Terminal cancer patients who receive information early about end-of-life care receive less medical care during their last days and are more likely to enter hospice, according to a study in the Journal of Clinical Oncology. The findings suggest that early discussion about the likely outcome of a terminal illness can dramatically change a patient’s end-of-life decision-making.
According to the study, which was carried out by a team led by Dr. Jennifer Mack of the Dana-Farber Cancer Institute in Boston, national guidelines suggest that doctors begin discussions about end-of-life care shortly after diagnosing a terminal illness. But, the researchers write, it has been unclear whether such conversations actually affect end-of-life care.
To find out, Mack and her team studied 1,231 patients who had stage IV lung or colorectal cancer and survived at least a month after the study began but died during the 15-month period of the study. The researchers recorded when patients had end-of-life discussions with their doctors and kept track of the care they received.
Overall, just under half of patients in the study received aggressive care during their final 30 days, with 14% receiving chemotherapy in their last 14 days, 9% ending up in the ICU and a full 40% receiving intensive treatments.