Palliative Care Aids in Recovery For Some Lung Cancer Patients

August 18, 2010 -- Patients with advanced lung cancer lived longer and with better quality of life when they received early palliative care as opposed to routine care, results of a randomized trial showed.

Early palliative care reduced use of aggressive measures at end of life by more than a third, cut the prevalence of depression in half, and added three months to the median survival of patients with advanced nonsmall-cell lung cancer (NSCLC).

The findings have implications for end-of-life decision making and use of healthcare resources, according to an article in the Aug. 19 issue of the New England Journal of Medicine.

"Although our findings must be replicated in a variety of care settings and cancer populations, the results nonetheless offer great promise for alleviating distress in patients with metastatic disease and addressing critical concerns regarding the use of healthcare services at the end of life," Dr. Jennifer S. Temel of Massachusetts General Hospital in Boston, and her coauthors wrote.

Much of the debate about healthcare reform revolves around quality of care and use of healthcare resources. With its focus on symptom management, psychosocial support, and assistance with decision making, palliative care offers the potential to improve quality of care and reduce use of medical services, the authors wrote in their introduction.

Historically, palliative care has entered patient management late in the disease course to patients who are hospitalized in specialized units or as a consultative service for uncontrolled symptoms, they continued.

Previous studies have suggested that employing palliative care late in a patient's clinical course has no effect on quality or delivery of care.

"To have a meaningful effect on patients' quality of life and end-of- life care, palliative care services must be provided earlier in the course of the disease," the authors noted.

In an effort to assess the impact of early palliative care, investigators conducted a prospective, randomized clinical trial involving 151 patients with metastatic NSCLC. Within eight weeks of diagnosis, the patients were randomized to standard care alone or with integrated palliative care.