If positive, this trial could result in a scalable and equitable intervention that improves function and quality of life in people with incurable cancer and reduces the burden of care for their families.
Professor Matthew Maddocks
29 September 2022
EU backs clinical trials that could transform incurable cancer care
Healthcare for incurable cancer could undergo reform following a study looking at how palliative rehabilitation can improve patient quality of life.
A new €4.6million (£3.98 million) study, on which King’s researchers will play a key role, will see hundreds of patients with life-limiting and incurable cancer across the UK, France, Italy, Denmark, and Norway take part in a trial to assess the clinical and cost-effectiveness of palliative rehabilitation on patient quality of life, disability, and symptom burden.
Funded by the European Union (EU)’s Horizon Europe programme and UKRI (UK Research and Innovation), researchers will work with healthcare staff in the participating countries to implement a model that empowers cancer patients to actively manage their condition themselves in their own environment – for example using self-management tools for breathlessness, physical activity advice and tailored action plans.
The team of experts in palliative care, oncology and rehabilitation will assess if this approach improves clinical outcomes and reduces the cost of hospital inpatient days. They will also consider how by responding directly to each individual’s concerns, priorities, and goals, they are able to target the adverse impacts of symptoms like breathlessness and fatigue on function and social participation.
Lead researcher Professor Matthew Maddocks, Professor of Health Services Research & Rehabilitation in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, said: "Routine integrated rehabilitation has been achieved for people with chronic respiratory, cardiac and stroke conditions but this is not the case for people with cancer, especially those living with incurable disease. Access to palliative care services has increased but access to rehabilitation remains varied.
“Our ambition is to identify an effective model of person-centred palliative rehabilitation that can be delivered as part of routine care for people with incurable cancer, that integrates with oncology, palliative care, and rehabilitation services across Europe.
He added: “It is about keeping people mobile and independent in the last months and years of their lives – and part of that is keeping them active in the things they enjoy doing.”
More than one million people in Europe are affected by disability related to incurable cancer every year. With population ageing and increased morbidity, the number of people living with disability and experiencing suffering towards the end of life is set to almost double by 2060, according to the World Health Organisation (WHO).
While the WHO recognises both rehabilitation and palliative care as essential quality health services, it is currently estimated that 40 million people worldwide and nearly five million people in the European region require palliative care every year – yet only 14% and 35% respectively receive it.
King’s will work on the study in collaboration with the University of Edinburgh, European Association of Palliative Care, European Cancer Patient Coalition, Hospices Civils de Lyon, Istituto Nazionale dei Tumori, Azienda Unita Sanitaria Locale di Reggio Emilia, Fonden for Almen Praksis, and University of Bergen.
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Professor of Health Services Research & Rehabilitation