A new study suggests that the practice of chemotherapy given to patients in their final months of life has almost no possibility of curing them.
The study was published online in the medical journal c Oncology on Thursday. It focuses on patients who have been diagnosed with the later stages of cancer and have a life expectancy of, or less than, six months.
In hopes that it may prolong one’s life, patients with advanced cancers are at times given chemotherapy.
“Chemotherapy is not meant to cure people like that,” Holly Prigerson, director of the Cornell Center for Research on End-Of-Life Care, says.
The results obtained from Prigerson’s study, of 312 patients who were expected to survive for not more than six months, showed the contrary. Not only did chemotherapy lower the patients’ quality of life, but even the healthiest patients experienced a worsening of their physical state of being.
Timothy Quill, a professor of medicine, psychiatry and medical humanities at the University of Rochester Medical Center, said, “People put a lot of stock in treatment and they tend to overestimate the odds that treatment will work.”
“There is a real potential for harm here and making quality of life worse.”
According to Thomas Smith, director of palliative medicine at Johns Hopkins Medical Institutions, Baltimore, chemotherapy can potentially cure several types of cancers that are still in the early stages.
Prigerson says, “The conventional wisdom is that patients and oncologists think, ‘Why not? I have nothing to lose.’
“And I think the wake-up call from these data, really, is to say, ‘There are harms being done, and there is a cost to getting chemo so late.’ ”
While she understands that certain patients may want to go for chemotherapy in these situations, she emphasizes that one needs to evaluate the harms and benefits of the practice towards the final phases of life.
“I think some patients would say, ‘I don’t care, I want to be on chemotherapy; it gives me something to do and it makes me feel that I’m fighting my cancer,'” she says. “That’s fine, if patients know that the likelihood of them benefiting from that chemotherapy is still remote, and it will probably make them feel sicker because of toxicities and side effects of the treatment.”
Nevertheless, Smith says that if the first two or three chemotherapy regiments have not been able to contain the cancer, there is a “vanishingly small” chance any subsequent regimens will help, as reported by USA Today.
Dr. Charles Blanke, an oncologist at the Knight Cancer Institute of the Oregon Health and Science University, and Dr. Erik Fromme, an internist and palliative care specialist at OHSU, say in an editorial that “equating treatment with hope is inappropriate.”
“If the doctor really doesn’t expect you to be around in six months, it’s probably better to focus your time on something that’s not chemotherapy,” Blanke says, according to NPR.
According to a study published in The Journal of Palliative Care Medicine last year, 17 percent of patients who had incurable lung cancer recognized that their life expectancy was not more than two years, while some of these patients realized that chemotherapy will not do them any good.
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