Make early palliative care and a goals conversation part of every advanced-cancer pathway
Chemotherapy in the last two weeks of life rarely helps and costs a great deal; patients who have an early conversation about what matters to them choose it less often and live at least as long.
Overview
Randomised trials of early specialist palliative care alongside cancer treatment in advanced lung and other cancers have shown better quality of life, less aggressive end-of-life care and, in some trials, longer survival. ASCO's Choosing Wisely list names chemotherapy for patients with poor performance status and no benefit from prior treatment as care to avoid. Embedding a structured serious-illness conversation at the start of any non-curative line, and automatic palliative referral at metastatic diagnosis, changes the default without restricting anyone's choice.
- Pain relief and palliative care are unavailable to most · Most people who die of cancer worldwide do so without adequate pain relief.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
Pages like this
not linked directly; found by shared links- IdeaMeasure and publish pain control rates in every cancer centre
Shares Pain relief and palliative care are unavailable to most, Toxicity and quality of life are undervalued.
- IdeaA public equity index for trial sites and sponsors, tied to funding
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
- IdeaCap public prices for new cancer drugs to tiers of the ESMO and ASCO value scales
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
- IdeaPay oncologists for the time it takes to enrol a patient
Shares American Society of Clinical Oncology (ASCO), Incentives reward me-too drugs and marginal gains.
- IdeaMake skipping radiotherapy the default for very low-risk breast cancer
Shares Incentives reward me-too drugs and marginal gains, Toxicity and quality of life are undervalued.
- IdeaA public fund for trials that test less treatment
Shares Incentives reward me-too drugs and marginal gains, Toxicity and quality of life are undervalued.
- PersonDame Cicely Saunders
Shares Pain relief and palliative care are unavailable to most, Toxicity and quality of life are undervalued.
- TechnologyAcupuncture and acupressure for chemotherapy nausea
Shares Multinational Association of Supportive Care in Cancer, Toxicity and quality of life are undervalued.