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• W2589496906 abstract "51 Background: End of life treatment decisions are challenging for cancer patients and oncology providers. Patients must understand their prognosis and options, deciding if and when to increase palliative care and decrease tumor-focused therapy. Cancer centers committed to offering clinical trials and evaluate new therapies add complexity to these decisions. To better define crucial points for decision making, we reviewed the care patients received during the last 6 months of life at one comprehensive cancer center. Methods: A retrospective chart review was conducted of the 301 cancer patients who died during one calendar year and were treated at the Huntsman Cancer Institute. We abstracted the care documented from all clinic visits, phone calls and hospitalizations including referrals and resources utilized during the last 6 months of life. Results: Men and women were equally represented with a mean age of 61at death and a median survival of 13 months after diagnosis. Over 1780 outpatient visits were documented during the last 6 months of life with treatment decision conversations noted at 68% of visits. Results of these discussions included new chemotherapy initiated at 26% of visits, treatment termination at 19% of visits, palliative therapy only at 9% of visits, and no treatment change at 47% of visits. Of the 64% of patients receiving chemotherapy in the last 6 months, 32% continued therapy in the last 30 days of life. Similarly, 34% of patients received radiation therapy in the last 30 days. Hospice was used by 59% of patients, with a mean length from referral to death of 29 days. Conversations about hospice occurred in 65% of patients with a mean/median of 2 conversations/patient. Approximately 37% of these conversations resulted in hospice enrollment, 49% deferred a decision and in 14% the patient requested additional treatment. Conclusions: Defining optimal timing for stopping cancer directed therapy is challenging in medical and radiation oncology, with 1in 3 patients continuing treatment in the last month of life. Goals of care and hospice conversations were required on multiple occasions, underscoring the need for oncology providers to have highly honed communication skills to minimize futile care and maximize palliative care." @default.
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• W2589496906 date "2016-10-09" @default.
• W2589496906 modified "2023-09-24" @default.
• W2589496906 title "Making treatment decisions at end of life in a comprehensive cancer center." @default.
• W2589496906 doi "https://doi.org/10.1200/jco.2016.34.26_suppl.51" @default.
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