Palliative Care Extends Life

An article published in yesterday's New England Journal of Medicine by Jennifer Temel and colleagues ends this way:  "Early integration of palliative care for patients with metastatic non–small-cell lung cancer is a clinically meaningful and feasible care model that has effects on survival and quality of life . . . the results . . . offer great promise for alleviating distress in patients with metastatic disease and addressing critical concerns regarding the use of health care services at the end of life."

The New York Times reports on the study:  "In a study that sheds new light on the effects of end-of-life care, doctors have found that patients with terminal lung cancer who began receiving palliative care immediately upon diagnosis not only were happier, more mobile and in less pain as the end neared — but they also lived nearly three months longer."

Amy Kelley and Diane Meier expertly observe:  "Despite the increasing availability of palliative care services in U.S. hospitals and the body of evidence showing the great distress to patients caused by symptoms of the illness, the burdens on family caregivers, and the overuse of costly, ineffective therapies during advanced chronic illness, the use of palliative care services by physicians for their patients remains low. Physicians tend to perceive palliative care as the alternative to life-prolonging or curative care — what we do when there is nothing more that we can do — rather than as a simultaneously delivered adjunct to disease-focused treatment."

Consequently, the Temel et al. study is just the first of what are soon to be many examples of research that shift a too-long-held "paradigm that has limited access to palliative care to patients who were predictably and clearly dying."