For cancer patients nearing the end of life, deciding whether to continue treatment or focus on comfort is deeply personal.
However, a new study from Rutgers Health, published in Cancer, suggests that the decision isn’t always based on the patient’s wishes—it may depend on their oncologist’s habits.
Doctor’s choice or patient’s choice?
The study, led by Login S. George, a researcher at Rutgers Institute for Health, found that oncologists have a major influence on whether a patient receives chemotherapy or other cancer treatments in their final weeks of life.
Even though clinical guidelines recommend stopping chemotherapy when it no longer provides benefits, some oncologists continue to prescribe it—while others don’t.
George explains, “A patient’s final days often don’t reflect what they want, but rather who their oncologist is. The data suggests that treatment decisions are often based on a doctor’s routine approach rather than the patient’s preferences.”
Study findings: who gets treatment?
The researchers analyzed data from 17,609 patients who died of breast, lung, colorectal, or prostate cancer between 2012 and 2017.
They studied billing records from Medicare to track chemotherapy and other cancer treatments given in the last two weeks of life.
They found:
- Patients with “high-prescribing” oncologists were 4.5 times more likely to receive treatment in their final days compared to those with “low-prescribing” oncologists.
- Breast cancer patients were more likely to receive late-stage treatment compared to lung cancer patients.
- Colon and prostate cancer patients had similar treatment rates to lung cancer patients.
- Black patients were less likely to receive treatment in the last month of life compared to white patients.
- Unmarried patients (single, divorced, or widowed) were also less likely to receive late-stage treatment compared to married patients.
Because the study used anonymous data, researchers couldn’t identify specific oncologists or clinics. However, the results highlight a major gap between treatment guidelines and real-life decisions.
Should patients have more information?
George believes patients should have access to information about their oncologists’ treatment habits—just like people check restaurant reviews before dining out.
“When we shop or eat out, we look at ratings and reviews. Shouldn’t cancer patients have the same right?” he asked.
The study raises an important question: Should patients have more transparency about how different doctors approach end-of-life care?
Future research will explore why oncologists and patients make different choices between continued treatment and hospice care.
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Source: KSR.
