JAMA Oncology: Timely Palliative Care is Associated with Survival for VA Patients with Advanced Lung Cancer

April 2, 2020

Takeaway: For the first time in real-world clinical settings, specialist-delivered palliative care is shown to be associated with an increase in survival among patients with advanced stage lung cancer. 

Palliative care is often underutilized or is delivered too late in the progression of the patient’s disease/condition. This study sought to determine whether the early use of palliative care – received soon after diagnosis – is associated with improved survival, if referral did not occur as part of the dying process. Investigators identified 23,154 VA patients diagnosed with advanced-stage lung cancer from 2007-2013, with follow-up until January 2017. Overall, 13,109 Veterans (57%) received palliative care, and there was a 41% relative increase in the use of palliative care from 2007 to 2013. Findings show:

• Palliative care was associated with survival among patients with advanced lung cancer; however, the timing of palliative care receipt was an important component of this benefit. Palliative care received 31 to 365 days after cancer diagnosis was associated with increased survival, while palliative care received within 30 days of diagnosis was associated with decreased
• Palliative care also was associated with a reduced risk of death in an acute healthcare setting – an important measure of high-quality end-of-life care.

Given the benefits, palliative care should be considered a complementary approach in patients with advanced lung cancer and integration with disease-modifying therapies should be considered earlier in the treatment plan.

Sullivan D, Chan B, Lapidus J, et al. Association of early palliative care use with survival and place of death among patients with advanced lung cancer receiving care in the Veterans Health Administration. JAMA Oncology. September 19, 2019; Epub ahead of print.