The importance of early palliative care (supportive treatment) in stage 4 cancer and the nuances of palliative care

Palliative care encompasses approaches seeking solutions to conditions that make life difficult because of cancer and other serious illnesses. In our previous article we discussed the importance of palliative care in cancer and various approaches for patients and their loved ones. Every medical approach is known to encompass a very broad range of possibilities, and palliative care for cancer patients is no exception. Cancer researchers place considerable emphasis on palliative care. Rather than standard healthcare alone, they focus on integrating palliative care into treatment early.

Published in December 2016 in the respected oncology journal Journal of Clinical Oncology, a study of stage 4 (metastatic) lung cancer and gastrointestinal cancer patients showed that initiating palliative care early improved quality of life and reduced depression.

Study details

Of the 350 patients included, 175 received early palliative care, while the other group of 175 received usual treatment. Patients receiving early palliative care met a palliative care specialist at least once a month. Those in the usual-treatment group met a specialist on request.

Results

When all cancer patients in the study were evaluated, quality-of-life scores at the end of week 12 increased from baseline in the early palliative care group, but decreased from baseline with usual care. Depression assessments at the end of week 24 also showed lower scores in the early palliative care group. These patients were also more likely to talk with their oncologists about the dying process.

Results were also evaluated separately for lung and gastrointestinal cancer patients. Among lung cancer patients, quality-of-life and depression assessments at weeks 12 and 24 were better in the early palliative care group. For gastrointestinal cancer patients, however, there was no significant difference in quality-of-life or depression scores between early palliative care and usual care.

The study results can be interpreted as follows: Early palliative care has positive outcomes in newly diagnosed patients with no prospect of complete cure, but outcomes can vary by cancer type. Planning early palliative care specifically for patients with different cancer types could therefore produce better results.

This study again demonstrates the importance of early palliative care throughout illness. However, another striking finding prompts us to consider whether different palliative approaches are needed for different cancers. This returns us to the broad scope of approaches within medicine. Healthcare professionals with developed palliative care skills who remain open to further development are therefore needed. Awareness of the importance of specialization in this field is emerging in our country.