Does palliative care, offered by specialized teams early in the course of advanced cancer, improve outcomes? To address this question, researchers in Toronto conducted a randomized trial in which 24 cancer clinics at a comprehensive cancer center were assigned to provide either standard care or early palliative care referral (with monthly visits to an outpatient palliative care clinic, telephone support, and other measures). A total of 461 patients (233 control, 228 intervention) with advanced cancer (lung, gastrointestinal, breast, gynecologic, or genitourinary) but good performance status participated in the trial; nearly all patients were receiving chemotherapy, radiation therapy, or both. About 400 patients completed at least one follow-up assessment; about two thirds of intervention patients had at least four palliative care visits.
At 3 months, differences between groups in quality of life according to two standard measures were of borderline statistical significance, favoring the intervention group; at 4 months, differences became highly significant. Patient satisfaction scores also significantly favored the intervention group.
The full article appears on NEJM Journal Watch.