Cancer Patients Who Elect to Die at Home Live Longer

Terminal cancer patients who choose to die at home live longer than those who choose to die at a hospital, according to a new study.

Researchers at the University of Tsukuba (Japan), Tohoku University (Japan), and other institutions across Japan conducted a multicenter, prospective cohort study from September 2012 through April 2014 in 58 specialist palliative care services to explore the potential differences in the survival time of cancer patients dying at home or in a hospital. In all, the study recruited 2,426 patients, of which 2,069 patients were analyzed; 1,582 receiving hospital-based palliative care and 487 receiving home-based palliative care.

The results revealed that eventually, 1,607 patients actually died in a hospital, and 462 patients died at home, with the survival time of patients who died at home significantly longer than the survival time of patients who died in a hospital. The median survival time was 13 days compared to 9 days in the daily prognosis group, and 36 days versus 29 days in the weekly prognosis group. No significant difference was found in the months' prognosis group. The study was published on March 28, 2016, in Cancer.

“Patients and their families tend to worry that home care won’t provide the quality of care that a hospital will. However, spending the last days or months at home doesn’t necessarily mean life would be shortened,” said lead author Jun Hamano, MD, an assistant professor of internal medicine at the University of Tsukuba. “Patients, families, and clinicians should be reassured that good home hospice care does not shorten patient life, and even may achieve longer survival.”

Most patients with advanced cancer would prefer to die at home, and many people in the United States, United Kingdom, and other countries are realizing this wish. But in other countries, such as Japan, Germany, Greece, and Portugal a trend towards institutionalized dying persists. But despite trends, the most frequent location of death for those dying from cancer is still a hospital, with marked variations in the odds of home death depending on illness-related, individual, and environmental factors.

Related Links:
University of Tsukuba
Tohoku University