As I explained to the family of a patient that he has Stage IV cancer, one relative said “Ay doktora wala nang pag-asa, hihintayin na lang mamatay” (“The patient is a hopeless case and there is nothing that can be done”).
Patients with advanced cancer are never hopeless and should never be considered as second class patients. They deserve the same amount of care and importance as any patient.
Stage IV cancer is not necessarily a death sentence. For some types of cancer, there are many treatment options available. Patients who respond well to treatment may live for a long time free of disease. Lance Armstrong had testicular cancer which has already metastasized to his brain. This is Stage IV cancer, yet he was able to win 7 Tour de France championships after his diagnosis.
Even if the patient has a form of cancer which is not very responsive to treatment, not actively treating the tumor does not mean abandoning the patient. There are important treatment goals that can still be achieved such as improving quality of life, achieving pain control and symptom relief.
Patients and relatives need not go through agonizing pain and suffering. We can always assist them every step of the way.