Advanced cancer patients likely to receive aggressive treatments, despite potential for harm

Cancer patients at the end of their lives still receive aggressive treatment, despite efforts by oncologists to curb the practice, according to research presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.

Researchers found that, despite warnings from ASCO that aggressive end-of-life cancer care can be harmful, the rate of such treatment occurring in cancer patients under 65 remained essentially the same and, in some cases, increased. The study compared data from 2012, when the ASCO launched the Choosing Wisely campaign, to data from 2014.

Researchers analyzed data pulled from insurance claims to Blue Cross or Blue Shield in 14 states, including nearly 29,000 patients of those with incurable colorectal or breast cancer. The figure, 71 and 74 percent respectively, remained unchanged over the two-year period. Patients with end-stage lung, pancreatic and prostate cancers, between 72 and 76 percent of whom were receiving aggressive treatment in 2012, saw an increase.

Such aggressive treatments, like continuing chemotherapy and radiation, "are widely recognized to be harmful," lead author Ronald Chen, M.D., a radiation oncologist at the University of North Carolina Lineberger Comprehensive Cancer Center, told STAT. Treatments like these can make the last few months or days of a patient's life much more uncomfortable, especially because common cancer drugs have painful symptoms like vomiting, mouth sores and fatigue.

Research has also found that many end-stage cancer patients are not aware of the extent of their diagnosis, which may compound the problem, according to STAT, as these patients are not informed enough to make care decisions.  Holly G. Prigerson, Ph.D., the co-director of the Center for Research on End-of-Life Care at Cornell and one of that study's authors, told STAT that oncologists are very reluctant to "put a number on how long patients have to live."

To learn more:
- here's the study
- read the STAT article
- view the Choosing Wisely website