In the United States, treating late-stage cancer patients who are in their last months or days of life with aggressive treatments seems to be the norm. Instead, say researchers, more doctors should be suggesting hospice care for these patients, providing them with comfort during their last days rather than making them more uncomfortable.
An article in Bloomberg reports on the findings of the Dartmouth Atlas Project, a study that looked at end-of-life trends in cancer treatment. The data used for the study was collected from Medicare. The findings of the group indicated that too many cancer patients who are nearing death are being inundated with more, usually unnecessary, treatments and with things such as invasive feeding tubes and other apparatus that make patients even more uncomfortable – and sicker – than they already are.
Also, the share of cancer patients receiving hospice care has increased to about 61 percent in 2010 from 55 percent in 2003-2007, which seems like good news. However, the specifics of that fact show a slightly different picture, researchers point out: the number of individuals admitted to hospice in the last three days of their life, when it’s too late to provide them with much comfort, rose 31 percent, said David Goodman, co-principal investigator for Dartmouth Atlas.
“We’re seeing some pretty rapid changes in patterns of care but the move toward the care that most patients prefer is happening very unevenly, at the same time that many patients are receiving more aggressive in-patient care and less effective hospice care,” Goodman said.
The study also showed that where you live greatly impacts whether you’ll die of cancer in a hospital or in a homier, more comforting setting. For example, 43 percent of Medicare cancer patients in Manhattan died in a hospital. In little Mason City, Iowa, only 11 percent spent their dying days in a hospital setting.
“Under the influence of the more-is-better mentality, well-intentioned clinicians and loving families can inadvertently cause people to spend precious, fleeting days at the end of a long illness in hospitals and ICUs, instead of at home or other places they would rather be,” said Ira Byock, former director of Palliative Care at Dartmouth-Hitchcock Medical Center. “Patients with cancer whose illnesses advance despite treatment and find themselves with waning strength and energy should be cautious about excessive medical care.”