End-of-life conversations begun early lessen risk of unnecessary, aggressive procedures

Having an end-of-life conversation with the terminally ill may help avoid unnecessary and aggressive treatment just before death.

Researchers at the Dana-Farber Institute in Boston found that when those discussions happened at least 30 days before the person's death, late-stage chemotherapy was less likely to be prescribed.

In those who had end-of-life discussions with their physicians less than 30 days before dying, about half received some kind of aggressive treatment, said Reuters.

The study authors stressed that their research did not mean they condemn aggressive end-of-life treatment.

"Aggressive care is not necessarily wrong for individuals at end of life," they said, according to MedPage Today.

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"It may fit with the preferences of select patients who want to pursue life prolongation at any cost. But most patients who recognize that they are dying do not want such care."

It is usually recommended that end-of-life discussions begin soon after the diagnosis with incurable cancer.

Yet, doctors often wait until the patient's health signficantly deteriorates and they are hospitalized before having the conversation.

"Physicians seem to wait until the patient begins deteriorating medically, a strategy that leads to a high incidence of inpatient discussions," they wrote, according to Reuters.

"Instead, physicians should consider moving conversations closer to diagnosis and initiating conversations while the patient is doing comparatively well, so the patient has time to plan for more difficult times in the future."

The findings were published in the Journal of Clinical Oncology.