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Early Palliative Care and Survival in Patients With Advanced Lung Cancer

By: Sarah Campen, PharmD
Posted: Thursday, October 3, 2019

A study published in JAMA Oncology suggests that early palliative care may improve survival in patients with advanced lung cancer within the Veterans Affairs (VA) health-care system. Timing with palliative care appears to be critical: the researchers discovered that palliative care received 31 to 365 days after diagnosis significantly increased patient survival, whereas palliative care received before or after this window of time did not enhance survival.

“This therapy that is already known to offer improved symptom burden, quality of life, and support also works like other cancer therapies to improve survival,” stated study author Donald R. Sullivan, MD, MA, MCR, of the VA Portland Health Care System, Portland, Oregon, in a U.S. Department of VA press release.

Dr. Sullivan and colleagues retrospectively collected data from patients with stage IIIB and IV lung cancer who received care in the VA health-care system between 2007 and 2013. Of the 23,154 patients enrolled, 57% received palliative care. The mean age of participants was 68 years old, and 98% were men.

They found that palliative care received up to 30 days after diagnosis was associated with a decrease in survival (adjusted hazard ratio = 2.13) compared with patients not receiving such care. However, palliative care received 31 to 365 days after diagnosis was associated with an increase in survival (adjusted hazard ratio = 0.47); no difference in survival was observed with palliative care received more than 365 days after diagnosis. Furthermore, palliative care was associated with a decrease in the risk of death in an acute care setting.

The researchers stressed that palliative care is most effective when included in initial disease treatment rather than as part of the dying process. “Research like this gets more clinicians and patients thinking about the importance of palliative care,” stated Dr. Sullivan, “and I believe more veterans with advanced cancer will receive this care along with other cancer therapies.”

Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.



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