Fulfilling hope: Supporting the needs of patients with advanced cancers

Though more and more individuals diagnosed with cancer become survivors, there still remains hundreds of thousands forced to succumb to their disease. How oncology specialists communicate bad news, discuss treatment options, and interact throughout the cancer journey greatly influences the expectations patients and their loved ones have regarding the goals and outcomes of treatment. There is limited residency education or nursing education about how to communicate effectively with patients who we know will be facing end of life rather than survival. Research studies have validated that more than 40% of patients with metastatic disease believe that their chemotherapy treatments they are receiving just weeks before they die were for the purpose of curing them of their cancers. Hospice remains an underutilized service due to the uncomfortable feelings it causes when discussing alternative options to treatment rather than continuing toxic drug therapy. On average, patients do not get referred until too ill to receive any more chemotherapy treatments. This is a time to be truly providing the patient and family patient centered care, factoring in their life goals, their hopes for themselves that transition over time, their hopes for their family without them, and how we can innovatively help them reach these important goals even after they have died, by identifying or serving as a "Hope Fulfiller." This book provides the research, knowledge and other tools and resources needed to help ensure you will be able to orchestrate a good death for your patient and feel confident and comforted yourself having done so. It begins however with an understanding of the origin of the word Hope, how to define it, give it, avoid taking it away, measure it, and fulfill it. There is also insightful information about the cost of hope. Intertwined throughout the book will be cases studies regarding actual patients and their loved ones experiencing advanced cancers and demonstrating some specific topic that will be covered in this book. When we give our all to our patients there is risk of burning ourselves out. A chapter on how to avoid clinician burnout is included. Additionally this literary work will provide a step by step program planning guide how to conduct retreats for patients and their family members coping with metastatic cancers as a unique means of supporting them in preparing for end of life, developing communication methods that enable decisions made by the patient to be heard and honored, as well as teaching loved ones as well as clinicians how to help fulfill hope of patients which need to be carried out in alternative ways because they linked to the future after their death.