From Survivorship to End-of-Life Care

Betty R. Ferrell, PhD, RN


November 10, 2017

Case Presentation

A previous case in this series introduced Delores, a 62-year-old woman initially diagnosed with stage IIB breast cancer who was seen by the palliative care service for symptoms experienced during survivorship, including peripheral neuropathy and symptoms associated with hormonal therapy. In the subsequent 5 years, Delores did very well and remained disease-free. She also became very involved in breast cancer survivorship events in her community. However, 1 month after celebrating 10 years as a cancer survivor, her disease recurred. With availability of new chemotherapy agents, she again experienced remission.

Ten months later, although Delores reported feeling well and active, follow-up testing revealed extensive recurrence of the cancer with involvement in the lungs, liver, and spine. She is in the oncology clinic and tells the clinic nurse that although she's disappointed in the news of her recurrence, she "knows that Dr James has another trick up his lab coat sleeve" and that she has "beaten cancer four times" and is confident that she will again. The nurse leaves the exam room and shares this information with Dr James as they prepare to go back in to discuss the complete findings of her diagnostic tests and her prognosis and treatment options.


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