During the last two decades, the range of oncological treatments have largely increased, and considerable progress has been made concerning the efficacy of anticancer treatments, especially in high income countries. Still, during the same period, the aggressiveness of cancer care near the end of life has emerged as a growing concern.
Many studies report a significant increase in the use of chemotherapy in the final weeks of life, which should serve as triggers to evaluate whether some healthcare systems provide overly aggressive end-of-life cancer care.
- One out of five hospitalized patients who die from metastatic cancers receive chemotherapy during their last month of life.
- A rate of 10% of patients receive chemotherapy in the last 14 days of life and a proportion of 2% of patients start a new chemotherapy regimen during the last month before death.
This information may indicate an overuse of potentially futile treatments, with negative effects on the quality-of-care provided to patients and their families.
One possibility to address this issue could be setting a defined level of appropriate and inappropriate rates of chemotherapy near the end of life to facilitate the aim of palliative care in oncology, i.e. to address the needs of each patient based not only on the illness trajectory or physical symptoms but also on the personal preferences and goals of care.
These are data mostly from studies in high income countries, but this information may be also useful for countries in other socio economic levels.
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Adapted from Medscape News & Perspective. Use of chemotherapy near the end of life. What factors matter? Internet. Available at https://www.medscape.com/viewarticle/878832_1 . Accessed on April 29, 2018. To view the entire article and all other content on the Medscape News and Perspective site, a free, one-time registration is required.