title: Aggressiveness of cancer care near the end of life: is it a quality-of-care issue?
abstract: The purpose of this article is to review the literature and update analyses pertaining to the aggressiveness of cancer care near the end of life. Specifically, we will discuss trends and factors responsible for chemotherapy overuse very near death and underutilization of hospice services. Whether the concept of overly aggressive treatment represents a quality-of-care issue that is acceptable to all involved stakeholders is an open question.
authors.affiliation: Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. craig.earle@ices.on.ca
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Landrum
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Souza
authors.forename: Bridget A
authors.initials: BA
authors.lastname: Neville
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D011785:Quality Assurance, Health Care; D018426:SEER Program; D013727:Terminal Care / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends
chemical_list: D000970:Antineoplastic Agents