End-of-life care in elderly cancer patients

Abstract

At the turn of the millennium, the age structures of our populations moved from the traditional pyramidal shape to a more rounded, wide column. This phenomenon illustrates the increased human survival length as a result of better hygiene, improved social conditions, as well as medical and surgical advances. However, chronic disorders have taken the lead, with cancers among the most prevalent of them, and specifically in older people. On the other hand, thanks to these additional years of life, the specter of death has almost disappeared from our daily concerns despite its tragic reality. The question of how to approach the end of life has found an answer through the development of palliative care. Although the deficits in providing good palliative care are well known in many areas, dramatic improvements have been made to allow healthcare professionals to achieve impeccable symptom control. However, patients’ existential suffering remains, and both suicide and euthanasia are advocated on occasion to terminate life under acceptable conditions in some countries. Our continual challenge will be to accommodate personal objectives (autonomy) with societal capacities (equity/justice) to remain beneficient (primum non nocere) while keeping maleficiency out of our professional duties.