Patients Receiving Early Palliative Care Live Longer

Patients receiving early palliative care had less aggressive care at the end of life but longer survival

The highly-regarded New England Journal of Medicine recently published a very interesting study that concluded that terminally ill patients with metastatic non–small-cell lung cancer who received palliative care soon after diagnosis lived longer than those who did not, even when receiving less aggressive treatment at the end of their lives.

According to Wikipedia:

Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay, or reverse progression of the disease itself or provide a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness. Non-hospice palliative care is not dependent on prognosis and is offered in conjunction with curative and all other appropriate forms of medical treatment.

In the United States, a distinction is made between general palliative care and hospice care, which delivers palliative care to those at the end of life; the two aspects of care share a similar philosophy but differ in their payment systems and location of services. Elsewhere, for example in the United Kingdom, this distinction is not operative: in addition to specialized hospices, non-hospice-based palliative care teams provide care to those with life-limiting illness at any stage of disease.

In plain English, this makes the case for hospice care being a very reasonable, and in fact beneficial, choice as soon as the patient becomes appropriate for hospice care, and also for pre-hospice palliative care before cessation of treatment that seeks to cure or halt the illness.

The NEJM study conclusions are very direct and clear:

Among patients with metastatic non–small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving standard care, patients receiving early palliative care had less aggressive care at the end of life but longer survival. (Funded by an American Society of Clinical Oncology Career Development Award and philanthropic gifts; ClinicalTrials.gov number, NCT01038271.)

For the complete study, see Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer

Originally posted 2010-09-19 10:00:00.