For Cancer Patients, Oncologists often Have the Final Word

For Terminally Ill Cancer Patients, The Final Days of Life Are Immensely Personal, Having the Choice to Continue Cancer Treatments, Or To Stop Treatments and Prioritize to More Comfortable Passing. What a Patient Wants, However, Isn’t Always What They Receive, According to Rutgers Health Study published In the Journal Cancer.

“A Patient’s End of Life is Often Not A Reflection of What They Want, But Rather, Who Their Oncologist Happens To Be,” Said Login S. George, Health Services Researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research, And Lead Author of the National Study.

“The Data Doesn’t Indicate Patiento-Centered Treatment Decisions, But Rather, MORE NURING OR DEFAULT WAYS OF TREATING PATINS,” Adds George, Who is also the Member of the Cancer Prevention and Control Program at Rutgers Cancer Institute, The State’s Only National Cancer Institute-DesignSive Cancer.

Clinical Guidelines for Many Cancers Recommend Stopping Chemotherapy in the Final Days of Life As It Can from More Harm Than Benefit. But While Such Treatment Discontinuation Decisions Should Be Based on Clinical Presentation and Patients’ Preferences, Oncologists Could Be Making Decisions Based on Their Characteristic Ways of Proceedings in Such Contexts, George Said.

To Assess How Oncologists Treat Terminally Ill Cancer Patients, George and Colleagues at Rutgers Health Analyzed National Data From the National Cancer Institute’s Surveillance, Epidemiology and End Results Program. By Examining Billing Codes in Medicare Hospital Outpatient and Carrier Claims, They Identified 17,609 Patients from Across the country who Died of Breast, Lung, Colorectal or Prostate Cancer FROM 2012 to 2017 and the 960 Oncologists who Treated them at 388 Different Practices and Clinics.

With this date as a starting point, the researchers then use Multilevel Models to Estimite Oncologists’ Rates of Prescription Chemotherapy and others Systemic Cancepies to Their Dying Patients in the Last Two Weeks of Life. ONCOLOGISTS WERE CATEGRIZED AS HAVING “HIGH” OR “LOW” PRESCRIBING BEHAVIOR DEPENDING ON WHETHER THEM PRESCRIBED TO HIGHER OR LOWER PROPHORS OF THEIR PATENTS, RELATIVE TO THEIR PERS.

By Accounting for Variation Coming from Patient- and Practice-Level Influences, The Researchers Were Able To IsoLet the Effects That the Treating Oncologist Had On Patients’ End-O-Life.

Results Showed A Patient Receue Care From an Oncologist with a High Prescription Behavior Had a Striking 4.5-Times Higher Odds of Receiving Cancer Treatment In the Final Days of Life, Compreded with a Patient Receiving Care Ancologist with Low Prescription Behavior.

ADDITIONALLY, Individuals with Breast Cancer Had Higher Odds of Receiving Late-Stage Treatment Than Those with Lung Cancer.

Other findings include:

• Patients with Colon Cancer and Prostate Cancer Didn’t Differ from Lung Cancer Patients.
• Black Patients Had Lower Odds of Treatment in the Last Month Of Life Compred with White Patients.
• Unmarried (single, divorced or widowed) Patients Had Lower Odds of Receiving Treatment Than Married Patients.

BECAUSE The Data was anonymized, The Researchers Couldn’t Identify the Prescription Oncologists by Name Or Practice. But the results indicate that breaking clinical prescription guidelines, there remains significant variations in what terminally ill cancer pits receive at the end of their lives.

George Said Making This Kind of Information Publicly Available Could Help Better Align Pats’ Treatment Wishes With Reality.

“When We Go Out to Eat or Go Shopping, We Don’t Just Blindly Pick a Restaurant Or Randomly Grab the First Thing We See On The Shelf.

“Shouldn’s Patients with cancer have the same luxury?” He added. “The Health Care Consumers, We Have a Right To Know About The Providers That We Pick.”

George Said Future Research Will Examine the Factors That Fuel Patients ‘and Clinicians’ Decisions Between More Cancer Treatments and Hospice Care.