"In an era when increased attention is being focused on what to do to reign in runaway healthcare costs, there should be a clear focus on limiting therapies that ultimately will fail for these patients - costly chemotherapy treatments, more imaging studies, emergency room visits, lengthy ICU stays," Litwin said. "We need to eliminate costs that don't provide benefit, and try to give our patients the most dignified deaths that we can."

For most prostate cancer patients, the arc from diagnosis to death is a long and often slow one, and men most often die from other causes before their prostate cancer can kill them. But there are about 30,000 men every year who will die from their disease and providing appropriate palliative care to this population is vital, Litwin said.

Hospice care, usually in-home care, includes pain and symptom management, management of appetite, psychosocial and mental health services, family counseling and patient mobility services. It is not meant to prolong life, but to make the patients and their families as comfortable as possible.

"Studies have shown that the quality of the death experience is much greater when everyone has the opportunity to face the issues and say the things they need to say," Litwin said. "Looking back, family members who use hospice rate the quality of the death experience much higher than those who did not use hospice."

For the study, Litwin and his team identified 14,521 men aged 66 and older who died of prostate cancer between 1992 and 2005. Searching in-patient and physician claims, the team was able to identify those patients that enrolled in hospice care. Of the 14,521 studied, 7,646 or 53 percent used hospice care for a median of 24 days. About 22 percent of patients in the study enrolled within seven days of their death.

"Hospice stays shorter than seven days are too brief to maximize the benefit of enrollment, and individuals making shorter stays receive fewer services and benefit less from the input of the full interdisciplinary team," the study states. "Increasing appropriate hospice use may improve the quality of death for men at the end of life while rationalizing health care expenditures during this high-cost period."

Source UCLA's Jonsson Comprehensive Cancer Center