Harvard Women's Health Watch

In the journals: Early palliative care extends life in lung cancer study

Palliative care is pain relief and other measures taken to help patients cope with the physical and psychosocial effects of serious illness and difficult treatments like chemotherapy. Many people think of it as "comfort" care provided mostly in the last weeks of life, when nothing else can be done. But experts say it should be offered sooner, in conjunction with medical care focused on treatment and recovery. Now, a study has found that lung cancer patients who get palliative care early on, along with standard medical therapy aimed at treating their illness, are happier and more comfortable and live longer than patients receiving standard care alone. Results of the study were published in The New England Journal of Medicine (Aug. 19, 2010).

The study. Researchers at Massachusetts General Hospital in Boston randomly assigned 151 women and men newly diagnosed with advanced (metastatic) non–small-cell lung cancer to receive either standard care (for example, chemotherapy) or standard care plus early palliative care. Non–small-cell lung cancer is the most common form of lung cancer and the leading cause of cancer death; on average, patients survive less than a year after the advanced form is diagnosed.

Before the study began and again after 12 weeks, participants answered questions about symptoms, social well-being, and physical and emotional health. A standard questionnaire on symptoms of depression was included. Patients receiving palliative care met at least once a month with physicians and nurses on the hospital's palliative care team, who followed a program adapted from National Consensus Project (NCP) guidelines on palliative care. These guidelines emphasize the importance of helping patients understand their illness and treatment goals; make treatment decisions; mobilize support from family, friends, and others; and manage symptoms such as pain, nausea, fatigue, anxiety, and depression. Throughout the study, researchers collected data on patients' use of end-of-life care, including anticancer therapies, medications, emergency room visits, hospital admissions, and referral to hospice.

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