Early pain relief and support give cancer patients better end of life

PEOPLE WITH advanced cancer need earlier access to specialist care to improve their quality of life in the weeks before they die, new research has found.

University of Leeds researchers found that patients who received longer periods of palliative care – designed to make them comfortable through pain relief and emotional support – were less likely to be admitted to hospital as an emergency before they died.

Patients given earlier palliative care were also more likely to be given pain relief with opioid drugs and were less likely to have aggressive anti-cancer treatment close to death.

The study, funded by Harrogate-based Yorkshire Cancer Research, used data from 2,479 adults who died of cancer between January 2010 and February 2012 in Leeds.

It was the first UK study of its kind in a large population.

Lead author Dr Lucy Ziegler, Yorkshire Cancer Research academic fellow, said: “Previous studies have shown that palliative care intervention is associated with an increased proportion of deaths at home and a reduction in emergency admissions.

“However, no study has investigated when and for how long patients need access to this care in order to receive quality-of-life benefits. Our research shows that for those with advanced cancer, access to palliative care and longer duration of care are significantly associated with better end-of-life quality indicators.

“Our study provides new evidence to support the early integration of palliative care for cancer patients.”

The study found that people who received palliative care more than two weeks before death were significantly more likely to die in a hospice than hospital.

When palliative care was given more than four weeks before death, patients were less likely to be admitted to hospital as an emergency. The researchers found that access to palliative care was associated with being twice as likely to have access to strong opioids for pain relief.

Up to 86 per cent of patients with advanced cancer suffer moderate to severe pain before death.

The study also found that palliative care being given more than 32 weeks before death was linked to a reduction in chemotherapy in the last four weeks of life.

Elsewhere, news has been welcomed that a “life-changing” drug for breast cancer patients has been given the final go-ahead for routine NHS use in England.

The National Institute for Health and Care Excellence (NICE) issued its final decision recommending Perjeta, also known as pertuzumab, for some women with breast cancer.

The drug previously had to be accessed through the Cancer Drugs Fund.

NICE recommended the drug for use for women with HER 2 positive breast cancer which has returned to the breast but is inoperable, or where it has spread to other parts of the body, in combination with other medication.

Baroness Delyth Morgan, chief executive at the charity Breast Cancer Now, said: “Perjeta is a truly life-changing drug and we are absolutely delighted and relieved that Nice has finally been able to recommend it for routine NHS use in England.”

The decision on the drug was announced as latest figures showed that the number of women taking up breast screening had fallen to its lowest level in a decade.

Just 71.1 per cent of women in England aged 50 to 70 took up invitations for routine screening in 2016-17 – down 1 per cent from the previous year.

Study provides evidence to support early integration of palliative care. Lead author and Yorkshire Cancer Research academic fellow Dr Lucy Ziegler.