How Is Cancer Managed at the End of Life?

Clinical practice guidelines generally note that chemotherapy given to dying cancer patients is a mark of poor-quality care. Still, decisions to withhold or withdraw cancer treatment are notoriously difficult, and the availability of novel anticancer agents complicates these decisions still further.

U.S. researchers analyzed Medicare databases between 2012 and 2017 for patterns in the care administered by 960 oncologists to 17,600 patients (age, >65) who were dying from lung, colorectal, breast, or prostate cancer. Most patients were white (81%) and had late-stage cancer at diagnosis. All patients had traditional Medicare coverage without a managed care component.

Receipt of systemic cancer treatment during the last month of life was associat…