Guess what happens when you give people with a deadly form of lung cancer early access to palliative care?
They live about two months longer. They also feel better throughout the course of treatment. And the people who get palliative care starting within three weeks of diagnosis are more likely to have recorded their end-of-life wishes and, ultimately, to have less aggressive and expensive care just before dying.
The provocative findings come from research at Massachusetts General Hospital, where 151 patients diagnosed with metastatic non-small-cell lung cancer were randomly chosen to get either standard treatment or the usual care plus early help with managing pain, psychological issues and decisions about what measures they wanted taken at the end of life.
Exactly why the people in the early palliative group lived significantly longer isn't entirely clear. The researchers note that previous work has shown lower quality of life and depression have been associated with shorter lives for patients like these. Improvements on those fronts, therefore, might explain an increase in survival.
It's also possible that adding the palliative help may aid coordination of the patients' overall cancer care, improving the results.
"I see the suffering day in and day out," Dr. Jennifer Temel, a lung cancer specialist and lead author of the study, tells the Boston Globe. "I never understood why we only asked palliative care clinicians to see patients toward the end of their life. It's too late then."
The results were just published in the New England Journal of Medicine.
An accompanying editorial says the study shows that offering palliative care at the time of diagnosis of a serious life-threatening disease is "appropriate and potentially beneficial." But, the authors caution, the substantial improvement in survival seen in this particular study needs to be replicated.