It has been reported that early palliative care for patients with lung cancer has optimized the final timing of chemotherapy and has led to improvements in both of quality of life, mood and survival of patients with lung cancer in the United States. On the other hand under Japanese health care system, the effect of introducing palliative care early after diagnosis for patients with cancer has not been clear. First of all, it is necessary to elucidate the difference of medical care for cancer between oncologist and palliative physicians.Objective
To research precise picture of Medical care for cancer on oncologist retrospectively and compare to concurrent research on palliative physicians.Methods
We examined medical records of 244 cases died of cancer from January to December 2010 at the facilities participating Hokkaido Team Oncology Meeting (HOME) of which consisted oncologists, palliative physicians, nurses and pharmacist belonging our center hospital and cooperating facilities. Then we compared these records to 230 cases concurrently investigated introducing palliative care by the palliative physicians.Results
The median time to death from date of last treatment was 39.5 days; this time was short in breast and colorectal cancer, long in liver and lung cancer. Chemotherapy within 14 days of death was carried out in 32 patients (23%), and in 14 patients with lung cancer (18%) was similar to the case of lung cancer in the US Cases of sedation with opioids alone carried out by oncologist was higher than that carried out by palliative physicians significantly (P < 0.004).Conclusion
Termination time of chemotherapy for patients varies depending on what type of cancer. But Oncologist did not tend to select the chemotherapy until the last minute of life in this study. Sedation method was clearly different between oncologist and palliative physicians. Early sedative intervention by palliative physicians suggested to be able to provide high-quality end-of-life care. In future we examine the influence of cancer species and health care system, evaluation of QOL and method of intervention, and then we will plan a prospective clinical trial.