Patients with terminal cancer live longer when cared for at home
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A new study shows that patients with terminal cancer tend to live longer when they choose to die at home instead of in the hospital.

Why it matters:

Previous studies have shown that most people would prefer to die in the comfort of their own homes. But many are concerned that they’ll die sooner at home because the medical care will be less comprehensive.

The nitty gritty:

Researchers studied the final days of over 2,000 terminal cancer patients in Japan. In terms of longevity, they found that patients who received palliative care at home didn’t fare any worse than those who received it in the hospital. In fact, those who were sickest — with either days or weeks to live — actually lived longer if they chose to die at home.

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Those who doctors predicted had days to live gained an additional 4 days, while those with weeks to live gained 7 days. That was despite the fact that patients in home palliative care were less likely to be given IV fluids and antibiotics, the authors reported in the journal Cancer.

What they’re saying:

There is a delicate tipping point where life-prolonging treatments become counterproductive, ineffective, burdensome, and may even hasten death. For doctors treating very sick patients, said Dr. VJ Periyakoil, associate professor of medicine at Stanford University, “that’s hard for us to wrap our minds around.” Being too aggressive with medical care may “take away both quality and quantity of life.”

But keep in mind:

Choice is the central factor here; the study does not imply that home-based palliative care is always preferable to a hospital setting, said lead investigator Dr. Jun Hamano.

But home-based care can be quite costly. Thus this study provides more “fuel to the fire for policy makers,” said Dr. Cardinale Smith, assistant professor at Mount Sinai, “so that we can provide this care to all of those who need it.”

The bottom line:

The study suggests that patients who want to die at home shouldn’t be concerned that they will have fewer days to live in that setting.

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