Daniel E. Epner, MD
Requests for Single Reprints: Daniel E. Epner, MD, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030; e-mail, email@example.com.
Epner D.; Black and White. Ann Intern Med. 2013;159:304-305. doi: 10.7326/0003-4819-159-4-201308200-00015
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Published: Ann Intern Med. 2013;159(4):304-305.
Mrs. Connor was a 51-year-old woman with stage IV colon cancer who was referred to our clinical trials unit after receiving extensive salvage chemotherapy. She was hospitalized for hyperbilirubinemia and possible biliary decompression in preparation for trial enrollment. Within seconds of meeting her, I knew that she would not be a candidate for experimental therapy.
She was severely cachectic and debilitated, barely able to sit up in bed. Her belly was tensely swollen. An abdominal CT scan revealed extensive ascites and hepatic metastases nearly replacing the liver. I knew that I was about to embark on the heart-wrenching task of discussing goals of care with a woman approaching the end of her life.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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