The utilization of palliative care in gynecologic oncology patients near the end of life

The Prevalence and Impact of Invasive Procedures in Women with Gynecologic Malignancies Referred to Hospice Care

“…There is no question that the study of palliative care and hospice is of growing interest in the field of gynecologic oncology. Currently, available literature hastypically extracted all deceased patients and then compared those who did or did not use hospice care [4][5][6][7][8]. Of these, there are a few that addressed procedures.Keyser et al in 2010 concluded that patients not on hospice were more likely to undergo invasive procedures 55% versus 31% [8].…”

“…The most common invasive procedures were paracentesis, gastrostomy tube placement and surgery. The most recent publication by Fauci et al examined the use of palliative care services in the last six months of life [4]. They concluded that 71.2% of patients underwent treatment with chemotherapy or radiation in the last six months of life and 58.6% had a procedure performed during that time.…”

“…This may be reflective of the society's endorsement of the early use of palliative care services with advanced or symptomatic disease [3]. With this trend, more literature has been dedicated to discussing hospice care in the gynecological oncology patient population [4][5][6][7][8][9][10][11][12]. The goal of hospice is to provide compassionate, holistic care for patients and their families and to maximize quality of life through a variety of methods [13].…”

“…Despite these findings, a large part of palliative care involves invasive procedures ranging anywhere from 30-60% in this patient population [4,8]. Common invasive procedures in the gynecologic oncologic patient population include paracentesis, thoracentesis, gastric tube placement, catheter and drain placements and even major surgery for the purposes of symptomatic relief [4].…”

“…Common invasive procedures in the gynecologic oncologic patient population include paracentesis, thoracentesis, gastric tube placement, catheter and drain placements and even major surgery for the purposes of symptomatic relief [4]. Physicians struggle with an ongoing dilemma regarding futility of certain aspects of care, particularly continuing invasive interventions [4]. Despite this important question, there is limited data that addresses the issue of preforming interventions on hospice patients and the impact this may cause.…”