Cancer patients who receive chemotherapy during the last stages of their life are more likely to die in hospital rather than their preferred location at home, a study has shown.

The research showed that many doctors have a hard time initiating end-of-life conversations with their patients, especially the young, even after cancer has spread to different parts of the body.

Such patients were also less likely to have discussed their final wishes with their doctors, meaning many were placed on a ventilator and had a less peaceful death than those who ended treatment early.

A survey has shown that cancer patients who continue treatment in the last stages of illness are less likely to have a peaceful death than those who ended treatment earlier.

Dr. Alexi Wright, an assistant professor of medicine at Dana-Farber Cancer Institute, and the study’s lead author, told the Boston Globe: ‘There’s a subtle dance that happens between oncologist and patient.

In 2011 there were roughly 330,000 diagnosed cases of cancer in the UK, with the most common being breast, lung, prostate and bowel cancers, with 160,000 deaths.

For men diagnosed with cancer 2007 there was a 43 per cent chance of surviving with the disease for five years or more, while for women it was 56 per cent.

Overall, since 2000, there has been a three per cent rise in cancer in the UK.

‘Where doctors don’t want to broach the subject of dying, especially in younger patients, because it makes those patients think we’re giving up on them.’

Wright and her team of researchers studied 386 terminally ill cancer patients. They found that the 56 percent that had chemotherapy tended to be younger, better educated, richer, and more optimistic about their outlook.

The patients died within an average of four months after participating in the study.

Sixty-five percent died in their preferred place; compared to 80 percent of those who chose to stop treatments.

The researchers found that those taking chemotherapy were more likely to die in a hospital intensive care unit rather than at home and were more likely to get placed on a ventilator.

The survey found that doctors struggled to have conversations with those still having treatment about end-of-life treatment, meaning patients were more likely to die in hospital against their wishes

Wright added: ‘Doctors are human beings, and sometimes we fail to have the clarity to determine when our patients are dying.

‘Even when we do, we may not want to give up on treatments as this study suggests is the case.’

Wright hopes the study, published in the British Medical Journal, will persuade doctors to talk through options with their patients, meaning they had a more peaceful death.

Written by Chris Pleasance and published by The Daily Mail, March 9, 2014.

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