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The Front Line


The Front Line: Charles D. Blanke, MD, SWOG Chair

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End of Life Issues Front and Center in April

April 7, 2017 - The last few days were a blur. Along with a heavyweight team from our SWOG executive advisory council, I published an analysis in JAMA Oncology yesterday of 18 years of data from Oregon’s first-in-the-nation Death with Dignity Act, which allows physicians to provide terminally ill patients with a lethal dose of medication.

The paper picked up an incredible (and surprising) amount of press attention, here in Oregon and nationally, and it engendered an invitation to pen an opinion piece on the work for today’s Cancer Letter, which was written with SWOG translational medicine vice chair and study co-author Dr. Lee Ellis. The interviews have been nerve-wracking, exhilarating, and inspiring. Who doesn’t love having a friend say: “Hey! I heard you on public radio when I was driving to pick up my kid at school!”

In San Francisco, we’ll hold a special symposium on palliative care, featuring four expert speakers presenting on clinical care delivery models, medical ethics, faculty training, and palliative care interventions. There will be plenty of time for questions and discussion at the two-hour session – and for a long time afterward. The goal of the symposium is to catalyze conversation in SWOG about adding end of life issues and palliative care to our research portfolio. To be clearer, the JAMA Oncology piece was our first research project under the (potential) new program, but SWOG’s interest extends far beyond physician aid-in-dying (PAD).

We have a lot to explore. What emerged from our physician aid-in-dying research is likely not a shock to you; namely that there are so many unanswered questions around end-of-life issues. There are specifics related to PAD (How can we develop new drug combinations? What are the long-term effects upon families?), and of course many aspects of the broad field of palliative care merit our attention and further research.

It seems like a good time to consider expanding beyond prevention and treatment research. Good medicine and policy are based on good evidence that arises from trials. End of life care should be no exception.

Here's the press release on the JAMA Oncology paper and go here for the Cancer Letter opinion piece. Big thanks to the study team – Drs. Michael LeBlanc, Dawn Hershman, Lee Ellis, and Frank Meyskens. Please attend the palliative care symposium on April 28 and join our new SWOG Oncology Facebook group any time, so we can keep this conversation going.

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