Palliative Chemotherapy More harm than good?

Palliative chemotherapy in cancer patients with metastases does not prolong life according to a recent study

09/15/2014

Palliative chemotherapy in cancer patients with metastases does not prolong life, according to an American study. Patients and physicians should therefore consider carefully when chemotherapy is still useful, the Society for Biological Cancer Defense (GfBK) e. V.

Patients receiving palliative chemotherapy no longer live as patients without this treatment. This is the result of a recent US study (Wright AA / BMJ2014). The oncologists dr. Alexi A. Wright and Professor Holly G. Prigerson evaluated the information of 386 cancer patients „All participants had metastases and physicians had a life expectancy of no more than half a year.

Tendency to overtreatment
Within the last eight weeks of life, 62 percent of patients received chemotherapy. Overall, the patients treated at the end of their lives were significantly worse off than those without chemotherapy. For example, in the last week of life, resuscitation, respiration, or both were more often required (14 vs. 2 percent). In addition, chemotherapy increased the likelihood of patients dying in the ICU rather than in their preferred environment.

Most of the time, palliative chemotherapy aims to prevent further growth of the metastases and alleviate the symptoms. A cure by chemotherapeutic substances is very unlikely from a certain point in time, according to the Society for Biological Cancer Defense (GfBK). „It can be observed that after palliative chemotherapy, the tumor cells usually begin to grow very fast again, "says Dr. med. György Irmey, medical director of the GfBK in Heidelberg.

Palliative medicine is about enabling seriously ill people to live a life of security and dignity. This includes talking to them about how they want their last phase of life. Doctors should not raise false expectations that chemotherapeutic treatment will prolong life.

In cancer patients in the study, only 37 percent of chemotherapeutic patients had talked to doctors about how they wanted their life to end. In contrast, this was the case in almost every second patient without chemotherapy.

The GfBK advises patients to consider the decision for or against chemotherapy well and to agree only if they are convinced of it internally. „Patients need time to decide without pressure. "That is why GfBK recommends physicians who can assess both orthodox and naturopathic methods. „Ideally, this is a physician who accompanies the patient, listens to him and shares his fate. "Furthermore, every patient has the right to stop chemotherapy if the side effects are too severe or unbearable.

For the last phase of life there are more hopeful approaches. For example, care can have a life-prolonging effect. (Temel J / New England Journal of Medicine 2010). Biological therapies have a supporting effect - and, above all, low side effects. Note: The Society for Biological Cancer Defense e. V. (GfBK) is an independent, non-profit association that supports cancer patients, relatives and therapists. (Pm)