Why is my father's oncologist making him choose between chemotherapy or hospice?

3 answers | Last updated: Oct 13, 2016
Ksfrantz asked...

My 86 year old father's new oncologist is pressuring him to start chemotherapy. His old oncologist said that unless he was feeling bad or having lots of complications that we would not treat his non-Hodgkin lymphoma aggressively. This doctor is now saying chemotherapy or hospice. We don't know what to do. Dad is not feeling any worse than when he was diagnosed in May.

Expert Answers

Andrew Putnam, M.D. is a Palliative Care physician at Smilow Cancer Center at Yale New Haven Hospital and Yale University.

I do not know why your father's oncologist is saying that now he must choose between chemotherapy and hospice. There may be a reason, such as the lymphoma might be growing and it is important to treat it now. If that is so, your oncologist ought to be able to explain it. If your father is not happy with that choice it is reasonable to ask for a second opinion from a different oncologist. A second opinion, with the possibility of changing oncologists might be reasonable instead of a decision that might not be necessary.

Community Answers

Polomom answered...

Bad response, it is stated that this is a NEW oncologist therfore a SECOND Opinion, that is recommending treatment. READ the statement before giving any answer.

Azhospicern answered...

This is a more complicated issue than just being given a choice between hospice and chemotherapy. The real question here is does he wish to pursue aggressive curative treatment or would he prefer to have palliative care instead. In this case, it sounds like the oncologist is saying that chemotherapy would be the mode of treatment that he/she would recommend, but that palliatve (comfort) care is also an option. At 86 years old, I would assume that your father is on Medicare. If this is true, then the reason for the choice is that he cannot pursue both hospice care and chemotherapy at the same time under Medicare guidelines. I hope this helps. I am sorry that you are having to go through this and hope for the best possible outcomes for your father.