Ontario’s latest cancer registry data reveals a troubling rise in the administration of systemic anticancer treatments (SACT) during patients’ final months. From 2015 to 2020, the use of such treatments at the end of life surged, primarily due to a significant uptick in immunotherapy applications.
Rising Trends in End-of-Life Treatments
The comprehensive analysis encompassed nearly 69,000 patients diagnosed with various solid tumors and hematologic malignancies. Out of these, over a quarter received SACT within the last 30 days of life. Notably, the period saw a monthly increase of 0.072% in SACT usage, with immunotherapy alone accounting for the majority of this rise.
Consequences of Increased Treatment at Life’s End
Patients undergoing SACT at the end of life experienced significantly higher rates of intensive healthcare services. The likelihood of multiple emergency department visits, repeated hospitalizations, and admissions to intensive care units more than doubled compared to those who did not receive such treatments.
– Immunotherapy’s popularity is driving the overall increase in SACT usage at life’s end.
– Different SACT types show varying levels of association with intensive healthcare service use.
– The data underscores the need for updated guidelines addressing novel cancer treatments in palliative care.
The study highlights that regardless of the SACT type, treatments administered during the final month of life correlate with heightened healthcare utilization and an increased likelihood of death occurring within hospital settings. Chemotherapy combined with immunotherapy presented the highest adjusted odds ratios for both high health services use and hospital deaths.
As the medical community grapples with these findings, it becomes evident that the decision to administer SACT at the end of life requires careful consideration of the benefits versus the potential strain on healthcare resources. Healthcare providers must balance the pursuit of extending life with the quality of remaining life, ensuring that treatments align with patients’ wishes and overall well-being.
Establishing comprehensive guidelines that incorporate the latest advancements in cancer treatments will be crucial. These guidelines should aim to optimize patient care by minimizing unnecessary hospitalizations and ensuring that end-of-life care remains compassionate and patient-centered. By doing so, the healthcare system can better support both patients and their families during these critical times.
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