End of life of the cancer patient: patient, family and physician perceptions

  • Lucía Arroyo Castillo a. Public Health Masters Program, Pontificia Universidad Javeriana. Cali, Colombia. b. Speech Pathology Department, Universidad del Cauca. Popayán, Colombia. https://orcid.org/0000-0002-1261-6297
  • Angélica Arango-Gutiérrez Clinical Epidemiology Masters Program, Pontificia Universidad Javeriana. Bogotá, Colombia. https://orcid.org/0000-0002-2980-6847
  • Esther De Vries a. Clinical Epidemiology Department, Pontificia Universidad Javeriana. Bogotá, Colombia. b. Biostatistics Department, Pontificia Universidad Javeriana. Bogotá, Colombia. https://orcid.org/0000-0002-5560-2258
Keywords: Perception, Terminal care, Palliative care, Cancer, End of life, Anesthesiology


Chronic diseases such as cancer have imposed challenges on health systems. Colombia has worked on the construction and implementation of a legal framework for palliative care, but a comprehensive approach to the care provided to cancer patients at the end of their lives is still lacking. Such an approach should be based on understanding of the perceptions of its different actors in order to allow for adequate decision-making and improved support during this stage.

Currently, the infrastructure to provide adequate oncological support is insufficient, the administrative procedures that patients and families have to go through to get authorization for treatments and medications for symptom relief are overwhelming and, many times, costs must be paid out of pocket.

On the other hand, it is important to train healthcare personnel to develop communication skills to approach patients from a place of compassion, personal development and reflection, creating spaces in which patients can speak openly about their wishes, fears and worries, even if they come together with the desire to accelerate the end of life. In addition, healthcare staff should support and initiate conversations about life and the end of life between patients and their families if this communication is complicated, given its importance for healthcare, quality of life and death.

This article seeks to reflect on the end of life of the cancer patient from the perceptions of the actors involved, namely, patients, caregivers and healthcare professionals.


Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer today/tomorrow. Lyon, France: International Agency for Research on Cancer [Internet]. 2020 [cited: 2020 Dec. 23]. Available at: https://gco.iarc.fr/today;https://gco.iarc.fr/tomorrow

Luna-Meza A, Godoy-Casasbuenas N, Calvache JA, et al. Decision making in the end-of-life care of patients who are terminally ill with cancer – a qualitative descriptive study with a phenomenological approach from the experience of healthcare workers. BMC Palliat Care. 2021;20(1):76. doi: https://doi.org/10.1186/s12904-021-00768-5

Calvache JA, Moreno S, Prue G, Reid J, Ahmedzai SH, Arango-Gutierrez A, et al. Knowledge of end-of-life wishes by physicians and family caregivers in cancer patients. BMC Palliat Care. 2021;20(1):140. doi: https://doi.org/10.1186/s12904-021-00823-1

Dees MK, Geijteman ECT, Dekkers WJM, et al. Perspectives of patients, close relatives, nurses, and physicians on end-of-life medication management. Palliat Support Care. 2018;16(5):580-9. doi: https://doi.org/10.1017/S1478951517000761

Arroyo L, Ortega-Lenis D, Calvache J, De Vries E. Percepciones médicas sobre la atención del final de la vida en pacientes oncólógicos [Tesis de Maestría]. 2021.

Almansour I, Seymour JE, Aubeeluck A. Staff perception of obstacles and facilitators when providing end of life care in critical care units of two teaching hospitals: A survey design. Intensive Crit Care Nurs. 2019;53:8-14. doi: https://doi.org/10.1016/j.iccn.2019.04.003

Kouyoumdjian V, Perceau-Chambard E, Sisoix C, Filbet M, Tricou C. Physician’s perception leading to the transfer of a dying nursing home resident to an emergency department: A French qualitative study. Geriatr Gerontol Int. 2019;19(3):249-53. doi: https://doi.org/10.1111/ggi.13600

Back AL, Anderson WG, Bunch L, et al. Communication about cancer near the end of life. Cancer. 2008;113(7 Suppl):1897-910. doi: https://doi.org/10.1002/cncr.23653

Kaplan M. SPIKES: a framework for breaking bad news to patients with cancer. Clin J Oncol Nurs. 2010;14(4):514-6. doi: https://doi.org/10.1188/10.CJON.514-516

Pattison N, Carr SM, Turnock C, Dolan S. ‘Viewing in slow motion’: patients’, families’, nurses’ and doctors’ perspectives on end-of-life care in critical care. J Clin Nurs. 2013;22(9-10):1442-54. doi: https://doi.org/10.1111/jocn.12095

Bradshaw A, Dunleavy L, Walshe C, et al. Understanding and addressing challenges for advance care planning in the COVID-19 pandemic: An analysis of the UK CovPall survey data from specialist palliative care services. Palliat Med. 2021;35(7):1225-37. doi: https://doi.org/10.1177/02692163211017387

Vries E De, Vergara-garcía OE, Karduss-preciado S, et al. The financial impact of a terminal cancer on patient′ s families in Colombia – A survey study. J Cancer Policy. 2021;28(40):2-4. doi: https://doi.org/10.1016/j.jcpo.2021.100272

