Cancer Patient Quality of Life Affected by Location of Treatment

Cancer patients who died in a hospital or intensive care unit were shown to have a reduced quality of life compared to those who died at home with hospice, according to a recent study published in the Journal of Clinical Oncology. Additionally, caregivers of patients treated in hospital settings are at an increased risk for developing a psychiatric illness.

The study highlights the potential importance of seeking hospice care at the end-of-life stages of cancer. Doing so may improve the mental health of both cancer patients and those faced with losing a loved one.

The results of the study, conducted by researchers at Harvard Medical School and Dana-Farber Cancer Institute in Boston, are based off of interviews conducted with 342 patients with advanced cancer (as well as their caregivers). Progression of mental health was continued from the time of study until death of the patient. The median interview time was reported at 4.5 months. Caregiver interviews also occurred throughout this time, with additional interviews occurring six months following death.

The differences in mental health are striking between those cared for in hospitals or ICUs and home hospice. Individuals who died at home exhibited a dramatic reduction in both physical and mental distress. Similarly, caregivers assisting home patients were five times less likely to develop Post-Traumatic Stress Disorder.

According to the study’s lead researcher, Alexi A. Wright, MD, ìOther studies have examined caregiversí psychiatric symptoms during bereavement, but we followed caregivers both before and after the patientís death, and ours was the first to specifically isolate caregiversí risk of developing psychiatric illness as a result of the patientsí place of death,î Wright said.

In response to the findings, researchers recommend finding solutions to increase the prevalence of at-home treatment for advanced cancer patients. Suggested ways of accomplishing this include improving doctor-patient communication and increasing end-of-life discussions with caregivers.