Palliative Cancer Care Lifts Spirits
Researchers Say Quality of Life Improves for Patients, but No Impact on Survival
By Hilary Parker
WebMD Health News
Reviewed By
Louise Chang, MD
Aug. 18, 2009 -- Palliative care may boost mood and quality of life for
people with advanced cancer, but it may not help them live longer, a new study
shows.
Palliative care is a kind of care for people who have a serious illness that
usually isn't going to go away and gets worse over time. It aims to ease pain
and suffering by helping patients and their families manage symptoms and the
side effects of treatments. It also provides emotional support to patients and
their families.
It's not the same as hospice care, which serves terminally ill patients who
are no longer seeking treatment to cure their illness.
Researchers from the Norris Cotton Cancer Center at Dartmouth-Hitchcock
Medical Center wanted to investigate the effectiveness of palliative care in
patients with advanced cancer. Their study is published in the Aug. 19 issue of
The Journal of the American Medical Association.
The researchers studied 322 patients newly diagnosed with advanced cancer
from clinics in New Hampshire and a VA medical center in Vermont. Half of the
patients were assigned to telephone-based palliative care intervention; the
palliative care consisted of four weekly sessions followed by ongoing monthly
calls conducted by specially trained advanced practice nurses. They also
received traditional cancer treatment.
The palliative care sessions conducted in the study focused on encouraging
active patient involvement in a number of areas, including:
- Communication with family members and the medical treatment team
- Symptom management
- Coping and problem-solving skills
- Advance care planning
- Treatment decision-making
The other group received usual cancer care, which included use of all
oncology and supportive services available at their institutions, including
referral to a palliative care service.
All patients were reassessed on quality of life, symptom intensity, and mood
after one month and then every three months until death or the conclusion of
the study. The study was conducted from 2003-2008.
Those patients who received the palliative care intervention reported
improvements in quality of life and depressed mood over patients undergoing
usual care. There were no significant differences between the groups, however,
in the intensity of symptoms, the number of trips to the emergency room, the
number of days spent in the hospital or intensive care unit, or survival.
"Comprehensive, high-quality cancer care includes interdisciplinary
attention to improving physical, psychological, social, spiritual, and
existential concerns for the patient and his or her family," the researchers
write. "While our study did not show that early intervention for patients with
advanced cancer by a nurse-led program improved symptoms or reduced use of some
resources, the study did show that it provides some patients with advanced
cancer a higher quality of life and mood."
As for the next steps, the researchers say they would like to study a
larger, more diverse group of people. They also recommend additional research
examining the effects of in-person palliative care as opposed to
telephone-based sessions.
SOURCES: Bakitas, M. The Journal of the American Medical Association,
Aug. 19, 2009; vol 302: pp 741-749. News release, The Journal of the American Medical Association. WebMD medical reference from Healthwise: "Palliative Care." GetPalliativeCare.org web site.
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