Abstract
BackgroundChemotherapy near the end of life is an issue frequently discussed nowadays. The concern is that chemotherapy could cause more harm than good in a palliative situation; this is even truer as the patient nears death. The objective of our study is to evaluate the aggressiveness of patient care near the end of life by determining how many cancer patients receive chemotherapy during their final weeks.MethodsIn a retrospective analysis of patient charts, we investigated whether cancer patients had been treated with chemotherapy during the last four or two weeks of life. If they had, we looked at whether treatment was ongoing or newly initiated.ResultsOut of the 119 cancer patients who died in our hospital over two years, 14 (11.7%) received chemotherapy during the last four weeks of life, nine of whom (7.6%) in the last two weeks of life. Treatment had been ongoing in six (5%) and newly initiated for eight (6.7%) within four weeks of death. Corresponding figures for the last two weeks of life were seven patients (5.9%) who continued previously prescribed treatment and two (1.7%) who were started on chemotherapy. Patients given chemotherapy during the last four weeks of life were significantly younger than those who were not (p = 0.003).ConclusionsCancer patient care in our hospital is not considered overly aggressive as only 7.6% of these patients receive chemotherapy within the last two weeks of life. To determine how aggressive care near the end of life really is, however, we suggest evaluating newly started chemotherapy alongside ongoing treatment. As the line between the effects (beneficience) and side effects (nonmaleficience) of chemotherapy is often very narrow, doctors and patients have to work together to find the best way of treading this fine line.
Highlights
IntroductionThe concern is that chemotherapy could cause more harm than good in a palliative situation; this is even truer as the patient nears death
Chemotherapy near the end of life is an issue frequently discussed nowadays
According to the Health Service Research Committee of the American Society of Clinical Oncology (ASCO), treatment can be recommended if it improves the quality of life in patients with metastatic cancer even though it does not improve survival [2]
Summary
The concern is that chemotherapy could cause more harm than good in a palliative situation; this is even truer as the patient nears death. The objective of our study is to evaluate the aggressiveness of patient care near the end of life by determining how many cancer patients receive chemotherapy during their final weeks. Patients and doctors are concerned that chemotherapy could cause more harm than good in a palliative situation. This is even truer as the patient nears death, when the main aim of treatment is usually palliation and not prolonging life. Giving palliative chemotherapy near the end of life, is a balancing act between clinical benefit and potential harm in terms of side effects. The ASCO Quality Oncology Practice Initiative (QOPI) included “Chemotherapy administered within the last two weeks of life (lower score-better)” as a benchmark for improving clinical practice [3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
