Palliative Chemotherapy Could Lead to Death, Study Reports
Palliative chemotherapy is used toward the end of a cancer patient's life in order to attempt to alleviate symptoms and extend life span. Even though this type of "last-ditch" chemotherapy is meant to help the terminally ill patient, a new study is reporting that it could increase risk of death in the intensive care unit (ICU). The researchers reported that for some patients, the extra fight for survival could actually result in a death that is uncomfortable and even miserable.
For this study, the research team headed by Dr. Alexi Wright from the Harvard Medical School and Dana Farber Cancer Institute examined 386 terminally ill cancer patients. Over 50 percent of the patients were given palliative chemotherapy even though the treatment would not save or extend their lives. In these patients, the researchers reported that 12 percent underwent CPR (cardiopulmonary resuscitation) or required ventilators. 13 percent of the patients had to be transferred to the ICU and 11 percent needed feeding tubes.
"Between 20 percent and 50 percent of patients with incurable cancers receive chemotherapy within 30 days of death, despite growing concerns that it may not be effective," the authors wrote according to NBC News. "Recently, the American Society for Clinical Oncology identified end of life chemotherapy as one of the top five practices that could improve patients' care and reduce costs, if stopped."
The team, which was also composed of researchers from the Weill Cornell Medical College, reported that 80 percent of the cancer patients who did not get palliative chemotherapy died where they wished. 66 percent of them died at the comforts of their own home, which is where most terminally ill patients choose to die. For patients who did get care, only 68 percent said they died where they wanted to die with 47 percent dying at home.
"It's hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer," said senior author Dr. Holly Prigerson of Weill Cornell Medical College in the news release. "Until now, there hasn't been evidence of harmful effects of palliative chemotherapy in the last few months of life. This study is a first step in providing evidence that specifically demonstrates what negative outcomes may result. Additional studies are needed to confirm these troubling findings."
The study's findings suggest that there is a great disconnect between what patients desire and the type of care they end up getting within the last few months of life. In order to improve life quality for terminally ill cancer patients, the researchers stated that doctor-patient rapport should be improved upon.
The study was published in the British Medical Journal.