Early intervention can lead to a better quality of life and fewer depressive symptoms, writes LORNA SIGGINS
THE IRISH Association for Palliative Care (IAPC) has described as “very significant” the findings of new research on seriously ill patients seeking support.
Patients who avail of earlier palliative care can live longer and enjoy a better quality of life, according to the research published last year in the New England Journal of Medicine.
The study of people newly diagnosed with metastatic non-small cell lung cancer involved randomly assigning them into two groups.
One group received “standard oncologic care” for their serious condition while the other got the same, but were also given early palliative care referral.
After 12 weeks, researchers found that the group with palliative care involvement had experienced a better quality of life, and recorded a lower incidence of depressive symptoms.
Significantly, this group also lived longer by an average period of three months, according to the research.
Commenting on the findings, former IAPC chairwoman and palliative care consultant, Dr Regina McQuillan, said it wasn’t clear why this longer life span had occurred, but it was very positive.
“Perhaps better symptom control allowed the patients to better tolerate active treatment, perhaps because they were less depressed,” she said.
“But the survival advantage is large, and equates with that which chemotherapy brings,” she said.
“In other words, if a new chemotherapy agent was found to bring this length of added survival, it would constitute major news around the world. Patients would be clamouring for the treatment.”
Dr McQuillan cautioned that the study had its limitations, as it was conducted in just one institution and only patients with lung cancer were studied. The numbers involved, while “statistically significant”, were also small, she said.
“Nevertheless, it may be the study that inspires other papers that will provide the evidence for us to reliably tell our referrers that we can help patients live longer,” she said.
“Judging when the time is right to refer a patient to palliative care is a contentious issue, and practice can vary enormously.”
From a palliative care perspective, referrals tended to be later than was best, said Dr McQuillan. The research could help in communication with the “reluctant referrer”, the patient or family or both, she noted.
IAPC chief executive Mary Ainscough said that most people associated palliative care with cancer and with end-of-life care, but patients could have “many years where they are not at this stage”.
“There are long conditions that are not curable, but need support for quality of life,” she said. “We want to get the message out there about what it means.”
The IAPC has recently appointed Dr Philip Larkin as its new chairman to succeed Dr McQuillan. Dr Larkin is professor of clinical nursing (palliative care) at University College Dublin and Our Lady’s Hospice and Care Service, Harold’s Cross, Dublin.