John McCain, Cancer, and End-of-Life Care
When John McCain passed away this weekend at the age of 81, he left behind quite the legacy. A prisoner of war during the Vietnam War, a longtime member of the United States senate, and the Republican nominee during the 2008 presidential election, McCain was known for his patriotism, integrity, and “maverick” spirit. Like any political figure, his long career was not without controversy, but McCain is still being fondly remembered by friends and colleagues from both sides of the aisle, and his impact on modern American politics is indisputable.
With a legacy like his, it’s no wonder that most of the coverage on McCain’s death is about his achievements. But his death also presents the opportunity to bring more awareness to two important medical issues.
The Importance of Early Detection . . .
The first point that McCain’s death raises is the importance of early detection for cancer patients. McCain suffered from glioblastoma, a notoriously aggressive type of brain cancer. Glioblastoma can lead to complications like seizures and memory loss, and has a particularly dismal survival rate. There is about a 30% chance of two-year survival after a diagnosis, and only a 4% chance beyond five years.
When it comes to cancer, early discovery and treatment can be the difference between life and death. It sounds dramatic, but the statistics back it up. For example, more than 90% of women with ovarian or breast cancer survive beyond five years if diagnosed at the earliest stage. For lung cancer, an early diagnosis leads to a 70% chance of living past five years, while people who are diagnosed at a later stage only have a 14% chance. Thanks to early detection, the percentage of people who die from cancer has fallen by 20% in recent decades. Even for an aggressive form, early diagnosis and treatment can still make a difference.
. . . And the Danger of a Failure to Diagnose
This is why a doctor’s failure to diagnose a cancer patient can be so devastating. Failure to diagnose occurs when a doctor fails or neglects to recognize a patient’s illness or misdiagnoses their illness. It can lead to a delay in treatment or even a total lack of treatment. Since failure to diagnose has such life-threatening implications, it falls under the umbrella of medical malpractice. For a patient with cancer, a doctor’s behavior might be considered medical malpractice if they:
- Dismiss the patient’s symptoms or mistake their symptoms for another illness
- Fail to properly perform routine tests, like mammograms or prostate exams
- Misread tests, scans, or other results that should have shown the patient’s cancer
- Do not diagnose the cancer at all
Regardless of the cause, a failure to diagnose can be a deadly issue for cancer patients.
The Complex Topic of End-of-Life Care
The second medical topic that McCain’s death brings awareness to is the importance of end-of-life discussions. A few days before his death, McCain’s family announced that he had stopped seeking treatment for his cancer. When a terminally ill patient decides to stop seeking treatment, it is sometimes called comfort care. Comfort care is a type of treatment than focus on a patient’s comfort and symptom relief, rather than active treatment. Comfort care does not aim to speed up by dying process, but allows patients to die in a natural way.
People with terminal debilitating conditions sometimes choose comfort care because of the pain, financial strains, and stress of aggressive treatment. For many, it gives them control over their body, their illness, and their final days. When someone is terminally ill, comfort care gives them the option of dying without complications. But because the medical field is full of the potential for medical malpractice and legal disputes, end-of-life care has the potential to be anything but simple.
Preparing for the End
One way that end-of-life decisions can be complicated is when a person is unable to make their own medical choices. For example, if someone is in a coma, the decision to continue treatment may fall on their family. This opens up the potential for clashes over whether to continue life-preserving measures, like a breathing tube. This kind of debate famously played out in Pinellas County in the early 2000s when a woman in a persistent vegetative state became the center of a right-to-die battle between her husband and her parents.
Generally, however, these kinds of issues only occur when a patient has not explicitly expressed their end-of-life desires. If a patient is terminally ill, it is important for them to discuss their plans and wishes.
Even at the end of a person’s life, their wellbeing can still be hindered or harmed by medical malpractice. For example, if a patient stops treatment but contracts an unrelated infection due to an error, it could cause them to experience unnecessary suffering. In other cases, a doctor could fail to provide an end-of-life treatment with the care and respect that they would provide to a patient who is undergoing treatment.
If a patient makes their end-of-life desires clear and a doctor fails to respect those wishes, it can have a devastating impact on the patient during this critical time. Even if a patient is in their final days, they still deserve the utmost care, dignity, and respect.
A Tremendous Legacy
Thanks to his early diagnosis, John McCain was able to continue to live his life to the fullest until the end, and hopefully his decision to end treatment allowed him to spend his final days with his loved ones. And by sparking important conversations about these medical issues, he is still having an impact on Americans everywhere, even in death.
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