Chemo for terminally ill cancer patients linked to more intensive care

Terminally ill cancer patients undergoing chemotherapy may die under more aggressive circumstances, according to a new study, compared to those who don't receive chemotherapy.

It is a preconceived notion that chemotherapy is a cure for cancer, but what patients don't realize is that it is a treatment to make them more comfortable. "Palliative chemotherapy" often makes patients sicker, one expert involved in the study says.

"Those who received palliative chemotherapy, even after adjustment for their better health and quality of life and treatment preferences at our baseline assessment, were worse off," Holly G. Prigerson told Reuters. "My oncologist colleague was surprised because she was certain chemotherapy would be beneficial."

Researchers analyzed data from 386 terminally ill cancer patients, 216 of whom were receiving palliative chemotherapy when the study began. Those undergoing chemotherapy survived four months on average, but their end-of-life care was more intense.

Fourteen percent of patients on chemotherapy had CPR or were put on a mechanical ventilator, or both, in their last week of life, compared to just 2 percent of people not on chemo. And 11 percent of those receiving chemotherapy treatment died in an intensive care unit (ICU), versus 2 percent of those not undergoing chemo.

What's more, 54 percent of chemo patients versus 37 percent of non-chemo patients were enrolled in hospice care within one week of their death.

"Often these cancer treatments in this situation have more risks than benefits, and this needs to be communicated better by doctors and their teams," said medical oncologist Dr. Andrew S. Epstein, who was not involved in the study.

But Dr. Thomas W. LeBlanc said that palliative chemo can be beneficial by shrinking tumors, reducing pain and improving quality of life.

"Like any tool, it must be applied very judiciously," he said.