Patients diagnosed with incurable lung cancer who were given palliative care usually reserved for people close to death had a better quality of life and lived longer than those getting standard treatment, researchers said.
The study from Massachusetts General Hospital in Boston suggests that preparing for death has a wide range of benefits. Patients who met with the hospital’s palliative-care team once a month were half as likely to suffer from depression. They received less aggressive care, including fewer rounds of chemotherapy, yet lived on average 2.7 months longer, according to the report in the New England Journal of Medicine.
The quality, intensity and cost of medical care at the end of life was a major issue during the debate last year over the U.S. health-care overhaul, with former Republican vice presidential candidate Sarah Palin warning that end-of-life counseling may lead to “death panels” that ration care. The perception about palliative care, which aims to ease symptoms and provide support, is flawed, the researchers said.
“One of the most common misconceptions about palliative care is that it indicates treatment has failed, that it means giving up,” said researcher Vicki Jackson, acting chief of the hospital’s Palliative Care Service, in a statement. “These patients not only lived longer, they also experienced improved quality of life and were better able to enjoy the time they had remaining.”
Lung cancer is expected to kill 157,300 people in the U.S. in 2010, making it the leading cause of cancer death, according to the American Cancer Society. More than 220,000 people will be diagnosed this year with the disease. The study included 151 patients with metastatic non-small cell lung cancer, a virulent form of the disease with an average survival of less than a year.
Previous studies tied depression and a lower quality of life to shorter survival times in cancer patients. The researchers hypothesized that improvements in both areas from palliative care resulted in longer lives for patients in their study. The findings, however, must be confirmed, they said.
“Given the trends toward aggressive and costly care near the end of life among patients with cancer, timely introduction of palliative care may serve to mitigate unnecessary and burdensome personal and societal costs,” the researchers said.
Future studies should examine individual components of palliative care that patients receive and look at a wider range of diseases, wrote Amy Kelley and Diane Meier, from Mount Sinai School of Medicine’s department of geriatrics and palliative medicine in New York. Still, the study shows that simultaneously providing palliative care and other medical therapies is appropriate and beneficial for patients newly diagnosed with a serious or life-threatening illness.
“This study is an example of research that shifts a long- held paradigm that has limited access to palliative care to patients who were predictably and clearly dying,” they wrote in an editorial accompanying the study. “Perhaps unsurprisingly, reducing patients’ misery may help them live longer.”