Palliative Chemotherapy Of No Benefit

Dad ‘s been diagnosed with lung cancer, stage IV, and the doctors want him to take chemotherapy, hoping to prolong his life.  He is worried it will only make him feel worse.  How much benefit is there for him?

A study published July this year in JAMA Oncology found that patients with any end-stage cancer who received chemotherapy, hoping to improve their quality of life and survival, actually were made to feel worse and didn’t live any longer!

661 patients with stage 4 [metastatic] cancer were followed:  half received at least one dose of chemotherapy, and the other half were the ‘control’ group, meaning they received only comfort care to control symptoms (pain, shortness of breath, nausea).  All the patients entered the study feeling ‘well’ and without any significant symptoms.

The accompanying editorial stated, “It is disturbing that this trial demonstrated no benefits of chemotherapy… and… that oncologists still recommend and use systemic therapy so close to patient death.”  The authors speculate that chemotherapy was given to patients already functioning well and without symptoms in an attempt to just reduce the cancer’s spread.

Based on this study, it unfortunately appears that once you have metastatic cancer, your chances of living longer and better by taking chemotherapy is not very good.  A person may be better served by informing themselves and making a choice that is right for them—which could still be a trial of  chemotherapy; or could be, eat and drink what you like, enjoying your family without the nausea and other problems that frequently accompany cancer treatment.  

Try not to give in to others’ false hopes.  Know that usually a comfort- focused approach helps you to live more comfortably and longer—which means, ask your doctor if hospice might be a better choice!