LIFE-PROLONGING MEASURES OFTEN FUTILE, ALWAYS COSTLY

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, February 10, 1993                   TAG: 9302100226
SECTION: NATIONAL/INTERNATIONAL                    PAGE: C5   EDITION: METRO 
SOURCE: Associated Press
DATELINE: CHICAGO                                LENGTH: Medium
LIFE-PROLONGING MEASURES OFTEN FUTILE, ALWAYS COSTLY
Life-prolonging treatment for critically ill cancer patients costs a fortune and usually buys little extra survival, researchers say. They are urging doctors to be sure patients and families really want it.
A study published this week found that cancer patients who spent any time in intensive care for reasons other than post-surgical recovery ran up subsequent hospital bills ranging from $82,845 to $189,339 per year of life gained.
Sixty-six patients of the 150 who were studied died in the hospital, the researchers report in today's Journal of the American Medical Association.
Most patients who made it home lived less than three additional months, and only 20 lived more than a year, the researchers said.
"Apart from the global aspect, the cost to the nation, there's the personal cost, the cost to the family," said the lead researcher, Dr. David V. Schapira of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla.
The study, conducted at the center, considered only hospital costs. Insurance coverage often is inadequate to cover those plus physician fees and other expenses, Schapira said.
"The medical costs can decimate the savings of the family - three or four decades of savings. They may lose their house, and the kids may have to come out of college" for a few weeks of added survival, he said.
The authors urged doctors to talk with patients and families before starting any cancer treatment that could cause critical illness, and inform them of the possible scenarios so a strategy can be agreed upon beforehand.
The researchers tracked hospital costs after placement in intensive care for 86 patients with tumors such as stomach, breast, lung and genital cancers and 64 patients with leukemia or lymph cancers.
Even though many such cancers are curable, some patients get critically ill because of complications from the malignancies or from the aggressive treatments used to fight them, the researchers said.
When cancer patients get so sick they must be admitted to intensive care, life-prolonging treatment may be unwarranted, the researchers said.
"Studies have reported mortality rates of 70 percent to 80 percent for cancer patients admitted to the ICU," they said.

by Archana Subramaniam by CNB