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Navigating the Grey Zones of Medical Opinion

by MedOncMD on January 15, 2024

In medicine, biases, whether implicit or explicit, can significantly impact patient care. These biases might manifest as preconceived notions or preferences that subtly influence treatment recommendations. In the case of a patient of mines with metastatic GIST who developed acute renal failure secondary to an obstructing pelvis mass, a consulting urologist on call suggested to me that allowing the patient to pass away due to renal failure might be a more peaceful option?  This perspective, while rooted in a certain medical understanding, sharply contrasts with the available treatment options that could significantly improve the patient’s survival and quality of life.  With a sincere attempt to advocate for the patient and after repeated conversations with several urologists along with the patient and family, the patient agreed to do nephrostomy tube placement and start 2nd line ckit inhibitors as opposed to accepting home hospice/comfort care. 

Importance of Patient-Centered Decision Making

Empowering Patients in Their Care Journey

In situations like these, it’s crucial to prioritize patient-centered decision making. Healthcare providers must balance their expertise and biases with the values and preferences of the patient. It involves providing comprehensive information about the pros, cons, risks, benefits, and uncertainties of each treatment option. In this scenario, involving the patient in the decision-making process was essential, especially considering the viable treatment options available for both the GIST and renal failure.

Navigating Complex Medical Decisions

Guiding Patients Through the Maze of Options

Patients often rely on their healthcare providers to navigate through complex medical decisions. It’s imperative that providers present all viable options, ensuring that patients are well-informed to make decisions that align with their goals and preferences. This includes exploring all avenues of treatment and offering a holistic view of the potential outcomes.  It is extremely important to involve all pertinent family members and/or close friends as well.

Ethical Considerations in Oncology Care

Balancing Treatment Benefits with Quality of Life

Ethical considerations play a pivotal role in oncology, where life-altering decisions are made regularly. Providers must weigh the benefits of aggressive treatments against the potential impact on the patient’s quality of life, ensuring that the treatment is not worse than the cancer itself.

Communication in Healthcare

Fostering a Transparent and Compassionate Dialogue

Effective communication is the cornerstone of patient-centered care. It involves not only imparting medical knowledge but also listening to and understanding the patient’s concerns, fears, and hopes. This ensures that patients feel supported and valued in their treatment journey.

A Collective Responsibility in Patient Care

Oncology care is a collective journey that involves not just treating the disease but also supporting the patient holistically. Providers need to be aware of their biases and ensure that these do not overshadow the patient’s autonomy in making healthcare decisions. At the heart of oncology lies a commitment to offering not just treatments but hope and compassion.


About the author

Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. Currently practicing at the renowned Orlando Health Cancer Institute, he brings a wealth of expertise to the complex and challenging world of oncology.

Embrace the opportunity to engage with Dr. Sajeve’s expertise, and feel empowered to explore the vast expanse of oncology with renewed curiosity and understanding on “Ask MedOnCMD“

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Meet the authors

Dr. Sajeve Thomas
Dr Daniel Landau


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  • Home
  • Blog
    • The essentials
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    • Research Advances
    • Navigation Corner
    • Video Library
  • Meet and Greet
    • About Dr Thomas
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  • Ask MedOncMD?
  • 🧠 How I Create My Blog Posts