AMA Morning Rounds on NEJM Palliative Care Article

Early palliative care may prolong survival, enhance quality of life in patients with advanced lung cancer.


The New York Times (8/19, A15, McNeil) reports that a trial "paid for by the American Society of Clinical Oncology and private philanthropy" appears to "shed new light on the effects of end-of-life care." In fact, it "confirmed what...specialists had long suspected," that is, patients with "terminal lung cancer who began receiving palliative care immediately upon diagnosis not only were happier, more mobile, and in less pain as the end neared, but they also lived nearly three months longer." The paper appears in the New England Journal of Medicine.



Notably, "palliative care specialists lament that their image as the medical world's grim reaper deprives patients and their families of care and support that can ease the burden of serious illnesses that exact a steep physical, psychological, and social toll," the Boston Globe (8/19, A1, Smith) reports on its front page. "All too often, they said, patients and doctors outside their field equate palliative medicine with hospice care, even though hospice is the refuge for people who have stopped aggressive treatment and whose death is imminent." But, "palliative care...is available at any juncture during a life-threatening illness and, at its core, is designed to make living with a serious ailment more comfortable, incorporating everything from exercise to counseling to pain medication."



The current study illustrates that and is "one of the best tests yet of palliative care," the AP (8/19, Marchione) reports. It should also "ease many fears about starting it soon after diagnosis, doctors say." Researchers at the Massachusetts General Hospital (MGH) began their study by looking at "151 people newly diagnosed with cancer that had spread beyond the lung."



Seventy-seven of the "newly diagnosed patients were assigned to receive palliative care along with the standard treatment for the cancer," while the "other 74 patients received the standard treatment without palliative care," the Los Angeles Times "Booster Shots" (8/18, Roan) blog reported. The team eventually discovered that "patients receiving palliative care...scored higher on measures of quality of life and enjoying the time they had left. They also were more likely to express their wishes regarding resuscitation at the end of life."



What's more, those "who received palliative care in addition to standard care had...a 50 percent lower rate of depression and they lived 2.5 months longer than patients not receiving palliative care early," HealthDay (8/18, Doheny) reported.



MGH's Jennifer S. Temel, MD, told WebMD (8/18, Mann), "We were surprised by the magnitude of impact that palliative care had on quality of life, which normally decreases over time in these cancer patients, and the magnitude of the impact it had on depression." And, "the survival benefit was the most surprising thing," she added. "Cancer care and palliative care are not mutually exclusive." Bloomberg News (8/19, Cortez), the Wall Street Journal (8/18, Hobson) "Health Blog" and MedPage Today (8/18, Bankhead) also covered the study

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