Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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No multiple myeloma (MM) patient, survivor or caregiver wants to think about end stage multiple myeloma much less the cost implications of our end-of-life. I think we all understand the concept, intellectually at least, but we don’t want to think about dying. In all fairness, PeopleBeatingCancer.org is about managing MM, not about dying from MM.
Once a survivor’s MM stops responding to chemotherapy (MDR or multi-drug resistence), the MM takes over causing side effects such as anemia (bleeding), infection (pneumonia), kidney failure and bone damage to name the most common MM side effects.
My point in listing these end stage problems is that they are difficult to manage at home. While I am the first MM survivor to go on record as saying that I would prefer to die at home, after reading the article linked below, I would rather die in hospice knowing that my end-stage problems would be managed properly.
The other important aspect of the study below was the phrase “cost savings” followed by “myeloma.” As much as I don’t like to think about my end-of-life, I do like to think about cost savings…
Or to put this idea another way, I don’t want my end-of-life care to amount to a larger than necessary bill for my family. And MM is an expensive cancer.
If you or a loved one has been living with MM for one or more years there is a good chance that you all have incurred serious expenses mananging this incurable blood cancer. After all, not only are medical expenses crushing in general, but the cost of managing MM is ridiculous.
I understand that having MM and thinking about, much less planning your life for end stage myeloma may feel like you’re giving up. But as a long-term MM myself, I assure you that thinking about hospice is like writing your will. It is more about planning and how your MM and death may affect your family.
Please scroll down the page and tell me if you think I am right or full of _____. I am curious to read what you think about this sensative topic.
“In addition to quality-of-life improvements, enrolling appropriate patients with multiple myeloma into hospice may also have cost implications, a new study found.
“We found that hospice enrollment among patients with myeloma is associated with decreased healthcare expenditure at end of life…”
Fiala and colleagues conducted a retrospective study of 2,075 patients with multiple myeloma diagnosed from 2007 to 2013 in the SEER-Medicare linked dataset. All included patients were 65 years old or older, received therapy for myeloma, and had an overall survival of 3 or more months. The median age of patients was 76 years.
Just over half of patients (56%) enrolled in hospice at the end of life. Among these patients, 18% enrolled within 3 days of death, which is considered to be “late enrollment,” according to the researchers.
Female gender and increasing age were associated with increased odds of hospice enrollment. In contrast, non-white race, Medicaid enrollment, and increasing comorbidities were associated with worse odds.
The study also found that the median overall survival was longer among patients who enrolled in hospice compared with those who did not (19.6 vs 16.6 months; P = .0045)…
The median cost of end-of-life care was $15,870. The median cost among patients enrolled in hospice was $9,175 compared with $22,921 for those not enrolled (P < .0001). Controlling for covariates, the researchers estimated that enrollment in hospice was associated with more than $13,000 in decreased costs.
The time of hospice enrollment also affected end-of-life costs. The median cost of care for patients who enrolled within 3 days of death was $19,582 compared with $15,914 for those who enrolled within 3 to 14 days of end of life, and $4,508 for those who enrolled with more than 14 days to end of life (P < .0001).
The researchers noted several limitations to the study, including that data did not reflect “information regarding patient preferences, physician recommendations, or appropriateness of care…”