This raises a tough question: should patients who know they are going to die soon spend a substantial amount of what little time they have left undergoing aggressive and difficult treatment — treatment likely to bring them only a brief period of additional life?
"It's about balancing quality and quantity of life, really," said Dr. Casey Boyd, a University of Texas Medical Branch at Galveston surgery resident and lead author of a paper analyzing the problem in the current issue of Annals of Surgical Oncology. "For pancreatic cancer we know the quantity of life is short, so maximizing the quality of life is important — and the best way we can do that is to give patients concrete data that they can look at and use in their treatment decisions."
Boyd and her colleagues approached the issue by drawing on the National Cancer Institute's Surveillance, Epidemiology and End Results database, examining SEER records for 25,476 pancreatic cancer patients and focusing on two factors that directly affect patients' lives: hospital days and days spent in medical care. (Hospital days were days spent as hospital inpatients, while medical care days included days in the hospital as well as other days on which the patient visited a physician, underwent a diagnostic test, or received a treatment).
"This study is the first to bring together hospital and medical care days in pancreatic cancer patients with stage, treatment and survival, and it gives us a quantitative look at the whole experience of a patient with pancreatic cancer," Boyd said. "We hope that physicians can use the information in this paper to give patients what they need to make critical decisions."
For example, Boyd said, a doctor could draw on the paper to counsel a patient with metastatic pancreatic cancer — the most common and deadly type. "The physician could say, if you have chemotherapy you may live four to six weeks longer, but a lot of that time you're going to be in the hospital, or getting a test, or getting a needle poked in your arm for your chemotherapy," she said. "Some patients may say, I want that, I want the most life that you can give me."
Others, she noted, might make a different choice if given an accurate picture of the treatment experience.
"They might say, it's not really worth it to me — it's a few extra weeks, but they may be miserable weeks," Boyd said. "They may decide not to have any treatment and maybe just have hospice, or just spend time with their family."
The ability to help patients make such difficult decisions was the main goal of the study, according to Boyd.
"Really, this paper is about empowering the patient," she said. "We want to provide them with the information they need to make their own personalized treatment decisions."
Other authors of the Annals of Surgical Oncology article include medical student Daniel Branch, assistant professor Kristin Sheffield, biostatistician Yimei Han, associate professor Yong-Fang Kuo, Sealy Center on Aging director Dr. James Goodwin and associate professor Dr. Taylor Riall. Support for this research was provided by the NCI; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services Inc.; the SEER program; and the Cancer Prevention Research Institute of Texas.
Jim Kelly | EurekAlert!
The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
21.09.2017 | Physics and Astronomy
21.09.2017 | Life Sciences
21.09.2017 | Health and Medicine