherapy and chemotherapy in the hospital and go back to his hometown. Chen Zuobing and his father reached an agreement. Chen Zuobing couldn’t be more clear about the pain of terminally ill patients. Even with the latest anti-cancer drugs, some patients can only prolong their lives by one to two months. They end up lying in the intensive care unit of the hospital, their lives are slowly exhausted, and even after brain death, their family members desperately ask doctors to rescue them. …..
When sending his father back to his hometown, he specially told his mother, If the father really reached the final stage, he was in a coma or had a heart attack Breathing has stopped, then give up active rescue measures, achieve sedation and hypnosis, and let father pass away peacefully and painlessly. Finally, Father Chen passed away without regret after living peacefully in his hometown for a period of time. Chen Zuobing also posted a story on the Internet that he had done the least treatment for his cancer-stricken father, causing an uproar. Who does not have the elderly, who can guarantee that the elderly will not get sick? Some people feel that it is unfilial to give up the treatment of elderly people with cancer, and some people think that letting go properly is the greatest respect for life.
1. When people are old, illnesses come to them, and cancer is most likely to find old people.February 27, Journal of the National Cancer Center Published the latest national malignancy incidence and mortality. Statistics show that in 2016, there were about 4.064 million new cases of cancer in my country and 2.4135 million deaths due to cancer. The incidence and mortality of cancer both increase with age, with the incidence peaking between the ages of 80 and 84 and the mortality rate above the age of 85.
Among them, 60-64 years old and 50-54 years old had the most malignant tumor cases, and 60-64 years old and 75-79 years old had the most malignant tumor deaths.
Why are older people more prone to cancer? Mainly related to three reasons.
1. The immune function is getting worse and worse
With the increase of age, the body’s immunity will also get worse and worse. The surveillance capacity of some diseased cells also declines. After the immune function declines, it is conducive to the development of tumors.
2. More and more exposure to carcinogenic factors
The older you are, the more likely you are to be exposed to cancer The more factors, the greater the impact of these substances on the body. For example, people who smoke for a long time, the longer they smoke, the greater the risk of disease.
3. Cancer incubation period is getting shorter and shorter
Cancer often needs a long “latency period” before onset, and after exposure to carcinogens, it needs to be in the body After 15-20 years, or even longer incubation period, the onset of the disease occurs. Carcinogens exposed to people in their 20s and 30s are likely to develop symptoms in their 40s and 50s.
In life, many families will face difficult choices like Dr. Chen Zuobing. The elderly suffer from cancer—to cure or not to cure? Follow Xiao Ai to learn more about this issue. Second, is it necessary to treat the elderly with cancer?
Deng Yanhong, director of the Medical Oncology Department of the Sixth Affiliated Hospital of Sun Yat-sen University, said that age should not be used as a criterion for whether the elderly should be treated for cancer. Instead, it is necessary to make specific analysis and countermeasures according to the specific situation of the elderly. 1. The disease is early and mid-term, and there is hope for long-term survival
Some elderly people are still in the early and mid-stage disease at the time of diagnosis, and they are expected to have a longer expected survival time after active treatment.< strong>For stage I early stage cancer, the five-year survival rate is above 80%. This situation has the significance of active treatment.
2. Treatment is sometimes to improve the quality of life
For patients with advanced cancer, Abstaining from treatment altogether is actually letting go of the suffering of the elderly. For example, in elderly patients with colorectal cancer, treatment can relieve abdominal distension, pain, gastrointestinal obstruction and other uncomfortable symptoms of the elderly due to illness. The purpose of treatment at this time is to improve the quality of life of the elderly and relieve pain, not to cure cancer.
Whether treatment is needed should be analyzed according to the specific situation. Blind abandonment of treatment or blind treatment is not recommended. Any decision must be carefully thought out and weighed. Just like Dr. Chen Zuobing, he neither gave up treatment completely nor over-treated. He would fight for it if he had a chance of survival. If his hope was too small, he chose to let go and die peacefully, which is also a fulfillment for the elderly. Third, hospitable death is also a kind of right and fulfillment
In layman’s terms, excessive medical treatment is to perform some unnecessary and useless treatments on cancer patients. According to data published by China.com, a website affiliated to the State Council Information Office, excessive medical treatment has caused at least 15% of patients to have an accelerated death. How to let cancer patients die well at the last stage of life and avoid too many ineffectivePain-increasing treatment requires the efforts of doctors, hospitals, family members, and all aspects of society.
1. Universal death education
In our country’s traditional education , Death is a very taboo thing, it seems that as long as it is alive, it is a good thing, whether it is quality or not. As ordinary people, it is very important for us to establish correct death values, break down information barriers related to death, and disintegrate the wrong cognitions and negative emotions built on death.
2. Promote palliative care
Palliative care does not mean giving up patients, but Patients undergo “hospice care”, and for some patients with limited expected survival time, palliative careneither accelerates or delays death, but keeps the patient as long as possible In the last time, reduce the pain and leave peacefully.
The elderly are a high-risk group of cancer. According to the incidence trend, there will be more and more elderly people suffering from cancer in the future. Death is always an unavoidable topic. How to strive for the survival of elderly people with cancer? And how to make the elderly with cancer die well are all difficult problems for medicine to overcome. In any case, as ordinary people, the first step to respect life is to prevent cancer and stay away from cancer.
References:
[1] “Experts: Overmedical Acceleration of Cancer Patients’ Death Suggests Standardized Course of Treatment”. China Net.2014.5.26
[2 ] “Good death, eternal pursuit”. Life Times. 2020.8.11
[3] “Palliative care does not make you give up your life! Expert: Palliative care runs throughout, not just “pain” in the final stage”. Physician Report Tumor Channel. 2020.4.15