Hi Everyone,

Last summer I wrote about my 81 year old mom and her battle against cancer in her jaw for the last two years. She had chemotherapy, then 7 weeks of radiation, then a fibular flap surgery last July. In November she developed an infection and last month the metal had to be removed from her jaw. Biopsies tested positive for more cancer in her jawbone and in the floor of her mouth. A chest xray also showed spots on her lung which we have just been told is metastatic disease.

Throughout all of this, she has been treated at the University of Southern California Medical Center in Los Angeles. Unfortunately the doctors do not really work together, they just pass my mom on to the next guy. The surgeon's last words were "I've done all I can for her" and referred her to yet another medical oncologist. Mom does not want anymore surgery, radiation or chemotherapy.

I guess my question is this: who oversees the "comfort care" when a patient no longer wants curative care? Is it appropriate for her internist to provide that, or is it usually an oncologist?

I'm not sure where to post this, so Brian you can move it to wherever is appropriate. Thanks.