Oncologists may have difficulty estimating how much longer terminal cancer patients will live and, as a result, their use of palliative radiation may be ineffective and inappropriate, according to the results of a study published in an early online version of Cancer.

Palliative care refers to care that is intended to provide comfort to patients, with no intention of prolonging survival or providing a cure. Palliative care is important for reducing pain and discomfort. When patients with terminal cancer are in the final stages of life, doctors will sometimes prescribe small doses of radiation in order to ease pain and, theoretically, provide a better quality of life. However, the results of a recent study indicate that this strategy may do more harm than good.

The study involved 216 patients with terminal cancer who were referred for palliative radiation. Within 30 days of admission to the hospital, 33 patients died; these 33 patients form the data group for this study. Only 26% of patients reported experiencing a reduction in pain as a result of palliative radiation, and 52% actually reported that their pain grew worse. Half of the patients spent 60% of their remaining lifespan undergoing radiation; most patients opted to prematurely discontinue the treatment (due to increasing pain).

The researchers speculated that doctors overall may be misjudging the value of palliative radiation, as well as overestimating potential survival time. Among 85 survival estimates made by doctors in this study, only 16% estimated survival correctly (to be 30 days). In fact, 21% incorrectly estimated that patients had more than six months to live.

The researchers concluded that many patients do not benefit from palliative radiation during the final stages of cancer, and this may be the result of overestimating survival. They suggest that it will be important for physicians to work toward being able to provide realistic survival estimates in order to avoid palliative treatment that is costly, provides little or no benefit, and may even cause painful side effects.


Gripp S, Mjartan S, Boelke E, et al. Palliative radiotherapy tailored to life expectancy in end-stage cancer patients. Cancer [early online publication]. April 12, 2010.

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