This study is unsurprising to me: A survey of colo-rectal cancer patients finds that they are more willing to take chemotherapy, even with a small potential for extending life at the cost of significant adverse side effects, than doctors thought would be the case. But when it is your life, you want to keep up the fight. People want to live and they are often willing to put up with the debilitations of chemo to gain a few extra weeks or months.

Unfortunately, this desire to “keep fighting” often keeps patients from accepting hospice care until it is too late to receive most of the benefits, which is a shame given the potential for great help that hospice–properly applied-offers. When I interviewed the late Dame Cecily Saunders, the founder of the modern hospice movement, she criticized this aspect of the US hospice system. She claimed that it creates the appearance of a “one-way street,” sort of an “abandon hope all ye who enter here.” As a consequence, she told me that (at the time of our interview, circa 2000), the USA had a 15% hospice usage rate versus the UK’s 65%.

I agree and it’s a shame. When my father was dying of colon cancer we had hospice and it was of tremendous help both to my dad and the entire family.