Choosing Not to Treat: How Do You Know When the Best Treatment is No Treatment?

Watch the full episode of Oncology Unfiltered: https://oncdata.com/oncology-unfiltered-choosing-not-to-treat In oncology, progress is often measured by how effectively we can treat disease. But what happens when the best course of action is no treatment at all? In this episode of Oncology Unfiltered, Melissa Cutrona, MS, Co-Founder and General Manager of i3 Health and Oncology Data Advisor, speaks with Matthew Hadfield, DO, Oncology Data Advisor Editor in Chief, about the nuanced, evidence-based decision to forgo systemic therapy. Dr. Hadfield discusses how modern targeted therapies and immunotherapy have changed the calculus of risk and benefit, and why quality of life must remain central when expected benefit is small and treatment burden is high. The conversation explores performance status, comorbidities, and prognostic uncertainty, along with practical ways clinicians can communicate transparently with patients and families during high stakes decisions. They also reframe the misconception that declining treatment means giving up. Instead, choosing not to treat can be an intentional, patient centered decision to prioritize meaningful time, symptom control, and personal goals. The episode concludes with an important discussion on the role of palliative care as supportive care and why early involvement can improve symptom management and even survival.