Navigation Links
Terminally ill cancer patients discuss end-of-life care with physician but often late
Date:2/9/2012

BOSTON--The vast majority of patients with incurable lung or colorectal cancer talk with a physician about their options for care at the end of life, but often not until late in the course of their illness, according to a new study by Dana-Farber Cancer Institute investigators published in the Feb. 7 issue of the Annals of Internal Medicine.

The researchers found that such belated conversations tend to occur under particularly stressful conditions when patients have been admitted to a hospital for acute care. And the doctor who shares in the end-of-life care talk is often a hospital physician, rather than an oncologist who has treated the patient for much of his or her illness.

Together, these circumstances may deprive patients of the opportunity for extended reflection and deliberation that would have been possible months earlier, when the conversation also could have occurred under less trying and hectic conditions, the authors suggest.

"Previous studies have shown that patients who discuss their end-of-life care preferences with a physician are more likely to choose palliative, comfort-focused care over aggressive measures, and receive hospice or other care consistent with their wishes," says the study's lead author, Jennifer Mack, MD, MPH, of Dana-Farber/Children's Hospital Cancer Center. "But studies haven't looked at the timing of these discussions, or where and with whom they occur."

The new study, which involved 2,155 patients with stage IV (highly advanced) lung or colorectal cancer, found that 73 percent of the patients had an end-of-life care talk with a physician, according to medical records or an interview with the patient or a companion. Among the nearly 1,000 patients who passed away and whose records document an end-of-life care discussion with a physician, the median time of those discussions was just 33 days before death.

Other findings pertain to the location of those discussions and the type of physician involved. Of the more than 1,000 end-of-life care discussions in medical records, 55 percent occurred in the hospital. Oncologists documented end-of-life care talks with only 27 percent of their terminally ill patients in the study.

Data for the study was provided by the Cancer Outcomes Research and Surveillance Consortium (CanCORS), a multi-region, population- and health system-based study of more than 10,000 patients with lung or colorectal cancer. Researchers interviewed patients at two time points and analyzed their medical records 15 months after diagnosis.

"It's encouraging to see such a high percentage of patients had end-of-life care conversations with a physician," Mack says. "There's a concern, though, that so many of these talks are taking place late in the trajectory of the disease."

Previous studies had estimated that fewer than 40 percent of patients with advanced cancer had end-of-life care discussions. Mack theorizes that this lower figure may reflect that earlier studies didn't record end-of-life talks that took place shortly before patients' death.

Other research has suggested that physicians may delay end-of-life care discussions because of a natural reluctance to broach the subject, or because it conflicts with physicians' problem-solving, hope-giving image. While such motivations are understandable, Mack says, they may work to patients' detriment if they postpone the conversations too long.

Mack and her colleagues are planning future studies to examine the quality and content of end-of-life care conversations, and then explore whether having such talks earlier in the course of illness can benefit patients.


'/>"/>

Contact: Bill Schaller
william_schaller@dfci.harvard.edu
617-632-5357
Dana-Farber Cancer Institute
Source:Eurekalert  

Related medicine news :

1. Doctors Religious Beliefs Can Color Their Care of Terminally Ill
2. Enhancing arrest of cell growth to treat cancer in mice
3. Paxil Blocks Tamoxifen, Lowers Survival Odds Against Breast Cancer
4. The National Coalition for Cancer Survivorship Joins the Commission on Cancer
5. Low forms of cyclin E reduce breast cancer drugs effectiveness
6. Racial disparities persist in the diagnosis of advanced breast cancer and colon cancer in the U.S.
7. Soft drinks may increase risk of pancreatic cancer
8. UH Case Medical Center researchers publish promising findings for advanced cervical cancer
9. Genes Play Role in Prognosis With Non-Small Cell Lung Cancers
10. Single gene mutation induces endometrial cancer
11. Certain genetic profiles associated with recurrence-free survival for non-small cell lung cancer
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Terminally ill cancer patients discuss end-of-life care with physician but often late
(Date:10/13/2017)... ... October 13, 2017 , ... The ... to promote standards of excellence for the field of eating disorders, announces the ... – 25, 2018 in Orlando, Florida at the Omni Resort at ChampionsGate. ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Apple ... care services, staged a mock evacuation of the facility as part of a disaster ... Fire Department, Echo Hose EMS and Shelton City Emergency Manager, as well as the ...
(Date:10/13/2017)... ... , ... Global Healthcare Management’s 4th Annual Kids Fun Run brought out many ... event, sponsored by Global Healthcare Management’s CEO, Jon Letko, is aimed at getting kids ... of all ages; it is a non-competitive, non-timed event, which is all about having ...
(Date:10/13/2017)... ... October 13, 2017 , ... “The Journey: From the Mountains ... possible to save lost souls in the Philippines. “The Journey: From the Mountains to ... dedicated teacher of the Bible. She has taught all ages and currently teaches a ...
(Date:10/12/2017)... LA (PRWEB) , ... October 12, 2017 , ... Planet ... in the U.S., announced today its plans to open a flagship location in Covington, ... occupy the former Rooms To Go store next to Office Depot in the Holiday ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... Holdings, Inc. ("Hill-Rom") (NYSE: HRC), today provided an update ... Puerto Rico , where the company manufactures ... Following a comprehensive onsite assessment, the ... temporary loss of power and minimal water damage due ... have resumed, and the company expects to return to ...
(Date:10/7/2017)... Oct. 6, 2017   Provista, a proven ... $100 billion in purchasing power, today announced a new ... The Newsroom is the online home for ... infographics, expert bios, news releases, slideshows and events. ... a wealth of resources at their fingertips, viewers can ...
(Date:10/4/2017)... -- According to the Centers for Disease Control and Prevention (CDC), influenza ... Care is helping communities across Massachusetts , ... no-cost* flu shots through the end of the month. *Some ... ... flu shot is by the end of October, according to the Centers ...
Breaking Medicine Technology: