Proudly produced by The Oncology Network |Overtreatment Factors with Nathan Cherny
In today’s episode, we welcome back Professor Nathan Cherny to discuss overtreatment at the end of life with our host Professor Christopher Jackson.
Why do some patients continue to receive aggressive therapies when the benefits are limited? What systemic, clinical and cultural factors drive these decisions? And how can healthcare providers and families make better, more compassionate choices?
Drawing on his extensive experience and research, Professor Cherny illuminates the complex factors driving excessive treatment, from departmental culture to cognitive biases.
“Oncologists need to learn not only when to treat, but when not to treat,” he emphasises, highlighting how treatment decisions for poor-performance status patients with resistant disease require particular scrutiny.
The discussion reveals eye-opening research showing patients might consider additional treatment worthwhile only if it provided 12-18 months of quality life – far beyond what late-line therapies typically deliver.
Throughout the conversation, both oncologists acknowledge the delicate balance between appropriate intervention and knowing when to step back. Professor Cherny offers practical guidance for reframing hope beyond treatment response and recognising that courage exists not only in pursuing another treatment but also in saying “enough.”
This nuanced exploration of patient-centred decision-making provides a valuable perspective for clinicians, patients and families navigating cancer’s most difficult moments.
A fifteen-minute podcast that will inspire you to make end-of-life cancer care smarter, kinder and more compassionate.
About The Oncology Journal Club:
We have taken an old concept and updated it with a new format. In each episode, a team of expert contributors will review topical journal papers and interview special guests who are leaders in their fields to help keep you informed of the latest developments on the go.
We hope you enjoy listening and find this a valuable and entertaining resource.
PAPER:
N.I. Cherny, et al. A taxonomy of the factors contributing to the overtreatment of cancer patients at the end of life. What is the problem? Why does it happen? How can it be addressed? ESMO Open, Volume 10, Issue 1, 2025. Access online here.
HOST:
Chris ‘CJ’ Jackson
Professor Christopher Jackson
Chris Jackson is Professor of Medical Oncology at the University of Otago, Dunedin, and a medical oncologist at Dunedin Hospital and Mercy Cancer Care. He specialises in GI cancers and melanoma, teaches medical students and specialists-in-training, and is heavily involved in both national and international cancer policy, leadership and research.
He was previously the medical director of the Cancer Society of NZ, and his advocacy led to the funding of new cancer drugs, to the development of a new national cancer plan, and to the birth of the national cancer agency Te Aho o Te Kahu. He currently chairs the agency’s clinical committee and serves on the advisory board. In addition, he is on the programme board of the International Cancer Benchmarking Project, and is a founding member of the Common Sense Oncology movement.
Chris is a self-confessed Radiohead tragic, and recent convert to Crossfit (even though you didn’t ask).
Connect with CJ on X/Twitter: @drkiwicj
GUEST:
Nathan Cherny
Professor Nathan Cherny
Nathan Cherny is married (to Nancy) with four children (Gil, Eitan, Noa and Calanit). He lives in Maccabim, central Israel. He was born in Melbourne, Australia, and studied medicine at Monash University Medical School.
In 1994 Dr Cherny joined with Prof Raphael Catane to establish the Oncology and Palliative Medicine Unit at the Shaare Zedek Hospital in Jerusalem. The model and standards for integrated oncology and palliative care developed by Prof Cherny and Prof Catane have since served as the basis for the designation criteria for the ESMO Designated Center program in Integrated Oncology and Palliative Care. He continues to head the Multidisciplinary Cancer Pain and Palliative Medicine Service at Shaare Zedek Medical Center, and, in addition, he maintains an active practice in general oncology. He runs a mentorship program for Palestinian oncologists from the West Bank and for the Al-sadeel Palliative Care Society in Bethlehem.
In 1999 he helped established the European Society of Medical Oncology Palliative Care Working Group. He is the current chair of the ESMO magnitude of clinical benefit scale working group. In 2019 he was awarded Member of the Order of Australia. Connect with Nathan on Twitter here: @ChernyNathan
PRODUCER:
Rachael Babin
Rachael Babin is Host of The Oncology Podcast, Editor-in-Chief of The Oncology Newsletter, and Publisher of Oncology News Australia and The Oncology Network.
With a background in oncology communications and academic publishing, Rachael is happiest sitting behind the mic chatting to interesting people about the impact their work makes in oncology.
Connect on Twitter: @OncologyNewsAus
