End-of-Life Care: Where Does the Standard Oncology Care Fail Our Patients and What Do We, as Oncologists, Need to Do Differently?

The study by Zhang et al¹ presents the final results of the Coping With Cancer (CWC) study, which is the most comprehensive, prospective study on end-of-life (EOL) care to date, examining patients, caregivers, and health care system end points, and for this the authors need to be congratulated. It puts in order of importance the predictors for better quality of life (QoL) for patients at the EOL. Essentially the 9 predictors can be divided into 2 groups. The first group, ie, intensive care unit admission, hospital deaths, site of cancer care, use of feeding tube, and chemotherapy in the last week in life, reflects aggressiveness of EOL care. The second group, ie, patient worry, religious prayer or meditation, pastoral care, patient-physician therapeutic alliance, reflects psychological/religious-spiritual met or unmet needs and coping mechanisms.