Palliative Care
CR Magazine: Collaberation – Results


Early Palliative Care

New research suggests that palliative care should be considered sooner.

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By Karen Patterson

Critical Care

Use of palliative care shows surprising benefit

By Karen Patterson

Promptly adding comprehensive supportive care to standard treatment may not only improve mood and quality of life in cancer patients, but also extend survival.

New research finds that among 151 patients with metastatic non–small-cell lung cancer, those assigned additional palliative care had a median survival of 11.6 months, compared with 8.9 months for those who received just standard cancer treatment.

The study, published Aug. 19 in the New England Journal of Medicine, also showed that these patients had a better quality of life and fewer depression symptoms.

Palliative care involves symptom management and psychological, social, logistical and spiritual aid. The objective is to help patients and families handle the trauma of major illness, understand treatments, make decisions and cope with consequences of their disease.

“Having a team of clinicians focused exclusively on patients’ symptoms,
distress and coping … led to better symptom control,” says Jennifer S. Temel, a thoracic oncologist at Massachusetts General Hospital in Boston and the study’s lead researcher. “I think [patients] were able to be more functional, and that enhanced their ability to enjoy their life.”

Internist Diane E. Meier, the director of the Center to Advance Palliative Care, at Mount Sinai School of Medicine in New York City, believes patients receiving early palliative support are likely to live longer as well because among other benefits, this care helps them avoid risky treatment, such as chemotherapy soon before death.

And by weaving a safety net around patients, palliative care helps prevent crises that lead to hospitalizations, and hence risk of medication errors and infections. “Hospitals are places to be entered with a great deal of caution,” Meier says.

No matter the clinic, or the diagnosis, it’s important that cancer patients and caregivers request palliative services as a complement to standard care, says Betty Ferrell, who chaired the National Consensus Project for Quality Palliative Care. Cancer specialists typically don’t think about referring patients to palliative care until death is near, she notes.

Ferrell, a professor and research scientist at City of Hope, a cancer treatment and research center in Duarte, Calif., says the new study represents the ideal of care for any cancer. “At the same time you’re diagnosed with cancer and there’s a plan for treatment of your tumor, there should be a plan for the treatment of you as a person.”