There are also numerous mortality risk indices for general use by clinicians in medical decision making for the geriatric population. As a result, physicians routinely quote survival and relapse rates to their patients with cancer. For each type of cancer there are substantial resources documenting the 1- and 5-year survival rates, often stratified by a person’s age, sex, race, tumor stage, grade, histology, and treatment. In the modern context, prognosis pays a central role in oncology, and cancer survival papers are numerous. Can clinicians be expected to do better than any of the above? Yet none of these is truly helpful to Mr. Response (D) at least provides some context, and is both sufficiently vague and properly worded to avoid the problems raised by (B). Response (C) may also be correct, but could be said about any person with any medical condition. Responses (A) and (B) are correct but decidedly unhelpful. P’s past medical history and stroke with resulting disabilities, he will probably live less time than this, but I am not certain exactly how much less. The life expectancy of an average man age 70 is 14 more years (age 84). It depends on how well he is cared for, what complications arise, how quickly and properly they are treated, and his general health.ĭ. He could live a long time or a short time. We physicians usually prefer not to prognosticate on such matters, knowing that if we give any prediction at all it will undoubtedly prove to be incorrect.Ĭ. What do you tell them? Common Responsesī. Both options depend in part on how long he is likely to live. His family is wondering how long they will have the energy to care for him at home or, alternatively, if they can afford placement in a skilled nursing facility. P is now wheelchair bound, although he retains some ability to care for himself. He is a long-term cigarette smoker with a history of myocardial infarctions and had an ischemic stroke 2 years ago. P, who is age 70, and his family visit your clinic. P’s Prognosis Clinical Presentation and History
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