Donald Sullivan, MD, MA, MCR Associate Professor of Medicine & Associate Fellowship Program Director Division of Pulmonary & Critical Care Medicine Oregon Health & Science University Investigator, Center to Improve Veteran Involvement in Care (CIVIC) VA-Portland Health Care System

Early Palliative Care Associated With Increased Survival in Lung Cancer Patients

MedicalResearch.com Interview with:

Donald Sullivan, MD, MA, MCR Associate Professor of Medicine & Associate Fellowship Program Director Division of Pulmonary & Critical Care Medicine Oregon Health & Science University Investigator, Center to Improve Veteran Involvement in Care (CIVIC) VA-Portland Health Care System

Dr. Sullivan

Donald Sullivan, MD, MA, MCR
Associate Professor of Medicine & Associate Fellowship Program Director
Division of Pulmonary & Critical Care Medicine
Oregon Health & Science University
Investigator, Center to Improve Veteran Involvement in Care (CIVIC)
VA-Portland Health Care System 

MedicalResearch.com: What is the background for this study?

  • Patients with lung cancer suffer from considerable physical and psychological symptom burden and palliative care is underutilized or delivered too close to death to provide meaningful benefits for these patients. Palliative care is associated with improved quality of life for these patients, but the findings regarding a survival benefit are not clear.
  • Palliative care is distinct from hospice. Palliative care is meant to be delivered along with disease-modifying therapy and focuses on improving quality of life by addressing pain and other problems, including physical, psychosocial and spiritual for patients and their families. Hospice care is focused on reducing suffering, pain and anxiety at the very end of life; typically within a few months of death.

MedicalResearch.com: What are the main findings?

Response: Palliative care was associated with survival among advanced lung cancer patients. The timing of palliative care receipt, relative to cancer diagnosis, was an important determinant of this benefit. Early palliative care received 31-365 days after diagnosis was associated with increased survival. Outpatient palliative care (by definition- considered early in the disease trajectory) was associated with a survival benefit regardless of the timing of initiation. 

MedicalResearch.com: What should readers take away from your report?

Response: Our study results help dispel the belief that early palliative care among patients with lung cancer is associated with shortened survival. As such, palliative care should be viewed as a complementary, not competing approach, with disease-modifying therapy in advanced cancer. Patients and clinicians should consider the potential associated benefits of palliative care and discuss this along with other treatments during clinic visits.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Examination of the specific palliative care factors that contribute to this associated survival benefit; in other words what are the essential aspects of palliative care that are most helpful.

MedicalResearch.com: Is there anything else you would like to add?

Response: Hopefully, this research and these findings help start conversations among patients and their clinicians- centered around providing patients the maximal amount of support during a difficult time.

Disclosures: Funding from the national institutes of health, national cancer institute (K07CA190706).

Citation:

Sullivan DR, Chan B, Lapidus JA, et al. Association of Early Palliative Care Use With Survival and Place of Death Among Patients With Advanced Lung Cancer Receiving Care in the Veterans Health Administration. JAMA Oncol. Published online September 19, 2019. doi:10.1001/jamaoncol.2019.3105

 

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Last Modified: Sep 19, 2019 @ 5:37 pm

 

 

 

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