This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Earle, C. C. Articles by Ayanian, J. Z. Search for Related Content PubMed PubMed Citation Articles by Earle, C. C. Articles by Ayanian, J. Z. Social Bookmarking                            What's this?

Aggressiveness of Cancer Care Near the End of Life: Is It a Quality-of-Care Issue?

Craig C. Earle, Mary Beth Landrum, Jeffrey M. Souza, Bridget A. Neville, Jane C. Weeks, John Z. Ayanian

From the Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute; Department of Health Care Policy, Harvard Medical School; and the Division of General Medicine, Brigham and Women's Hospital, Boston, MA

Corresponding author: Craig C. Earle, MD, MSc, Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room G-106, Toronto, Ontario, M4N 3M5 Canada; e-mail: craig.earle{at}ices.on.ca

The purpose of this article is to review the literature and update analyses pertaining to the aggressiveness of cancer care near the end of life. Specifically, we will discuss trends and factors responsible for chemotherapy overuse very near death and underutilization of hospice services. Whether the concept of overly aggressive treatment represents a quality-of-care issue that is acceptable to all involved stakeholders is an open question.

Supported by Grant No. CA 91753-02 from the National Cancer Institute.

Presented in part at 42nd Annual Meeting of the American Society of Clinical Oncology, June 2-6, 2006, Atlanta, GA.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. T. Tang, S.-C. Wu, Y.-N. Hung, J.-S. Chen, E.-W. Huang, and T.-W. Liu Determinants of Aggressive End-of-Life Care for Taiwanese Cancer Decedents, 2001 to 2006 J. Clin. Oncol., September 20, 2009; 27(27): 4613 - 4618. [Abstract] [Full Text] [PDF]

				M. Bakitas, K. D. Lyons, M. T. Hegel, S. Balan, F. C. Brokaw, J. Seville, J. G. Hull, Z. Li, T. D. Tosteson, I. R. Byock, et al. Effects of a Palliative Care Intervention on Clinical Outcomes in Patients With Advanced Cancer: The Project ENABLE II Randomized Controlled Trial JAMA, August 19, 2009; 302(7): 741 - 749. [Abstract] [Full Text] [PDF]

				T. Salz and N. T. Brewer Offering Chemotherapy and Hospice Jointly: One Solution to Hospice Underuse Med Decis Making, July 1, 2009; 29(4): 521 - 531. [Abstract] [PDF]

				K. Hashimoto, K. Yonemori, N. Katsumata, M. Hotchi, T. Kouno, C. Shimizu, K. Tamura, M. Ando, M. Takeuchi, and Y. Fujiwara Factors That Affect the Duration of the Interval Between the Completion of Palliative Chemotherapy and Death Oncologist, July 1, 2009; 14(7): 752 - 759. [Abstract] [Full Text] [PDF]

				R. E. Enck Broadening the Horizon of Treatment or Is the Grass Always Greener on the Other Side? American Journal of Hospice and Palliative Medicine, April 1, 2009; 26(2): 73 - 74. [PDF]

				D. Z.J. Chu Quality of Care Review: Some Progress, and Toward What Goal? J. Clin. Oncol., March 20, 2009; 27(9): 1524 - 1524. [Full Text] [PDF]

				K. A. Lorenz Progress in Quality-of-Care Research and Hope for Supportive Cancer Care J. Clin. Oncol., August 10, 2008; 26(23): 3821 - 3823. [Full Text] [PDF]