Costly late-stage cancer treatment doesn't guarantee longer life
March 15, 2013 | by Hiu Chung So
In hopes of a cure, or delaying the inevitable a little longer, patients with advanced cancer will often opt for more aggressive — and costlier — treatments. But such an investment may often be spent in vain, with a new study suggesting that spending more does not necessarily lead to a longer survival time.
The results were published in the Journal of the National Cancer Institute on March 12. In the study, researchers used data from more than 116,000 Medicare patients who were diagnosed with, or died from, advanced stage cancer between 2002 and 2007. Their Medicare payments, survival time and use of health services were then tallied and analyzed.
After examining the data, the authors found that, although the amount spent to treat advanced cancer can vary up to 41 percent (with regional averages ranging from $27,446 to $38,630 over a six-month period), there were no significant differences in survival even between the highest spending and lowest spending regions.
Spending more, however, was linked to more frequent and longer hospital stays, as well as a decreased use of hospice services.
According to Carin van Zyl, M.D., assistant clinical professor in the Department of Supportive Care Medicine at City of Hope, such spending can have serious quality-of-life implications for patients and their loved ones.
“We don’t talk about [end-of-life issues] soon enough and lay out a plan so that it’s not a crazy frenzied rush,” she told Everyday Health.
Areas for improvement in late-stage cancer care, according to van Zyl and other experts, include discussing end-of-life decisions early in treatment, making the patient’s preferences known to his or her care team and integrating supportive and palliative care into the treatment plan.
Wrote the study’s authors: “Health-care providers should be incentivized to develop strategies aimed at reducing potentially avoidable hospitalizations and increasing timely access to palliative care for patients with advanced cancer.”
This not only reduces societal health-care costs, but is also “consistent with patient-centered care” by aligning treatment to their end-of-life preferences rather than automatically bombarding them with harsh, expensive and ineffective therapies throughout their final days.
Referring to late-stage cancer patients, the study's lead author, Gabriel Brooks, M.D., told Everyday Health: "Rather than spending the last few months of their life in a hospital, they should be home and receiving palliative services."