[End of chemotherapy decision for metastatic breast cancer patients.].
If chemotherapy beyond the third line often gives sum clinical benefits, it is sometimes prescribed only to avoid telling bad news to patients. Palliative chemotherapy can lead to symptom reduction and greater health related quality-of-live, but longer survival is unlikely. Physician's questioning about chemotherapy continuation is an ethical duty so is the discussion with patients and caregivers about prognosis and possibility to receive principally palliative care. Medical information about prognosis must be told "step by step", following patients questioning and their capacity listening to the answers. Exhaustion of chemotherapy efficacy is the best argument to explain chemotherapy stop, which does not mean end-of-life, particularly for patients with slow growing tumour. Maintain hope for patients in regard with their medical situation is vital in a psychological way, to stay alive and to be able to project himself in the close future. Modalities of decisions taking about end of chemotherapy have to be defined but consultation of all caregivers implicated in the palliative patients care is essential.
Bouleuc
C
C
Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, Paris, France, Centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France.
Chvetzoff
G
G
D001943:Breast Neoplasms / Q000188:drug therapy; D017028:Caregivers; D006801:Humans; D009369:Neoplasms / Q000523:psychology; D010166:Palliative Care / Q000523:psychology; D011379:Prognosis; D012017:Referral and Consultation