Introduction

Cancer palliative care, including end-of-life care, is specialised care for people who have cancer that cannot be cured.¹ It aims to prevent suffering by means of treating pain, as well as addressing emotional, psychosocial and spiritual needs.² It is, therefore, an important aspect of improving outcomes for cancer patients, their families and carers.

 

Data availability

There are currently no national data available for this indicator. Cancer Australia is continuing engagement with the palliative care sector to progress national reporting of the measures for this indicator.

Data on aspects of palliative care are collected across some jurisdictions in Australia. In New South Wales, the proportion of patients with bone metastases receiving a single fraction dose of external beam radiotherapy ranged from 21% to 54% across local health districts and specialty health networks in 2015–2018.³ A large Victorian population-based study reported that 29% of patients with bone metastases received a single fraction dose of external beam radiotherapy for palliative treatment, in 2013–2016.⁴ Evidence has shown that single fraction and multiple fraction regimens of external beam radiotherapy are equally effective for palliation of painful bone metastases.⁵

Information about the measure(s):

The measures for monitoring palliative care at the national level are:

1. Proportion of patients who died from advanced cancer who were admitted to an ICU in the last 30 days of life.

Numerator: Number of patients with advanced cancer who were admitted to an ICU in the last 30 days of life.

Denominator: Number of patients who died from advanced cancer.

2. Proportion of patients receiving a cytotoxic drug(s) within 2 weeks of death.

Numerator: Patients receiving chemotherapy within 2 weeks of death

Denominator: Number of patients who died from cancer

3. Proportion of patients with painful bone metastases receiving a single fraction versus multiple fractions of external beam radiotherapy with palliative treatment intent.

Numerator: Patients with painful bone metastases receiving either single or multiple fraction external beam radiotherapy dose/s with palliative treatment intent

Denominator: All patients with painful bone metastases who received external beam radiotherapy

 

Links to other content:

 

Cancer Australia – Breast cancer - Palliative care

Medical Oncology Group of Australia – Evolve – Top 5 Recommendations on low-value practices

 

Data:

Australian Institute of Health and Welfare – Palliative care services in Australia

Cancer Institute NSW – Proportion of people receiving single fraction radiotherapy for bone metastases

Canadian Partnership Against Cancer – Place of Death

 

References:

1. Cancer Australia. Palliative Care. Sydney: Cancer Australia. Available here.

2. Department of Health (WA) 2011. Western Australia Cancer Plan 2012-2017. Cancer & Palliative Care Network, Department of Health, Western Australia.

3. Cancer Institute NSW. Proportion of people receiving single fraction radiotherapy for bone metastases. Accessed 10 June 2021. Available here.

4. Ong WL, Foroudi F, Milne RL and Millar JL. 2021. Medical Journal of Australia. Issue 214, no. 5. DOI: 10.5694/mja2.50954

5. Chow R, Hoskin P, Schild SE, Raman S, Im J, Zhang D, Chan S, Chiu N, Chiu L, Lam H, Chow E and Lock M. 2019. Single vs multiple fraction palliative radiation therapy for bone metastases: Cumulative meta-analysis. Radiotherapy and Oncology. Issue 141, no. 56-61. DOI: 10.1016/j.radonc.2019.06.037. Erratum in: Radiotherapy and Oncology 2020 Jul. Issue 148, no. 115. PMID: 31445837.