Many People With Cancer Wait Too Long to Start Palliative Care, Study Finds

By: Bec Roldan, PhD

From: breastcancer.org

For more than 15 years, healthcare workers in the U.S. have been calling attention to the importance of taking early steps to improve the quality of life in people diagnosed with advanced cancer. Despite these efforts, a recent study found that many people over 65  with advanced cancer aren’t receiving supportive care in the final months of their lives.

Supportive care (includes palliative care and hospice care) helps both people living with serious illnesses as well as their families and caregivers. This type of care can improve the quality of life of people living with breast cancer by

• reducing the symptoms and stress of their illness

• encouraging them to think and talk about their end-of-life wishes

• providing them with emotional and spiritual support

About 15 years ago, U.S. health organizations including the National Quality Forum and American Society of Clinical Oncology began highlighting the risks of the overuse of medical care at the end of life and the benefits of starting palliative care early for people with advanced cancer.

Research shows that starting palliative care early is good for both people with advanced-stage cancer and their caregivers and family. Still, most people don’t receive this care at the end of life.

To get a better idea of how supportive care is being used by people nearing the end of life, Robin Yabroff, PhD, MBA, and a team of researchers analyzed healthcare data from people with advanced cancer (breast, prostate, pancreatic, or lung cancer) who died between 2014 and 2019. Yabroff is a researcher at the American Cancer Society.  The study focused on 33,744 people aged 66 or older who had health insurance through Medicare.

The study found that instead of receiving supportive care in their last months of life, people started new therapies, visited the hospital at high rates, or both. For instance, more people visited the hospital in their last month of life (46%) compared to six months before death (14%). Nearly half of the people in the study went to the emergency room the last month they were alive.

Rates of palliative care and advance care planning were low, even in the last month of life. And the researchers found that most people enrolled in hospice late — only 6.6% received hospice care six months before death while 74% received hospice care in the last month of life.

“This research highlights the need for interventions to improve quality of care for patients with advanced cancers, especially those helping to remove barriers to better access palliative care,” Yabroff said in a statement. “It also suggests the importance of clear, proactive communication between providers and patients and their families regarding advanced care planning to better guide end-of-life care efforts.”