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Adults age 65 and older with cancer received more chemotherapy towards the end of life throughout the 1990s, according to a new study.
Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, researchers reviewed the care received by all Medicare-eligible patients age 65 and older who died of cancer between 1991 and 2000. Of these patients, 215,488 met eligibility criteria for the study.
The purpose of this study was to find the best way to measure end-of-life care. However, during the review of the treatments these patients received, the researchers observed a steady increase from 10% in 1993 to 12% in 1999 in the use of chemotherapy within two weeks of death. Admissions to the intensive care unit (ICU) in the last month of life increased from 8% in 1993 to 11% in 1999. During this period, the patients entering hospice in the last three days of life increased from 12% to 15%, which is too brief for most patients to receive the benefits of hospice.
"This study indicates that cancer care towards the end of life is continuing to become increasingly aggressive, and possibly as a result, some patients are not benefiting from palliative services, such as hospice care," said Craig C. Earle, MD, Associate Professor of Medicine at Harvard Medical School in Boston and the study's lead author.
What This Means For Patients
This study illustrates the importance of older patients and their families, friends, and caregivers honestly discussing the reasons for cancer treatment. For example, is chemotherapy being used to treat the cancer or relieve symptoms? If it becomes clear that effective treatment options are no longer available, patients may wish to talk with their doctors or nurses about hospice care.