Patients With Cancer Still Get Therapy at End of Life
Terminal patients with cancer continue to get systemic therapy in the last weeks of life, despite concerns about such care’s cost and utility, new research shows.
The rate of systemic anticancer therapy within 30 days of death across all cancer types remained the same — 39% — between 2019 and 2015, according to the study published in JAMA Oncology. Within 14 days of death, about 17% continued to receive treatment. The type of treatment during that time did shift somewhat: Patients received less chemotherapy and more immunotherapy, the study finds.
Why it matters: Previous research shows that systemic anticancer therapy at the end of life is associated with later hospice enrollment, higher cost, and potentially adverse quality and length of life.
Drop in chemo: Chemotherapy use declined from 26% in 2015 to 16% in 2019. Immunotherapy jumped more than threefold, to 18% in 2019 from 5% in 2015.
Public Divided on Organ Donor Deemed Consent
The public is divided on deemed consent laws, under which residents are presumed to agree to postmortem organ donation unless they opt out, according to a new descriptive study. The study, published in the Clinical Journal of the American Society of Nephrology, assessed public reaction to the passage by two Canadian provinces of the first deemed consent laws in North America in 2019.
“One of the themes that came out from our study is the general public’s distrust of the government and healthcare system,” said study author Ngan N. Lam, MD, an associate professor of nephrology at the University of Calgary.
Positive comments: “It is easier for a few to opt out than to require the majority to opt in,” one person said. “This system is going to help many people in need of an organ,” another suggested.
Negative comments: “The state should not presume that it can harvest your organs without your explicit consent,” according to another person. “What next, required donation?” another agreed.
Nausea Neural Pathway Revealed?
The neural pathway that leads to nausea and vomiting may have been identified by a new animal study, The New York Times reports. The study, published in Cell, found what may be the mechanism by which both bacteria and chemotherapy drugs trigger the same molecular pathways in the gut that lead to vomiting.
The findings, based on experiments with mice, suggest a way to counter nausea caused by chemotherapy medication and other drugs.
The mechanism: The study identified certain neurons in the brain that released neurotransmitters when a drug or toxin reached the gut and the cells in the small intestine that reacted. A central player in the pathway to nausea was an immune system molecule called interleukin 33 (IL-33).
The implication: It’s possible that drugs that interfere with IL-33 or other players in the pathway could help alleviate the suffering of people treated with chemotherapy.
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