Clinical Operational Research Unit (CORU)


NCEPOD report highlights concerns over chemotherapy

19 May 2011

A report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) on 13 November 2008 has raised concerns about the use of cancer therapy to treat patients close to the end of life. In a study of more than 600 cancer patients who died within 30 days of receiving chemotherapy, the treatment was found to have probably caused or hastened death in 27% of cases.

The report, titled ‘For better, for worse?’, examines the quality of care provided for this selected group of patients (estimated at 2% of those receiving chemotherapy). Clinical practice and hospital facilities are reviewed and recommendations made on how current cancer services could be improved. Among its contributors were Dr Martin Utley and Professor Steve Gallivan of CORU (Clinical Operational Research Unit), who act as Scientific Advisors to NCEPOD.

Although 35% of the study’s patients who died within 30 days of receiving chemotherapy were found to have been given good care, the report’s co-author Mr Mark Lansdown, Surgical Oncologist at the Leeds Teaching Hospital, stated that NCEPOD advisors believed that more than 1 in 4 of the patients in the study had died due to contributory factors from the treatment. The majority of the patients involved in the study were receiving the treatment with the aim to “alleviate symptoms of cancer with the minimum of side-effects”, but 14% of the subjects were patients for whom the treatment was intended to cure them of their cancer. According to Mr Lansdown, 43% of patients in all suffered significant treatment-related toxicity.

NCEPOD advisors also found that the decision to treat with chemotherapy was inappropriate in 19% of cases, and raised questions about whether cancer patients are given enough information about chemotherapy to allow them to give informed consent to treatment.

Despite these findings, Professor Tom Treasure, Chair of NCEPOD and an Honorary Professor at CORU, said that cancer treatment in the UK today is enormously successful: “Chemotherapy has transformed the outlook for many cancer patients. However, our study asked difficult questions and found some unpalatable answers about decisions made in the weeks before [the patients] died. These merit careful consideration and we have made recommendations for how things could be improved upon.”

For further please see the original UCL news story.

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