'Wiser' Surgeries for Those With Terminal Cancers

Surgeons are focusing on life-enhancing procedures for patients, study finds

By Robert Preidt

Monday, May 11, 2015

MONDAY, May 11, 2015 (HealthDay News) -- While surgery rates for patients with late-stage, terminal cancers have stayed about the same in recent years, complications and deaths for these patients have fallen because surgeons are more selective about who has surgery, a new study finds.

"Surgeons are becoming wiser," study author Dr. Sarah Bateni, a surgery resident at the University of California, Davis, said in a university news release.

"Our research suggests that surgeons may be operating on healthier patients who are more likely to recover well from an operation," she said. "These are patients who can perform activities of daily living without assistance, for example."

As Bateni explained, there are a number of reasons why surgeons might operate on late-stage cancer patients.

"Some of it has to do with the patients and families," she said. "If the patient is uncomfortable, the family wants a solution. In some cases, the surgeon also may be too optimistic about what the surgical outcome will be."

Still, the decision to undergo a surgery is a difficult one, because patients with late-stage cancer who have such procedures are at high risk for complications and death.

"It is common that patients end up dying in the intensive care unit instead of being managed with medication with hopes of returning home with their families, including with hospice care," Bateni noted.

In the study, her team tracked nearly 22,000 patients in the United States who had late-stage cancer between 2006 and 2010. The study found only a slight decline in the use of surgeries -- from 1.9 percent to 1.6 percent of all procedures performed on the patients.

The most common type of surgery was the removal of bowel obstructions in patients with cancers that had spread from their original location.

However, Bateni's team also found that, over the study period, doctors became more likely to restrict surgery to healthier patients, such as those who were more independent and did not experience dramatic weight loss or a serious blood infection called sepsis.

The researchers also found that rates of illness linked to the procedure among the patients fell from about 34 percent in 2006 to about 27 percent in 2010, and that the death rate fell from 10.4 percent to 9.3 percent during that time.

The study was published recently in the Journal of Surgical Research.

SOURCE: University of California, Davis, news release, May 1, 2015

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