This was a unique end-of-life scenario, at least in my experience.

Our Thursday morning Head and Neck Cancer Clinic had been busy, as usual. It was a particularly optimistic day, with most of the patients being follow-up patients in remission. The new patients that morning, being evaluated for recently diagnosed cancers, all had very treatable disease.

Our last patient of the day, however, was a wonderful man who had extensive skin cancer that eroded into bone, including the skull bone, and it had recurred in spite of multiple treatment modalities. At this point, this was end-stage, or terminal, cancer.