Advanced NSCLC Patients Still Receive Aggressive Treatment

by U.S. Medicine

February 9, 2018

PROVIDENCE, RI—Aggressive care for cancer patients appears to be increasing at the end of life, and the VA is part of that trend, according to a new study.

The report published in the Journal of Palliative Medicine found that invasive procedures are commonly performed when veterans with Stage IV non-small cell lung cancer (NSCLC) reach their last month of life.1

To evaluate the use of invasive procedures at the end of life in patients with advanced NSCLC, researchers from the Center of Innovation at the Providence, RI, VAMC and the Alpert Medical School of Brown University conducted a retrospective cohort study of veterans with newly diagnosed stage IV NSCLC who died between 2006 and 2012. Records of 19, 930 patients were pulled from the VA Central Cancer Registry.

Including all VA and Medicare fee-for-service healthcare utilization and expenditure data, the primary outcome was the number of invasive procedures performed in the last month of life. Procedures were classified into three categories: minimally invasive, life-sustaining and major-operative procedures.

Results indicated that 15.1% of subjects underwent 5,523 invasive procedures during the last month of life. The majority of procedures (69.6%) were classified as minimally invasive.

The receipt of procedures in the last month of life was associated with receipt of chemotherapy (odds ratio [OR] 3.68, 95% confidence interval [CI] 3.38-4.0) and ICU admission (OR 3.13, 95% CI 2.83-3.45) and was inversely associated with use of hospice services (OR 0.35, 95% CI 0.33-0.38), the study authors noted.

  1. Tukey MH, Faricy-Anderson K, Corneau E, Youssef R, Mor V. Procedural Aggressiveness in Veterans with Advanced Non-Small-Cell Lung Cancer at the End of Life. J Palliat Med. 2017 Dec 21. doi: 10.1089/jpm.2017.0022. [Epub ahead of print] PubMed PMID: 29265906.

Related Articles

VA/National Cancer Institute Partnership Increases Veteran Access to Trials

Thanks to a new partnership between the National Cancer Institute and the VA, veterans with cancer will now have greater access to potentially lifesaving clinical trials.

VA Continues Hepatocellular Screening, but Study Questions the Value

Although a recent study determined that screening veterans with cirrhosis for hepatocellular carcinoma did not reduce the risk of death associated with liver cancer, the VA has no plans to change its screening practices.

U.S. Medicine Recommends

More From department of veterans affairs

Department of Veterans Affairs (VA)

VHA Makes Progress in Improving Safety of Opioid Prescribing

VHA medical facilities should ensure that its providers are following three key opioid risk mitigation strategies, including conducting urine drug screening, a recent report recommended.

Department of Veterans Affairs (VA)

VA faces healthcare staffing shortages, barriers to hiring facility leaders

A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.

Department of Veterans Affairs (VA)

Veteran nephrologist labors to improve ESRD treatment at VA

When Terrence O’Neil, MD, retired as chief of nephrology at the James H. Quillen VAMC in Johnson City in December 2016, he left in his wake decades of work treating kidney disease—nearly 35 years in the Air Force and DoD, plus 11 more at VA.

Department of Veterans Affairs (VA)

Committee approves bill to provide agent orange benefits to ‘blue water’ vets

A long sought-after bill that would make it easier for Blue Water Navy veterans to receive Agent Orange benefits has been passed by a key House of Representatives committee.

Department of Veterans Affairs (VA)

Bill to Streamline, Expand VA’s Choice Program Signed Into Law

Legislation that would streamline VA’s community care programs into one program and expand VA’s caregiver program to veterans of all eras was signed into law earlier this month..

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up