Many cancer patients are eventually faced with the dilemma of choosing whether or not to stop chemotherapy.
Oncologists may not recommend the treatment for very sick patients but despite its toxic effects, some doctors may still recommend chemotherapy to end-stage patients in the belief that this could buy them time or ease their discomfort.
Now, a new study could make it easier for patients, their families and healthcare provider to make a decision if it is worth taking another round of chemotherapy.
A new study published in JAMA Oncology on July 23 suggests that for those nearing the end of their lives, even the so called self-sufficient and stronger patients may not gain benefit from chemotherapy.
The treatment could even negatively affect the quality of life of many patients getting the treatment as it could worsen their final weeks of life compared with those who forego a last-ditch treatment.
Study researcher Holly Prigerson, from the Weill Cornell Medical College in New York, and colleagues followed over 300 cancer patients with prognosis of up to six months to live, half of whom opted to receive end-stage chemotherapy.
After each of the patients died, the researchers asked a caregiver or relative who was most familiar about the well-being of the patient to rate the quality of life of the patient during the last week of life.
The researchers found that for patients who were more sickly since the beginning, their quality of life was essentially the same regardless if they received chemotherapy or not.
Among patients who started with fewer symptoms, 56 percent of those who received chemotherapy experienced lower quality of life in their last week. Of those who forego chemotherapy, on the other hand, 31 percent experienced lower quality of life in their final week.
"The QOD in patients with end-stage cancer is not improved, and can be harmed, by chemotherapy use near death, even in patients with good performance status," the researchers reported in their study.
Oregon Health & Science University oncologist Charles Blanke said that chemotherapy is supposed to help patients live better or live longer but the study revealed that the treatment did neither.
"It was the patients that were feeling good that had the most to lose by taking chemo before their death," Prigerson said. "If the purpose was to improve the quality of life, these findings really raise questions about the legitimacy of that claim."
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