An increasing number of older U.S. cancer patients are receiving aggressive medical care when they are near death, according to an article in the January 15th issue of the Journal of Clinical Oncology. The study follows presentation of preliminary data at the annual meeting of the American Society of Clinical Oncology in June 2003.

"Our research has shown that the treatment of cancer patients near death is becoming increasingly aggressive and that more patients are being admitted to emergency rooms and to intensive care units during their last few weeks of life," said lead author Craig Earle, MD.

The American researchers reviewed the records of 28,777 patients aged 65 years or older who died within 1 year of being diagnosed with lung, breast, or colorectal or other gastrointestinal cancer between 1993 and 1996. During the 4-year period, use of chemotherapy among these patients increased from 27.9 percent to 29.5 percent. Among those patients, the proportion receiving chemotherapy within 2 weeks of death increased from 13.8 percent to 18.5 percent.

The researchers also observed an increase in the number of cancer patients who were seen in the emergency room during the last month of life (7.2 percent to 9.2 percent) or were admitted to an intensive care unit (7.1 percent to 9.4 percent). However, over the same period, fewer patients died in acute-care hospitals (decrease from 32.9 percent to 29.5 percent) and more used hospice care (increase from 29.3 percent to 38.8 percent).

"Interestingly, the findings suggest that the availability of hospice services and related medical resources may reduce the chance that a patient will receive aggressive treatment at the end-of life," said Earle. "Increasing the availability of hospice may improve the quality of care for many terminally ill patients."