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End-of-life care in advanced cancer: an international challenge

Author: Mariëtte Verkissen



Date: 01-26-2022

Prof. dr. Luc Deliens (Vrije Universiteit Brussel, Promotor)
Prof. dr. Aline De Vleminck (Vrije Universiteit Brussel, Co-Promotor)


Summary of the dissertation


Due to ageing and the progress made in cancer treatment over the past few decades, people are living longer after being diagnosed with cancer, even those with cancer in an advanced stage. During their cancer journey, usually characterized by a slow but steady decline over a period of many months or years, these individuals have to cope with continuing challenges in setting and shifting personal goals and in planning their care to achieve these goals. Effective symptom management and communication throughout the illness trajectory and towards the end of life are foundational skills that healthcare providers need in order to help patients with advanced-stage illness live as well and comfortably as possible.

Advanced cancer is a big societal challenge across many nations and regions. This dissertation aims to contribute to a more comprehensive picture of the care delivered to cancer patients near the end of life, which could assist European policy makers and practitioners in establishing priorities to improve the quality of care for this patient population. The dissertation is divided in three parts. The first part describes patient-reported emotional and physical functioning, symptom intensity and quality of life, and how these outcomes vary across European countries and over time. The second part describes
trends in general practitioner-patient communication on end-of-life topics in primary care in Belgium, the Netherlands and Spain; and also describes how cancer patients and bereaved relatives of cancer patients evaluate information provision by different types of specialist palliative care services in Belgium. The third part describes the prevalence of end-of-life decisions across cancer types
and characteristics of the preceding decision-making process in Belgium.

Based on the findings, the dissertation offers several important implications and recommendations for future research, practice and policy in relation to end-of-life care for advanced cancer patients.

pdf fileDissertation_Mariëtte Verkissen_Final_190122.pdf (4.5 MB)