End of Life with Cancer: A Better Outcome at Lower Cost

Unfortunately, patients with terminal cancer often have poor communication with their doctors as the end approaches. There are still decisions to be made at this time, and a physician’s advice is very helpful. Just how valuable this can be is revealed in a study reported in the Archives of Internal Medicine.

Investigators interviewed 603 cancer patients who had less than 6 months to live. The patients were then followed up until they died. Their costs were recorded and aggregated, and set in relation to whether they had had an end-of-life discussion with their physician.

Out of the 603 patients, 188 (31%) reported end-of-life discussions at baseline. The remainder (61%) said that end-of-life discussions had not occurred. The average cost of total care was $1,876 for those patients who had had an end-of-life discussion at enrollment compared with $2,917 for patients who had not. A quality-of-life measurement showed that patients with higher costs had worse scores in their final weeks than those with lower costs.

The important point to be taken from these findings is the need for education of physicians in their duties towards their patients. Although the main measure here was financial, there’s no doubt that the carry-over into “a good death” can be helped enormously by guidance from a competent physician.