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I'm looking for a word that describes the following:

A patient who has received all possible medical treatment but all of them have failed to initiate a cure or remission. The patient cannot be (meaningfully) helped according to traditional medicine. The patient's illness does not necessarily have to be a terminal disease.

Hence: The patient is 'treated-out' or 'therapied-out'.

I'm aware that 'treated-out' and 'therapied-out' do not exist. And currently I don't intend to use them.

The word or two-worded term I'm looking for could be the counterpart to the German word 'austherapiert'.

NOTE: I'm NOT looking for untreatable patient, terminal-stage patient, palliative care, palliative treatment, or palliative care patient

I am looking for a word or two-worded term that relates to the patient and implies that essentially all conceivable treatment has been tried and applied, unsuccessfully.


(UPDATE)

THE MOST APPROPRIATE TERMS FOUND

The following expressions seem to match best with what I was looking for:

  • all treatment options exhausted
  • a treatment-exhausted patient
  • an end-stage patient
  • 'therapied out' - seems to be an uncommon but more and more frequently used term, according to the search results on Google Books but much less in scientific literature; bear in mind Google's Ngram Viewer has no entries for 'therapied out' (Ngram Viewer version 2012/2013, as available on 22 Nov 2018)
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    how about untreatable – Jim Nov 12 '18 at 18:25
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    I don't know of anybody who would use a single word. Of if there even is one that means a patient for whom all known treatments have been exhausted. – Jason Bassford Nov 12 '18 at 18:34
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    The problem with out-treated, is that it will be perceived in the same manner as out-paced, out-matched, out-gunned etc. – Jim Nov 12 '18 at 18:43
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    Don't you think that's backwards? What, exactly, according to at least three or four and preferably five or six medical dictionaries does "'austherapiert'' leave unclear? At the most basic level, consider please linguee.com/german-english/translation/austherapiert.html – Robbie Goodwin Nov 18 '18 at 20:59
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    I believe one sees: all treatment options have been exhausted. that therapy out is really bad, so treat out. google.com/… – Lambie Nov 19 '18 at 19:33
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treatment resistant

...are treatment resistant in the sense that the majority do not achieve full remission with the first somatic or psychosocial treatment they receive.

There is however, no stable definition of treatment resistant:

The definition of treatment resistance remains controversial in spite of its importance. This review discusses the importance of treatment resistance and the factors affecting its definition in the light of recent advances in knowledge and treatment.

And again:

Little attention has been given to formalizing criteria for evaluating the nature and extent of treatment resistance, even though determining the adequacy and outcome of prior treatment trials is key in clinical decision making about subsequent treatment.

  • Thanks for your post, Duck... Not sure if the paper mentioned by you was written by a native speaker. To me, treatment resistance implies that the patient is resistant whereas 'treatment response' would relate to the illness and its treatment, and the treatment's effect. – johann_ka Nov 12 '18 at 20:06
  • @johann_ka The first and third references are from a North American born psychologist, Harold A. Sackeim's paper. The second reference, is as you may observe from Jozef Peuskens' paper, who is a native of Belgium... – Duckisaduckisaduck Nov 12 '18 at 20:16
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    ... @johann_ka in western medicine, it is the paradigm to diagnose and describe conditions, not to characterise patients independant of such criteria, ie. the condition is treatment-resistant not the patient. – Duckisaduckisaduck Nov 12 '18 at 20:26
  • I don't contradict this, but I would like to find a word that relates to the patient. In other languages, there are words for this. E.g. 'austherapiert' in German. – johann_ka Nov 12 '18 at 20:56
  • @johann_ka Understood, I'll make a second answer. – Duckisaduckisaduck Nov 12 '18 at 20:59
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There was a discussion about this in 2005 on proz.com The two most popular translations of austherapiert were:

  1. (have/has) exhausted all therapeutical options
  2. therapied out

However, the proz.com OP chose "all treatment options exhausted" as her preferred answer. You can view the discussion thread on the link below.

https://www.proz.com/kudoz/german-to-english/medical-general/1181660-austherapiert.html

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    Your answer needs to contain an actual answer, not just a link to one. Please edit your answer to include what's relevant so it isn't deleted. See this MSE post for more information. – Laurel Nov 16 '18 at 5:55
  • @Airport ... - Thank you for replying. One would say 'treatment-exhausted patient' or 'all-treatment-exhausted patient'? 'Exhausted' is already in the title of the post, but still valuable input from you. Thank you! – johann_ka Nov 16 '18 at 14:12
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    therapied out is a monstrosity. Typical crap one sees on proz. However, exhausting treatment options is kosher, for sure. I'm only upvoting the exhaustion/exhaust one. – Lambie Nov 19 '18 at 19:32
  • therapeutical is a mistake on Proz. exhausted all "treatment options" – Lambie May 26 at 16:28
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+25

From Webster's New World Medical Dictionary, 3rd ed:

refractory Not yielding, or not yielding readily, to treatment.

