Palliative care is care that is focused on symptom management, psychosocial issues, decision-making, and quality of life. Among patients with newly diagnosed, metastatic, non-small cell lung cancer, the addition of early palliative care to standard cancer treatment resulted in better quality of life and mood and longer survival than standard treatment alone. These results were published in the New England Journal of Medicine.
Lung cancer remains the leading cause of cancer death in the United States. Nonâsmall cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers.
Although patients with advanced lung cancer often experience a range of symptoms, palliative care is often not provided until late in the course of disease. Earlier provision of palliative care (which can be integrated with standard cancer treatment) could reduce symptoms and improve quality of life.
To explore the effects of early palliative care, researchers conducted a study among 151 patients with newly diagnosed, metastatic, NSCLC. Patients were assigned to receive either early palliative care integrated with standard cancer care, or standard cancer care alone.
Patients assigned to early palliative care met with a member of the palliative care team at least monthly. Palliative care visits included assessment of physical and psychosocial symptoms, discussion of goals of care, and assistance with treatment decisions.
Outcomes of interest included quality of life, mood, survival, and receipt of aggressive care at the end of life. Aggressive end-of-life care was defined as any of the following: chemotherapy within 14 days before death, no hospice care, or admission to hospice three days or less before death.
- Patients in the early palliative care group reported better quality of life and mood. Depressive symptoms were reported by 16% of patients in the early palliative care group compared with 38% of patients in the standard care group.
- Patients in the early palliative care were less likely to received aggressive end-of-life care. Aggressive end-of-life care was received by 33% of patients in the early palliative care group compared with 54% of patients in the standard care group.
- In spite of the less aggressive end-of-life care, patients in the early palliative care group tended to live longer. Median survival was 11.6 months among patients in the early palliative care group compared with 8.9 months among patients in standard care group.
The results indicate that for patients with advanced lung cancer, early palliative care improves quality of life and mood. Patients in the palliative care group received less aggressive care at the end of life but lived longer.
Reference: Temel JS, Greer JA, Muzikansky A et al. Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine. 2010;363:733-742.
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