Late chemotherapy refers to the administration of chemotherapy to a person with terminal cancer who has a life expectancy of less than 30 days. It can be appropriate but often is not.
Late chemotherapy does not refer to
(1) chemoradiation performed to make a terminal patient more comfortable.
(2) a nonterminal patient who dies as a result of chemoradiation
Arguments against late chemotherapy:
(1) It does not improve survival.
(2) It can have serious adverse effects on the patient's health.
(3) It may delay or prevent initiation of palliative care or end-of-life decisions.
(4) It has associated costs and exposures to toxic compounds.
Reasons that it may be given to justify late chemotherapy:
(1) The patient may want to try anything in order to live longer.
(2) The discussion about end-of-life may be difficult due to strong emotional responses from the patient, family or provider (means of avoidance or denial).
Uncertainties around the end of death or cancer therapy:
(1) estimates for life expectancy are often inaccurate
(2) a new therapy may be revolutionary
