There was an unusual sports story in the news last week.
Hall-of-fame slugger Harmon Killebrew announced that he’s ending his medical treatment for esophageal cancer, choosing instead to enter hospice care. As quoted in the NY Times piece, Killebrew wrote (via the Minnesota Twins’ press office), “I am very comfortable taking this next step and experiencing the compassionate care that hospice provides.” He said he had “exhausted all options with respect to controlling this awful disease.”
This is the first time I can remember a celebrity declaring publicly a choice to stop medical treatment and pursue hospice.
Certainly many other terminally ill patients choose this course. Yet most of the time this choice is made in begrudging fashion, only after death is imminent. [See a related post here.]
Killebrew’s announcement gives me hope that the public’s view of hospice can change from one of “no hope” to one of providing comfort and sustenance in one’s final days. Ironically, when you have the least control, hospice gives a sense of control over the time and place of death.
Those of us that work in hospitals too often see elders die there, when their wish is to instead die peacefully at home, in a “non-medicalized” fashion.
While Killebrew’s announcement doesn’t give us the medical details of his cancer, there are a few things that are plain: His prognosis is poor, less than six months (the main criterion for activating hospice).
We also know that the overall survival for advanced esophageal cancer is dismal, on the order of 15% at 5 years. Most of the people afflicted with it die within the first year.
The treatments for it are terrible. The esophagus is a muscular “food” tube that connects our mouths to our stomachs. It lacks a serosa, or outer layer, which is why when doctors perform surgery on it to remove a tumor, it usually heals poorly. The same is true for radiation aimed at it to shrink tumors.
And chemotherapy used against it is usually very toxic to the whole GI tract, which causes patients to become violently ill and lose weight, making the battle to stay alive a battle of nutrition.
I applaud Killebrew for his courage, openness (just the right level), and his willingness to “go to bat” for hospice.