25 Jul Chemotherapy At End Of Life May Bring More Harm Than Good
MedicalResearch.com Interview with:
Holly G. Prigerson, Ph.D.
Irving Sherwood Wright Professor in Geriatrics
Professor of Sociology in Medicine
Director, Center for Research on End of Life Care
Weill Cornell Medical College
New York Presbyterian Hospital
New York City, New York
Medical Research: What is the background for this study? What are the main findings?
Dr. Prigerson: End-stage cancer patients are often offered “palliative chemotherapy” so we wanted to know if it, indeed, palliated their symptoms. ASCO guidelines recommend chemotherapy only be given to those with good performance status
(e.g. ecog scores < 3).
We found over half of these cancer patients (who died a median of 3.8 months from our baseline assessment), were receiving chemotherapy at our baseline assessment and that it did not improve quality of life in the last week of life for patients with poor baseline performance status and it significantly harmed quality of life in the patient’s final week for those with good performance status.
Medical Research: What should clinicians and patients take away from your report?
Dr. Prigerson: For terminally ill cancer patients, regardless of performance status, more harm than benefit to quality of life appears to result from use of chemotherapy. There is a need for open, honest discussion of the pros and cons of chemo for this group of patients.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Prigerson: We need to examine the factors influencing receipt of palliative chemotherapy and the mechanisms through which it results in worse quality of death. We also need to examine cost effectiveness of such care.
Holly G. Prigerson, Ph.D. (2015). Chemotherapy At End Of Life May Bring More Harm Than Good