Illness trajectories of incurable solid cancers

Illness trajectories in the age of big data

“…They also add a new trajectory, multimorbidity, to describe a person with conditions from multiple trajectories (such as heart disease from organ failure and cognitive impairment from frailty) 2. Geijteman et al describe how people with cancer are increasingly defying the traditional trajectory of rapid decline seen in terminal illness because of newly available disease modifying treatments such as targeted therapy and immunotherapy 3. Both articles highlight the importance of understanding trajectories of illness to inform care planning and achieve goal-concordant care.…”

Is there too much care in advanced cancer?

“…Geijteman and colleagues tackle a very pertinent issue in cancer care 1. They rightly ask whether there is too much care towards the end of life in cases of incurable cancer.…”

“…Newer molecular targeted therapies and immunotherapies have made the situation even more challenging because they provide the opportunity to extend prognosis by years in a significant minority of patients. Because the trajectory of illness in a particular patient is not known beforehand, owing to the lack of good survival prediction tools,1 patients as well as oncologists are reluctant to give up active cancer treatment.…”

How to model life’s trajectory from major diagnosis to death

“…An international team led by Eric Geijteman explores the different trajectories of incurable solid cancer (doi:10.1136/bmj-2023-076625). 3 New cancer treatments, such as targeted therapy and immunotherapy, have brought more success, challenge, and unpredictability. It is now possible to outline illness trajectories for people whose response to therapy is a major temporary improvement, long term response, or rapid decline after an adverse event.…”