How do you counsel patients with locally advanced malignancies who have ECOG 3-4?

I agree with @Dr. First Last and @Dr. First Last's comments about the implications of PS and specific situations where medical therapies have the potential to improve PS (heme malignancies small cell) and/or extend quality of life. I have two goals in this conversation. To make sure I understand the...

My answer depends almost entirely on *why* the patient's ECOG is so worrisome.

If the person was physiologically elderly (regardless of chronologic age) before cancer manifested itself, then chemotherapy is very likely to be more harmful than helpful and I strongly counsel against it. If there is a ...

Helped overcome barriers and challenges encountered in my care of patients at my nephrology practice