As the patient had refractory hemispheric epilepsy, a commissurotomy was performed.

  • Thank you for your input. Do you think this would imply 'treatment options are exhausted' ? – johann_ka Nov 17 '18 at 19:03
  • It means that they've not been getting better from treatment, with the implicit assumption being that if one treatment failed you'd try another. – faustus Nov 17 '18 at 19:05
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    +1. An online source would have been ideal, but citing Webster's NWMD is certainly sufficient, and your edit now makes this a valid answer, although tying it in to the OP's request for description of the patient would be a further improvement. Just one minor point: is the example sentence your own, or given in Webster's? If the latter, it should be included within the blockquote formatting to make this clear. – Chappo Nov 17 '18 at 23:50
  • @faustus - I see. It is a good word but I'm looking for something that precedes the word 'patient', so that the layperson 'a kind of understands' what is being spoken about. – johann_ka Nov 18 '18 at 16:17
  • @johann_ka then i think treatment resistant is your best bet. – faustus Nov 19 '18 at 3:37
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Your desire for a term that “relates to the patient” (and not to the condition) makes this question difficult, for as pointed out by @Duckisaduckisaduck in this comment,

in western medicine, it is the paradigm to diagnose and describe conditions, not to characterise patients independant of such criteria, ie. the condition is treatment-resistant not the patient.

Personally, I like “Duck’s” answer of “treatment-resistant” (+1) and with the context/particular condition well established, perhaps that answer could apply/transfer to the patient, i.e.,

With regard to his/her [heart/skin/mental/etc] condition, the patient is treatment/therapy-resistant.

Regardless, even if there is a perfect English term relating solely to the patient (as “austherapiert” seems to do in German), I think it would still be necessary to preface its use with a mention of the particular condition at issue. Without such a context-setting reference, it might sound as if the patient is “[all] treated-out” for any and all conditions that s/he might have now or in the future.

With this need (as I see it) to include/restate (even to the point of redundancy) the particular condition at issue in mind (along with my [probably incorrect] assumption that you are not necessarily limiting your search to formal medical/clinical terms), maybe you could consider something like:

With regard to his/her [heart/skin/mental/etc] condition, the patient is [therapeutically] out-of-options.

(cf: this (albeit sans hyphens and the veterinarian’s, not the patient’s) use of the above suggestion in the last paragraph of Dr. O’Brien’s entry from petmd.com)

2

I’ve worked with infectious disease docs who treat HIV+ patients and say that a patient “failed” a treatment (e.g. “failed Atripla”), as if the patient gave the drug an ‘F’ for the semester or something. It seems odd to say because it likely wasn’t the patient’s fault, so while I might not agree with this phrasing, the phrasing is nonetheless used to indicate that the drug is no longer effective. Another problem is that I've only heard "failed” to refer to the most recent Tx option, and HIV+ patients rarely run out of options, so I can only assume that a doc would say that a patient “failed ARV treatment” if no other options were left.

In referring to aggressive tumors, oncologists I’ve worked with use “recalcitrant” or “refractory” (e.g. “a treatment-refractory tumor”, or "...tumor is recalcitrant to treatment") to indicate the tumor won’t respond or will no longer respond to drug treatment. I think that might be what you’re looking for.

  • Upvoted as I consider your input valuable. Thank you. – johann_ka Nov 16 '18 at 14:13
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How about

The patient is incurable.

Although most often applied to ailments, it can also be applied to people. See for example Oxford Dictionaries:

1 (of a sick person or a disease) not able to be cured.

0

intractable 1

intractable 2

intractable: adjective

1

formal: very difficult or impossible to deal with

2

Stubborn; obstinate (of a person)

  • I have voted your two answers up. You seem very committed and although the quest hasn't been cracked yet, your post is very valuable input. – johann_ka Nov 12 '18 at 21:46
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    @johann_ka Thanks, I'm curious to know how this goes too, though I'm bowing out for now. I'll brew popcorn and watch. – Duckisaduckisaduck Nov 12 '18 at 21:48

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