A new study published in JAMA Oncology suggests that chemotherapy doesn’t improve quality of life for cancer patients who are close to death—and may actually make it worse for patients who have a healthier performance status.
Study researchers, led by Holly G. Prigerson of the Weill Cornell Medical College in New York, assessed 312 patients who were diagnosed with terminal cancer between September 2002 and February 2008. These patients had an estimated life expectancy of six months or less.
More than half of the patients received chemotherapy and their performance status (i.e. activity levels and self-care capabilities) were evaluated. The higher their score, the worse the performance status.
In comparison to patients who didn’t receive chemotherapy, patients with a poor performance status who received chemo treatments saw no improvement in their quality of life in the final week before death.
Researchers also discovered that the quality of life got worse for patients who received chemo treatments and who had a good performance status, compared to patients with a good performance status who did not receive treatment.
Guidelines from the American Society of Clinical Oncology (ASCO) currently state that patients with terminal cancer, who have a good performance status, could benefit from chemotherapy.
But according to the study’s researchers, the findings suggest that this may not be the case: “Results of this study suggest that chemotherapy use among patients with chemotherapy-refractory metastatic cancer is of questionable benefit to patients’ QOL (quality of life) in their final week.”
Researchers conclude that the ASCO may need to revise guidelines regarding chemotherapy for patients with terminal cancer to reflect the potential harm of this treatment in patients with progressive metastatic disease.
Sources for Today’s Article:
Prigerson H.G., et al., “Chemotherapy use, performance status, and quality of life at the end of life,” JAMA Oncology, doi:10.1001/jamaoncol.2015.2378, published online July 23 2015.
Whiteman, H., “Chemotherapy for near-death cancer patients does not improve quality of life,” Medical News Today web site, July 24, 2015; http://www.medicalnewstoday.com/articles/297239.php.