Chemo Worsens Quality of Life for Patients Near Death
New research published in JAMA Oncology suggests that chemotherapy can hasten deterioration in patients with advanced cancer who haven’t yet lost their ability to perform normal activities. As one of the study’s lead authors puts it, “Patients who were feeling good had the most to lose and the least to gain by using chemo.”
To see what effects chemotherapy has on cancer patients in their last week of life, the researchers at Weill Cornell Medical College and New York Presbyterian Hospital monitored the final days of 312 patients treated at six U.S. oncology clinics. They interviewed caregivers shortly after patients died to see if they received chemotherapy during those last days and what type of physical and mental declines they suffered during that time. Among the patients who began their last week with the highest level of functionality, chemotherapy reduced their quality of life and they fared worse than similar patients who didn’t receive the drugs.
The research team concluded that clinical guidelines may need to be revised to recognize the potential harm of chemotherapy at the end of life for patients with progressive metastatic disease, where tumors grow and spread rapidly. However, it becomes challenging when doctors can’t predict how soon a patient might die, compounded with the fact that most patients want to continue fighting the disease with all available options.
The team notes that more research is needed to understand how chemotherapy may impair quality of life and which aspects of physical and mental functionality may be most at risk.