title: Ovarian cancer care: a case study in determined living.
abstract: BACKGROUND
  The balance between quality of life and aggressive treatment fuels strong debate in cancer care. Recently, more attention is focused on blending advanced care, palliative care and hospice treatments in a patient-specific, tailored manner. This case study explores quality of life, the role of psychosocial factors in treatment selection, and the role of medical bias in end-of-life decision-making.
  
  
  METHODS
  The patient was a 55-year-old woman with advanced recurrent epithelial ovarian cancer. The disease course was essentially unremitting with only 5 months of non-progression after initial treatment. Multiple courses of chemotherapy were provided, in addition to a wide range of advanced and aggressive therapies to treat the cancer, as well as prolong life. Hospice care was an active part of treatment over 2 separate time periods, with a 1-year hiatus between admissions into hospice care.
  
  
  CONCLUSIONS
  This case study provides an example of blending aggressive treatment, palliative care and hospice care to allow a patient to achieve specific life milestones, while attempting to preserve quality of life.
authors.affiliation: Clinical Faculty, Depsrtment of Psychiatry, Georgetown University, Washington, DC 20036, USA. naturalbob@gmail.com
authors.forename: Robert L
authors.initials: RL
authors.lastname: Umlauf
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Orloff
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D003131:Combined Modality Therapy; D005260:Female; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D013727:Terminal Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents