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Chemotherapy: overused at the end of life?

In May of 2001, a study reported to the annual meeting of the American Society of Clinical Oncology suggests that patients with aggressive, non-responsive cancers are being overtreated with chemotherapy at the expense of a decent quality of life in their last months of life. Side effects of chemotherapy include vomiting, nausea, extreme fatigue and hair loss. "Many are concerned with the quality of end-of-life care and specifically that patients should not be overtreated with ineffective therapies that won't improve their quality of life," says Dr. Ezekiel J. Emanuel of the National Institutes of Health and lead researcher of the study. The study found that chemotherapy was used pretty much the same in all patients, no matter what type of cancer they have, even those types that have shown that they do not respond to treatment in any way. Therein lies the concern of the researchers; why are doctors putting patients through the agonizing side effects of chemotherapy for cancers they know are unlikely to respond? One explanation was that doctors give in to pressure from patients and their families to "try everything." Chemotherapy in the last year of life is also much more expensive. Chemotherapy costs patients in their last year of life $38,308 compared to $27,567 for those not in their last year. According to Emanual, "Weare going to need to do a lot of research to figure out what is driving the need for chemotherapy during the last months of life, especially for patients with umesponsive cancers." We agree. Unnecessary treatment that offers false hope and decreases a person's quality of life in the final few months is unconscionable.

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