Hospice Enhances End of Life Experience for Bladder Cancer Patients

Pauline Filippou, MD, Acting Instructor and Society of Urologic Oncology senior fellow at the University of Washington’s Department of Urology, concluded that patients with bladder cancer enrolled in hospice have a higher quality end-of-life experience, as documented in a recent study in coordination with Department colleagues and the H. Lee Moffitt Cancer Center in Florida.

Through careful examination, Dr. Filippou and colleagues studied the number of people that had died from bladder cancer between 2004 and 2015, and through stratified selection honed in on 11,874 of these individuals to study their end of life experiences. Of these, only 55% were enrolled in hospice at the end of their lives. Dr. Filippou and colleagues identified a series of eight indicators measuring end-of-life quality. Patients enrolled in hospice more than 30 days prior to death achieved all eight indicators, while individuals not enrolled in hospice met two. Through an electronic survey of patients with bladder cancer and their caregivers, she found that most had high knowledge and positives beliefs surrounding palliative care and hospice. Despite these findings, fewer than 9% of patients and caregivers reported discussing palliative care and hospice with their medical providers. In addition, an astonishing 65% of patients with advanced disease wished palliative care had been mentioned as an option by their provider, while 30% of all patients desired this discussion as well.

The study concluded there is overwhelming evidence that the end-of-life experience for patients with bladder cancer greatly improves when they are enrolled in hospice for more than the last 30 days of life. Comprehensive cancer centers and scientists stand at the forefront of developing a mechanism to close the gap and improve access to hospice for patients with cancer and their families, and continue to work to achieve this goal.