Medina Rico MA. Deseos al final de vida en pacientes con cáncer no curable: un abordaje desde la perspectiva del paciente [Internet]. 2020. [cited: 2021 Nov. 10]. Available at: http://hdl.handle.net/10554/53557

Herrera A, Ríos M, Manríquez JM, Rojas G. Entrega de malas noticias en la práctica clínica. Rev Med Chil. 2014;142(10):1306-15. doi: https://doi.org/10.4067/S0034-98872014001000011

Olsson L, Östlund G, Strang P, Jeppsson Grassman E, Friedrichsen M. Maintaining hope when close to death: insight from cancer patients in palliative home care. Int J Palliat Nurs. 2010;16(12):607-12. doi: https://doi.org/10.12968/ijpn.2010.16.12.607

Chittem M, Norman P, Harris P. Primary family caregivers’ reasons for disclosing versus not disclosing a cancer diagnosis in India. Cancer Nurs. 2020;43(2):126-33. doi: https://doi.org/10.1097/NCC.0000000000000669

Ozdogan M, Samur M, Bozcuk HS, et al. “Do not tell”: what factors affect relatives’ attitudes to honest disclosure of diagnosis to cancer patients? Support Care Cancer. 2004;12(7):497-502. doi: https://doi.org/10.1007/S00520-004-0633-2

Murcia E, Aguilera J, Wiesner C, Pardo C. Oncology services supply in Colombia. Colomb Med. 2018;49(1):89-96. doi: https://doi.org/10.25100/cm.v49i1.3620

Hawley P. Barriers to access to palliative care. Palliat Care Res Treat. 2017;10:1-6. doi: https://doi.org/10.1177/1178224216688887

Ting FIL, Juan MDS. The last request. J Cancer Educ. 2021;36:653-4. doi: https://doi.org/10.1007/s13187-020-01891-2

Calderón Rocha S, Cardona Chávez J, Echenique Ramos D, Fonseca García A. Percepción de cuidadores informales frente a la experiencia de cuidado de una persona adulta en cuidado paliativo con patología oncológica, asistentes al cjo 1 [Internet]. 2016. [cited: 2021 Nov. 10]. Available at: https://repository.javeriana.edu.co/bitstream/handle/10554/21096/CalderonRochaStephany2016.pdf?sequence=1

Hall ET, Sridhar D, Singhal S, et al. Perceptions of time spent pursuing cancer care among patients, caregivers, and oncology professionals. Support Care Cancer. 2021;29(5):2493-500. doi: https://doi.org/10.1007/s00520-020-05763-9

Litzelman K, Kent EE, Mollica M, Rowland JH. How does caregiver well-being relate to perceived quality of care in patients with cancer? Exploring associations and pathways. J Clin Oncol. 2016;34(29):3554-61. doi: https://doi.org/10.1200/JCO.2016.67.3434

Rangel RL, Ramírez OJG. Experience of caregivers of relatives who died of cancer: Pain they must learn to overcome. Aquichan. 2018;18(4):395-406. doi: https://doi.org/10.5294/aqui.2018.18.4.2

Sánchez C de M, Romero AL. Eutanasia y suicidio asistido: conceptos generales, situación legal en Europa, Oregón y Australia (I). Med Paliativa. 2006;13(4):207-2015.

Loucka M. supporting treatment decision-making in practice. En: Abstracts from the 17th World Congress of the EAPC 2021. Palliat Med. 2021:1-243. doi: https://doi.org/10.1177/02692163211035909

Biondo CA, da Silva MJP, Secco LMD. Distanasia, eutanasia y ortotanasia: Percepciones de los enfermeros de unidades de terapias intensiva e implicaciones en la asistencia. Rev Lat Am Enfermagem. 2009;17(5):613-9. doi: https://doi.org/10.1590/S0104-11692009000500003

Villamizar E. El morir y la muerte en la sociedad contemporánea problemas médicos y bioéticos. Rev Gerenc y Políticas Salud. 2002;2:66-80. doi: https://doi.org/10.2307/j.ctvt9k3zt.29

Ahronheim J, Morrison R, Baskin S, Morris J, Meier D. Treatment of the dying in the acute care hospital: Advanced dementia and metastatic cancer. Arch Intern Med. 1996;156(18):2094. doi: https://doi.org/10.1001/archinte.1996.00440170110012

Franca O, Fontes N, González ML, et al. Archivo histórico. ARS Rev Ciencias Médicas. 2016;34(69):1-18. doi: https://doi.org/10.11565/arsmed.v34i2.207

How to Cite
Arroyo Castillo L, Arango-Gutiérrez A, De Vries E. End of life of the cancer patient: patient, family and physician perceptions. Colomb. J. Anesthesiol. [Internet]. 2022 Jan. 19 [cited 2024 Feb. 23];50(3). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1024


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How to Cite
Arroyo Castillo L, Arango-Gutiérrez A, De Vries E. End of life of the cancer patient: patient, family and physician perceptions. Colomb. J. Anesthesiol. [Internet]. 2022 Jan. 19 [cited 2024 Feb. 23];50(3). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1024


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