Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer

The authors randomly assigned patients with metastatic lung cancer to receive either standard oncologic care or early palliative care, focused on symptom control and psychosocial support for patients and families, together with standard oncologic care. Patients receiving early palliative care had lower rates of depression, a better quality of life, and better mood scores. They also received less aggressive care at the end of life, but surprisingly, had significantly longer survival than did patients receiving standard care alone. The quality of care and the use of medical services for seriously ill patients are key elements in the ongoing debate over reform of the U.S. health care system. 1 Oncologic care is central to this debate, largely because anticancer treatments are often intensive and costly. 2 Comprehensive oncologic services for patients with metastatic disease would ideally improve the patients' quality of life and facilitate the efficient allocation of medical resources. Palliative care, with its focus on management of symptoms, psychosocial support, and assistance with decision making, has the potential to improve the quality of care and reduce the use of medical . . .