Abstract
All too often neglected, maximal quality improvement in the setting of life-limiting illness and noxious symptomatology is a worthy medical, public health, and humanitarian goal [...]
Highlights
AUTHOR AFFILIATIONS *Adult Palliative Medicine Services, MultiCare Auburn Medical Center, and MultiCare Institute for Research and Innovation, Auburn, WA, U.S.A
It seems evident that at least one advantage was gained from the use of the remedy—the awful malady was stripped of its horrors; if not less fatal than before, it was reduced to less than the scale of suffering which precedes death from most ordinary diseases
The physician will perhaps esteem the means which enable him “to strew the path to the tomb with flowers,” and to divest of its specific terrors the most dreadful malady to which mankind is exposed
Summary
Maximal quality improvement in the setting of life-limiting illness and noxious symptomatology is a worthy medical, public health, and humanitarian goal. What oncologists mean by “palliation,” such as when palliative chemotherapy lines are routinely offered, might be changing as well, as stronger evidence emerges that such chemotherapy might not provide palliation—such as was seen in a recent prospective cohort study of 621 patients with progressive end-stage metastatic cancer who had a life expectancy of 6 months or less and who had already completed at least 1 chemotherapy regimen. Use of “palliative chemotherapy” was found to be associated with a reduction in the quality of life near death for patients who had a good baseline performance status (odds ratio: 0.35; 95% confidence interval: 0.17 to 0.75) and was not found to be associated with quality of life near death for patients with a moderate or poor baseline performance status[6]
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