title: Diagnosis matters: the differing  clinical trajectories for terminal prostate,  lung and haematological cancers.
abstract: BACKGROUND
  There is a belief that end-of-life care issues are similar for all cancer patients, irrespective of their primary cancer diagnosis. This exploratory study into the terminal trajectories of three common cancers challenges this belief.
  
  
  METHODS
  A retrospective, systematic, and mixed qualitative and quantitative medical record review of 30 deceased patients in 2010 was performed between two Victorian networks. The last 90 days of life were examined in three equally distributed cancer groups - prostate, lung and haematological.
  
  
  RESULTS
  The trajectories for the three malignancies differed in temporal, symptomatic, supportive and interventional characteristics.
  
  
  CONCLUSIONS
  Our study suggests diagnosis does indeed matter. The varying symptomatology for the different cancers markedly influenced clinical management, utilisation of palliative care services and the site of care and site of death. Our study suggests potential areas for better collaboration between general practitioners, community and specialist palliative care services. Emerging work supports our findings, but this area warrants further research.
authors.affiliation: BSc (Hons), MBBS, MRCGP, FAChPM (RACP), Palliative Care Physician, Supportive and Palliative Care Unit, Monash Health and Monash University, Clayton, VIC.
authors.forename: Leeroy
authors.initials: L
authors.lastname: William
authors.forename: Kate
authors.initials: K
authors.lastname: Jackson
authors.forename: Adam
authors.initials: A
authors.lastname: Bostanci
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ward
authors.forename: Peter
authors.initials: P
authors.lastname: Martin
authors.forename: Lise
authors.initials: L
authors.lastname: Pittman
authors.forename: Gaye
authors.initials: G
authors.lastname: Moore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058006:General Practice; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D013727:Terminal Care