Palliative care recipients live longer and in less pain, study finds

Aug 20 2010

The New York Times: "In a study that sheds new light on the effects of end-of-life care, doctors have found that patients with terminal lung cancer who began receiving palliative care immediately upon diagnosis not only were happier, more mobile and in less pain as the end neared — but they also lived nearly three months longer. The findings, published online Wednesday by The New England Journal of Medicine, confirmed what palliative care specialists had long suspected. The study also, experts said, cast doubt on the decision to strike end-of-life provisions from the health care overhaul passed last year. … In the three-year study, 151 patients with fast-growing lung cancer at Massachusetts General, one of the nation's top hospitals, were randomly assigned to get either oncology treatment alone or oncology treatment with palliative care — pain relief and other measures intended to improve a patient's quality of life. They were followed until the end of 2009, by which time about 70 percent were dead" (McNeil, 8/18).

Read the NEJM findings. 

The Associated Press: "Palliative care involves doctors, nurses, social workers, nutritionists and even chaplains who specialize in pain control and treating nausea, shortness of breath and other symptoms that affect quality of life. It's not the same as hospice or comfort care, when doctors think a patient has less than six months to live and treating the illness no longer helps. … The study was one of the best tests yet of palliative care, and the results should ease many fears about starting it soon after diagnosis, doctors say. … Quality of life and physical functioning improved in the palliative care group and worsened in the others. Depression was less than half as common in the palliative care group" (Marchione, 8/18).

The Wall Street Journal Health Blog: "The palliative group's median survival was 11.6 months, vs. 8.9 months. And fewer of them received aggressive care at the end of life. What's going on? The authors say the improved quality of life and better mood, both of which have been linked to survival time, may play a role. Also, integrating the two avenues of care 'may facilitate the optimal and appropriate administration of anticancer therapy,' they write" (Hobson, 8/18).

The Boston Globe: "Palliative care specialists lament that their image as the medical world's grim reaper deprives patients and their families of care and support that can ease the burden of serious illnesses that exact a steep physical, psychological, and social toll. All too often, they said, patients and doctors outside their field equate palliative medicine with hospice care, even though hospice is the refuge for people who have stopped aggressive treatment and whose death is imminent. Palliative care, in contrast, is available at any juncture during a life-threatening illness and, at its core, is designed to make living with a serious ailment more comfortable, incorporating everything from exercise to counseling to pain medication" (Smith, 8/19).

Related, earlier KHN coverage: Bunny's Last Days: When Living Will Isn't Enough (Brink, 3/5).