Anticancer therapy within the last 30 days of life is an important indicator of quality end of life care. The decision to cease treatment is complex with several patient, family and clinician driven factors. Similarly, the development of novel anticancer therapies create opportunities for more treatment options. This is reflected in trends toward more aggressive treatment near the end of life. Other institutions in Australia have reported treatment rates within the last 30 days of life of between 10 - 26%.
Deaths between 1 January 2015 and 30 June 2018 of patients who attended the oncology department were analysed through a retrospective review of medical records.
122 of 444 deaths (27%) occurred in patients who had received anticancer therapy within the last 30 days of life. The majority (96%) were treated with palliative intent. Palliative care service referral status was low (50%) and tended to be later in those who received treatment within the last 30 days of life. Treatment within the last 30 days of life was associated with other indicators of aggressiveness of care including more emergency presentations, hospitalisations and ICU admissions.
A significant number of patients received anticancer therapy within the last 30 days of life. This emphasises difficulties in disease prognostication, the conflict between treatment cessation and trialling other tempting treatment options and the need for referral to palliative care services.
Clinical trial identification
Legal entity responsible for the study
Goulburn Valley Health.
Has not received any funding.
The author has declared no conflicts of interest.