| Quality of Life in Cancer Clinical Trials | |
The study was presented here Tuesday morning at the annual meeting of the
American Society of Clinical Oncology.
"In the past, it's been an either-or situation: Seriously ill patients have been
told they can have a clinical trial or they can go home and focus on quality of
life," said Frederick J. Meyers, professor and chair of internal medicine at UC
Davis School of Medicine and Medical Center and director of the West Coast
Center for Palliative Education and Research.
"In our opinion, that's not an acceptable choice. Why can't patients have both?"
To answer this question, Meyers and his colleagues compared two groups of cancer
patients enrolled in phase I and phase II clinical trials of investigational
chemotherapy treatments. All of the patients had a prognosis of less than one
year to live.
One group of patients received the investigational chemotherapy protocol only.
Patients in the other group received palliative care in addition to the
investigational treatment. Quality-of-life assessments were administered monthly
to all patients.
In the palliative care group, a nurse and social worker made regular home visits
to patients, and also accompanied patients to their clinic appointments. At
these visits, the nurse and social worker emphasized symptom management,
emotional support and discussion of end-of-life issues.
At the end of the seven-month study, patients in the treatment-only group scored
lower on quality-of-life measurements than they had when they entered the study,
while patients in the palliative care-plus-treatment group scored higher. In
addition, patients in the palliative care group were more likely to finish all
of their chemotherapy cycles. And more palliative-care patients were referred to
hospice.
"Patients, families and physicians can address palliative care and
disease-directed treatment simultaneously, without disruption of care," said
Meyers, who is also medical director of the hospice program at UC Davis Medical
Center.
The study was supported by a grant from the Robert Wood Johnson Foundation's
Promoting Excellence in End of Life Care initiative.
According to Meyers, combining investigational and palliative care would
represent a significant change in the culture of most cancer centers -- but the
change is needed. "Quality of life issues often go un-addressed by cancer
centers around the country," he said.
"This model of simultaneous investigational and palliative care emphasizes
patient choice -- and is superior to the current, sequential approach," he
concluded.
With a $2.5 million National Institutes of Health grant, Meyers will now conduct
a larger, multi-institutional study of this simultaneous care model. That study
will get under way later this year.
Meyers will be available to answer questions about his study following its
presentation at an 11 a.m. poster discussion session Tuesday, May 21.
Copies of all news releases from UC Davis Health System are available on the Web
at http://news.ucdmc.ucdavis.edu
---University of California, Davis, Health System
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