Gastroesophageal cancer patients need earlier palliative intervention - Using data to inform appropriate care

Lee, A ORCID: https://orcid.org/0000-0003-1378-3123, Khulusi, S and Watson, R (2019) Gastroesophageal cancer patients need earlier palliative intervention - Using data to inform appropriate care. European Journal of Oncology Nursing (EJON), 40. pp. 126-130. ISSN 1462-3889

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Abstract

Purpose: To evaluate demographics of survival in patients with gastroesophageal cancer so that it informs nursing practice. Method: Data on 2215 patients diagnosed with gastroesophageal cancer who presented to a specialist referral centre between the years 2000 and 2011 were extracted from a Public Health repository. Survival time was calculated and analysed against clinical and lifestyle factors to reveal whether they had an impact on survival outcomes. Results: Over 60% of patients had died within the first year, 39% of these died within the first 6 months. Survival outcomes were reduced in advancing age, and in those patients who present as ‘emergency’ cases. One quarter of patients were seen by a GP, but were not referred urgently through the two week wait system, to specialist care. Thus, gastroesophageal cancer patients need specific and appropriate treatment options, including earlier referrals to palliative care provision. There is also a need for cancer specific education and information at community and clinical levels. Conclusions: The globally applied one and five-year statistics applied to cancer survival studies do not adequately capture rates of early demise with gastroesophageal cancer. This study presents a novel approach to statistical analysis, based on patient derived data. It identifies factors linked to earlier deaths. However, rather than a focus on early presentation and diagnosis (which are essential) - it also reveals a significant need to consider early referrals for palliative care and nursing interventions to alleviate pain and suffering in patients with poor prognosis.