ATLANTA (CBS Atlanta) – More than half of end-stage cancer patients receive chemotherapy during the last few months of their life, and those who received such treatment were more likely to die in a hospital intensive care unit, hooked to a ventilator, rather than at home as they would have preferred, says a new study.
Patients were also less likely to have discussed their end of life wishes with their oncologist compared to other end-stage cancer patients who opted not to continue chemotherapy.
Researchers say doctors have a hard time initiating conversations with their patients, especially those dying from metastatic cancer.
“There’s a subtle dance that happens between oncologist and patient,” Dr. Alexi Wright, an assistant professor of medicine at Dana-Farber Cancer Institute, and the study’s lead author, told the Boston Globe. “Where doctors don’t want to broach the subject of dying, especially in younger patients, because it makes those patients think we’re giving up on them.”
Wright and her team of researchers studied 386 terminally ill cancer patients. They found that the 56 percent that had chemotherapy tended to be younger, better educated, richer, and more optimistic about their prognosis.
The patients died within an average of four months after participating in the study.
Sixty-five percent died in their preferred place; as compared to 80 percent of those who chose to stop treatments. The researchers found that those taking chemotherapy were more likely to die in a hospital intensive care unit rather than at home and were more likely to get placed on a ventilator. Most were referred to hospice within a week of their death.
“Doctors are human beings,” Wright said. “And sometimes we fail to have the clarity to determine when our patients are dying. Andy even when we do, we may not want to give up on treatments as this study suggests is the case.”
Wright is hoping this study will make more doctors aware that patients who receive chemotherapy may get a false sense of hope and be denied a more peaceful death.
The study was published in this week’s edition of the British Medical Journal.
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