Pancreatic cancer is devastating—most patients with this disease suffer from symptoms that require hospitalization and the disease is associated with high mortality rates. For this reason, their quality of life near death and the quality of care that they receive is important. Aggressive care near death for patients with incurable cancers is an important indicator of end-of-life quality; it has been linked with worse quality of life for patients and worse bereavement adjustment for their caregivers.
A study by a team led by PM Cancer Centre’s Dr. Raymond Jang examined whether palliative care (PC) impacts the aggressiveness of the medical care that patients with advanced pancreatic cancer receive near death. By conducting a retrospective population-based cohort study using data from Ontario patients, they analyzed measures of aggressive care, including: chemotherapy within 14 days of death; intensive care unit admissions, and multiple emergency department admissions and hospitalizations, all within 30 days of death. The results showed that patients who received a PC consultation experienced significantly less aggressive care—this was consistent across all four measures.
“More intensive PC follow-up was also associated with fewer instances of aggressive care near death,” says Dr. Jang. “These results emphasize the benefits of PC for these patients and hopefully provide motivation for increasing its availability worldwide.”
This work was supported by the Conquer Cancer Foundation of the American Society of Clinical Oncology, the University of Toronto Medical Oncology Postgraduate Ontario Student Opportunity Trust Funds, the Division of Medical Oncology and Hematology at the Princess Margaret Cancer Centre, and The Princess Margaret Cancer Foundation.
Palliative care and the aggressiveness of end-of-life care in patients with advanced pancreatic cancer. Jang RW, Krzyzanowska MK, Zimmermann C, Taback N, Alibhai SMH. Journal of the National Cancer Institute. 2015 January 20. [Pubmed abstract]
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