Palliative Care
JANUARY 10, 2011
Quality of life improvement, half the rate of depression and a longer life. It's not a junk email pitch. It's what researchers learned about the benefits of early palliative care in patients with advanced lung cancer.

Kathryn Borgenicht, MD, is medical director of Palliative Care at Bozeman Deaconess Hospital. She says patients who receive a diagnosis of serious illness often worry that if they begin palliative care they can no longer receive treatment. “This study, published in the August 19 issue of The New England Journal of Medicine, is the first to show that that the sooner we begin a team approach that focuses on managing pain, symptoms, and emotional distress the better for patients,” Dr. Borgenicht states.

Researchers compared patients diagnosedwith small cell lung cancer who received standard care with those who were given palliative care—in addition to standard care—right after diagnosis. "The patients who received palliative care in addition to standard care had marked improvement in quality of life, a 50 percent lower rate of depression and they lived 2.5 months longer than patients not receiving palliative care early," said study author Dr. Jennifer S. Temel, an assistant professor of medicine at Harvard Medical School and a thoracic oncologist at Massachusetts General Hospital in Boston. "In this disease, two months is a significant amount of time, " she said. "We were all surprised with the magnitude of the impact."

Dr. Borgenicht says she anticipates, thanks to the study, more patients with serious illness will accept palliative measures early on in their illness rather than holding off, bearing pain and anxiety. “With palliative care, we can help patients focus on quality of life during the time they have to live—however long that may be,” she said.

The study showed that patients in the palliative care group lived an average of 11.6 months, while those in the standard caregroup lived less than nine months. "This was true even though those people seen by palliative care tended to opt for less aggressive chemotherapy as their illnesses worsened and many more have orders that they not be resuscitated in a crisis, " Dr. Borgenicht notes.

The Palliative Care consult service at Bozeman Deaconess Hospital is currently in its 6th year. The team includes Dr. Borgenicht, nurse practitioners who specialize in palliative medicine, social workers, spiritual counselors, massage therapists and music therapist. Dr. Borgenicht is board certified in palliative medicine. “We work with patients who have serious illness and their families to help address symptoms that may not be controlled, ” she says. “In addition, the team often helps the patient understand the nature of their disease and their preferences for treatment.”

In addition to hospitalized patients, Dr. Borgenicht sees those who have serious illness and may need a palliative care evaluation in her Bozeman Deaconess Internal Medicine Associates clinical practice.


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