According to Managed Care Magazine, physicians are ignoring efforts by the American Society of Clinical Oncology (ASCO) to cut back on costly and potentially harmful aggressive treatment of cancer patients in end-of-life care, when earlier rounds of treatment have stopped working and were actually more adverse to the patient.
The researchers found that 71% to 76% of patients across different cancers received aggressive care within the last 30 days of life, including 30% to 35% of patients who died in the hospital. The rates of aggressive care between early 2012 (before ASCO’s Choosing Wisely campaign) and 2014 were unchanged in patients with colorectal and breast cancers (71% and 74%, respectively), and were increased in lung cancer (76%), pancreatic cancer (74%), and prostate cancer (72%).
[M]ost cancer drugs have serious adverse effects, including heart failure, mouth sores, and constipation, and because a patient who has not responded to earlier treatments and is fading has almost no chance of benefitting from more.
The researchers concluded that “there is substantial overuse of aggressive end-of-life care among younger patients with incurable cancers.”
“As oncologists, we give treatments that both prolong life and improve quality of life. However, when our treatments can no longer accomplish both goals concurrently, it is our duty to talk with patients and understand their goals and priorities. Aggressive treatment is not always in accordance with patients’ wishes,” said Anthony Lam, Medical Director for PharMedQuest, a national leader in providing proven cost-effective solutions to some of the most challenging issues in healthcare.
“Palliative care is an important component of oncology care that needs to be offered to patients with advanced disease. Data have shown that early referral to palliative care specialists improves patient outcomes, and in certain scenarios, can even prolong life better than aggressive chemotherapy, ” added Dr. Lam.
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