Palliative Care Early On Has Many Benefits

Palliative care is meant to ease symptoms at the end of life, but who can estimate accurately when that stage begins? Reasoning that most physicians initiate palliative care way too late, U.S. researchers explored the effects of beginning the process immediately after a cancer diagnosis.

In a randomized study, 151 ambulatory patients with newly diagnosed metastatic non–small-cell lung cancer received standard oncologic care; 77 of them also received palliative care. Intervention patients averaged four visits with a palliative care service before they died. Compared with patients who received just standard care, the palliative care group survived significantly longer (median, 11.6 months vs. 8.9 months), and, in a multivariate analysis that included age and performance status, early palliative care was a significant independent predictor of survival.

Among 107 patients in both groups who survived to 12 weeks, members of the palliative care group reported significantly better quality of life on each of three standard scales. Although the study was not powered to compare specific modes of care, the palliative group patients received less chemotherapy, made fewer emergency department visits, and were more likely to die at home than the standard-care group.