Intensity of diagnostic and treatment activities during the end of life of patients with advanced breast cancer

Abstract

The aim of this study was to assess the intensity of diagnostic testing and cancer treatment of 335 women with advanced breast cancer during their last 6 months before death between 1995 and 1998 in the Pirkanmaa and Satakunta health care districts and to compare it to the practice in earlier decades, the 1970s and 1980s. Data for 1990s material were collected from medical records in 30-day periods starting from the patient’s death backwards. In this material 46.9% of all laboratory tests and 40% of radiological tests during the last 6 months of life were made during the last 2 months prior to death. In the last month 63.9% of patients continued on endocrine therapy and 19.7% on chemotherapy. Patient symptoms and deterioration in general condition showed the appropriate point to discontinue cancer-related treatment and concentrate on palliation of symptoms to be about 2 months prior to death. Resources devoted to diagnostic investigations and treatment of cancer in terminally ill patients could be better used for their care. This would be more likely to improve patients’ quality of life and save resources.