Doctors should recommend treatment accompanied by conversations about the pros and cons for the individuals who are in front of them

Weeks before major surgery, a patient cancels his appointment with our geriatric oncology service, declaring it unnecessary. An astute nurse convinces him otherwise.

In his mid-80s, the patient has been diagnosed with an early cancer. The surgeon advises that surgery would be the only cure but, noting the lack of urgency, sends him to see me. I can see why. The proposed procedure is long and complicated; in elderly people, even temporary setbacks can result in long-term effects.

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