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Chemotherapy in the last two weeks of life rarely helps and costs a great deal; patients who have an early conversation about what matters to them choose it less often and live at least as long.
Randomised trials of early specialist palliative care alongside cancer treatment in advanced lung and other cancers have shown better quality of life, less aggressive end-of-life care and, in some trials, longer survival. ASCO's Choosing Wisely list names chemotherapy for patients with poor performance status and no benefit from prior treatment as care to avoid. Embedding a structured serious-illness conversation at the start of any non-curative line, and automatic palliative referral at metastatic diagnosis, changes the default without restricting anyone's choice.
Shares Pain relief and palliative care are unavailable to most, Toxicity and quality of life are undervalued.
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
Shares Pain relief and palliative care are unavailable to most, Toxicity and quality of life are undervalued.
Shares Incentives reward me-too drugs and marginal gains, Toxicity and quality of life are undervalued.
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
Shares Multinational Association of Supportive Care in Cancer, Toxicity and quality of life are undervalued.