"FATE" survey assesses end of life in head and neck cancer

Palliative treatments, death outside of the hospital, and involvement by a palliative care team all improve the end-of-life experience for persons with head and neck cancer.

This was the finding of a study undertaken by a team headed by Andrew G. Shuman, MD, of the department of otolaryngology–head and neck surgery at the University of Michigan Medical School in Ann Arbor, and the school's adult-ethics committee. Shuman and fellow investigators sought to determine the perceived quality of care received by persons with head and neck cancer at the end of their lives in order to improve the experience for future patients.

The researchers administered the Family Assessment of Treatment at End of Life (FATE) survey to the families of 58 patients who had died of head and neck cancer. The majority of patients had had advanced-stage tumors, with T3 or T4 primaries. Approximately half (55%) of that subgroup had laryngeal cancer at the time of death.

As Shuman and colleagues reported in Otolaryngology – Head and Neck Surgery (2011;144[5]:733-739), the survey responses revealed the following:

  • The location of death in the home or in hospice (vs. hospital) significantly improved FATE score; the approximately one-third of patients who died in the hospital had a notably lower FATE score, indicating less satisfaction with end-of-life care.
  • Involvement of a palliative care team improved the care at the time of death.
  • Palliative treatments (radiation and/or chemotherapy) improved scores in managing symptoms and care at the time of death.

The researchers concluded that the FATE survey is a useful measure of the end-of-life experience of persons with head and neck cancer.

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