TUESDAY, April 16, 2019 (HealthDay News) — Learning you have a cancer that looks imminently terminal is tough news to swallow.
And new research indicates that when given just one month to live, a significant number of patients still opt for aggressive and often costly interventions, despite little evidence to suggest they’ll help.
A study of just over 100,000 patients in the United States found that the urge to undergo ultimately fruitless cancer treatment “is not a rare phenomenon,” said study author Dr. Helmneh Sineshaw, of the American Cancer Society.
More than one-quarter underwent active treatment, such as surgery or chemotherapy, in the final weeks of life, said Sineshaw, director of treatment patterns and outcomes research for the cancer society.
“Patients newly diagnosed with metastatic cancer who die soon after diagnosis are a unique population,” he said. The findings suggest a need to better identify people who would fare better with palliative care — aimed at symptom and stress relief — rather than aggressive and expensive treatments.
Dr. Richard Schilsky, chief medical officer for the American Society of Clinical Oncology, agreed that this group is “pretty rare,” accounting for just 5 percent of cancer cases.
“This is a challenging scenario for doctors and patients,” Schilsky added. “But oncologists have an obligation to inform their patients as best as they can about the prognosis, the goals of treatment, and the expectations for benefit and side effects from any treatment plan.”
For those affected, care planning can be very “complex,” said Sineshaw. Decisions involve a tricky interplay of doctors, patients and loved ones, he explained.
“Although there are some guidelines to streamline the decision-making process, a more concerted effort is needed to improve quality of care for these patients,” he said.
For the study, Sineshaw’s team reviewed data from the U.S. National Cancer Data Base on adult patients newly diagnosed with advanced (metastatic) lung, breast, pancreatic and/or colon cancer between 2004 and 2014.
The analysis confirmed that most –about 73 percent — do not undergo active treatment during their last month of life.