Dementia and Cancer

I met a patient recently who has advanced cancer, which is treatment (but not curable). The options include chemotherapy, radiotherapy and surgery. Chemotherapy options include cytotoxic medications and targeted biological agents.

The problem is that the patient also has very advanced dementia and has no understanding of what is going on. The devastation on the family members is just heart-rending. They want to treat their loved one for the cancer, but know that it would prolong the suffering.

Where does informed consent come into the picture?

Where does compassion come?

Where does common sense come?

The art of medicine never ceases to amaze me.