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Palliative Cancer Care Lifts Spirits

Researchers Say Quality of Life Improves for Patients, but No Impact on Survival
By Hilary Parker
WebMD Health News
Reviewed by Louise Chang, MD

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Aug. 18, 2009 -- Palliative care may boost mood and quality of life for people with advanced cancer, but it may not help them live longer, a new study shows.

Palliative care is a kind of care for people who have a serious illness that usually isn't going to go away and gets worse over time. It aims to ease pain and suffering by helping patients and their families manage symptoms and the side effects of treatments. It also provides emotional support to patients and their families.

It's not the same as hospice care, which serves terminally ill patients who are no longer seeking treatment to cure their illness.

Researchers from the Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center wanted to investigate the effectiveness of palliative care in patients with advanced cancer. Their study is published in the Aug. 19 issue of The Journal of the American Medical Association.

The researchers studied 322 patients newly diagnosed with advanced cancer from clinics in New Hampshire and a VA medical center in Vermont. Half of the patients were assigned to telephone-based palliative care intervention; the palliative care consisted of four weekly sessions followed by ongoing monthly calls conducted by specially trained advanced practice nurses. They also received traditional cancer treatment.

The palliative care sessions conducted in the study focused on encouraging active patient involvement in a number of areas, including:

  • Communication with family members and the medical treatment team
  • Symptom management
  • Coping and problem-solving skills
  • Advance care planning
  • Treatment decision-making

The other group received usual cancer care, which included use of all oncology and supportive services available at their institutions, including referral to a palliative care service.

All patients were reassessed on quality of life, symptom intensity, and mood after one month and then every three months until death or the conclusion of the study. The study was conducted from 2003-2008.

Those patients who received the palliative care intervention reported improvements in quality of life and depressed mood over patients undergoing usual care. There were no significant differences between the groups, however, in the intensity of symptoms, the number of trips to the emergency room, the number of days spent in the hospital or intensive care unit, or survival.

"Comprehensive, high-quality cancer care includes interdisciplinary attention to improving physical, psychological, social, spiritual, and existential concerns for the patient and his or her family," the researchers write. "While our study did not show that early intervention for patients with advanced cancer by a nurse-led program improved symptoms or reduced use of some resources, the study did show that it provides some patients with advanced cancer a higher quality of life and mood."

As for the next steps, the researchers say they would like to study a larger, more diverse group of people. They also recommend additional research examining the effects of in-person palliative care as opposed to telephone-based sessions. 

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