In the three-year study, 151 patients with fast-growing lung cancer at Massachusetts General, one of the nation’s top hospitals, were randomly assigned to get either oncology [= anti-cancer] treatment alone or oncology treatment with palliative care — pain relief and other measures intended to improve a patient’s quality of life. They were followed until the end of 2009, by which time about 70 percent were dead. …
"not much can be done" - Um, that's not what palliative care is about. If you want to frame it in terms like that, maybe "opt for including realists in your health care team along with interventionalists," but the media (and this thread's) tendency to focus on length of survival is misguided regardless. Quality of life was better and there was less depression - these were the main outcome measures. The length of life data is solid for this particular patient group (this is the New England Journal, after all), but I wouldn't count on it as a consistently reproducible outcome measure for involvement of palliative care. Most interesting, though. [and don't get me started on whatever vague link some people are making between palliative care professionals and 'death panels,' but if that's a connection that's being formed in some people's minds, then Ms. Palin may have done more damage with her popularization of that phrase than with anything else she may achieve. Okay, you did get me started after all:)]
It's more like a comparison between a group receiving A+C and a group receiving A+B which found that A+B is better. This proves that B is greater than C, but not necessarily that B is positive. The researchers assume C is positive, and so conclude B is also positive.
Even though substantially fewer of them opted for aggressive chemotherapy as their illnesses worsened and many more left orders that they not be resuscitated in a crisis, they typically lived almost three months longer than the group getting standard care, who lived a median of nine months. …
Exactly. This interpretation is consistent with my vague impression that many cancer treatments (e.g. chemo) are very taxing on the body and, when not successful, leave the body in significantly worse shape.
Let's see ... A comparison between a group receiving A and a group receiving A+B shows A+B is better. This is sold as showing the benefits of B instead of A. Run that by me again?
Median survival does not seem like the right measure here since 30% survived through the entire study period. What if the aggressive treatment is more like a gamble: if you are one of the 7/10, it will shorten your life, but if you are one of the 3/10, you actually beat the cancer and live many more years. I don't think the data in the NYT article and excerpt here supports the conclusion.
We should choose how to deal with mental problems?
"not much can be done" - Um, that's not what palliative care is about. If you want to frame it in terms like that, maybe "opt for including realists in your health care team along with interventionalists," but the media (and this thread's) tendency to focus on length of survival is misguided regardless. Quality of life was better and there was less depression - these were the main outcome measures. The length of life data is solid for this particular patient group (this is the New England Journal, after all), but I wouldn't count on it as a consistently reproducible outcome measure for involvement of palliative care. Most interesting, though. [and don't get me started on whatever vague link some people are making between palliative care professionals and 'death panels,' but if that's a connection that's being formed in some people's minds, then Ms. Palin may have done more damage with her popularization of that phrase than with anything else she may achieve. Okay, you did get me started after all:)]
It's more like a comparison between a group receiving A+C and a group receiving A+B which found that A+B is better. This proves that B is greater than C, but not necessarily that B is positive. The researchers assume C is positive, and so conclude B is also positive.
Even when successful, they can leave you with, say, no bladder control. You get another year of life but you spend it wearing a diaper.
This is why quality-of-life measures are an important part of the discussion.
The key lines are as such:
Even though substantially fewer of them opted for aggressive chemotherapy as their illnesses worsened and many more left orders that they not be resuscitated in a crisis, they typically lived almost three months longer than the group getting standard care, who lived a median of nine months. …
Exactly. This interpretation is consistent with my vague impression that many cancer treatments (e.g. chemo) are very taxing on the body and, when not successful, leave the body in significantly worse shape.
Should we avoid optimistic Doctors and and opt for the guys who tell us not much can be done?
Let's see ... A comparison between a group receiving A and a group receiving A+B shows A+B is better. This is sold as showing the benefits of B instead of A. Run that by me again?
Median survival does not seem like the right measure here since 30% survived through the entire study period. What if the aggressive treatment is more like a gamble: if you are one of the 7/10, it will shorten your life, but if you are one of the 3/10, you actually beat the cancer and live many more years. I don't think the data in the NYT article and excerpt here supports the conclusion.