Your first patient of the day is a 59-year-old man with advanced stage IV head and neck cancer, who will be meeting with you and his medical oncologist in a discussion regarding future management of his recurrent and metastatic cancer. In spite of chemo-radiation therapy, surgical excision, and adjuvant immunotherapy, the patient’s cancer has continued to spread, and there appears to be no other approved treatment available to him. The discussion today with the patient and his wife will be to examine what options might be available to the patient at this late stage of his disease, and determine how the patient would prefer to handle what is now an end-of-life decision process.
Explore this issue:October 2018
During your last appointment with the patient, you indicated that the patient should consider palliative care and hospice with a physician in that specialty. In a separate discussion with his medical oncologist, both of you were unable to identify a current clinical trial which addressed his specific cancer state and for which he would qualify, given his near-terminal condition.
At the onset of your discussion, the patient indicates that he and his wife have learned about a new federal law that provides an accelerated pathway for patients to work directly with a drug manufacturer to utilize a drug under investigation without involving the FDA—the so-called “right to try” (RTT) law. They are hopeful that there might be an investigational drug that could be appropriate for his cancer, and want to discuss how to proceed with this process.