Volume : 13, Issue : 08, August – 2026

Title:

EARLY PALLIATIVE CARE AND QUALITY OF LIFE IN PATIENTS WITH ADVANCED CANCER: A COMPREHENSIVE EVALUATION OF PATIENT OUTCOMES, SYMPTOM BURDEN, AND HEALTH RESOURCE UTILIZATION

Authors :

Sarah Saleh Alsaeed, Aliyah Al Ali, Heba Yaseer Ali Al-Saghah

Abstract :

Background: historically, palliative care was integrated late in the trajectory of advanced malignancy, often restricted to end of life care. However, concurrent early palliative care (EPC)-initiated alongside standard oncological disease, modifying therapy at diagnosis- has emerged as a transformative clinical model.
Objective: To systematically synthesize and evaluate the impact of early integrated palliative care compared with standard oncology care on health-related quality of life (HRQoL), depressive symptoms, symptom burden, overall survival (OS), healthcare utilization among patients with advanced malignancies.
Methods: A systematic search was conducted across MEDLINE, EMBASE, CINAHL, and CENTRAL through 2025. Randomized controlled trials (RCTs) evaluating integrated EPC interventions initiated within eight weeks of advanced cancer diagnosis versus usual care were included. Standardized mean differences (SDMs) and pooled mean differences with 95% confidence intervals (CIs) were estimated using random-effects meta-analysis models. Primary outcomes were HRQoL at 12-24 weeks follow-up.
Results: 14 RCTs involving 3,428 patients met inclusion criteria. Meta-analysis demonstrated that EPC significantly improved overall patient HRQoL compared to standard care (SMD = 0.22; 95% CI: 0.10 to 0.34; P<0.001; FACIT-Pal mean difference = 5.8 points). EPC led significant reductions in depressive symptoms (SMD=0.19; 95% CI: -0.31 to -0.07; P=0.002) and overall symptom burden (ESAS SMD = -0.21; 95% CI: -0.35 to -0.07; P=0.003). Pooled overall survival showed a favourable non-significant trend (HR = 0.91; 95% CI: 0.81 to 1.02; P=0.10). Patients receiving EPC had higher rates of advance care planning (RR = 1.62; 95% CI: 1.34 to 1.96) and lower rates of aggressive end-of-life medical interventions.
Conclusion: Early integrated palliative care delivers clinically meaningful improvements in quality of life, reduces psychological distress, mitigates symptom burden, and optimizes end-of-life, reduces psychological distress, mitigates symptom burden, and optimizes end-of-life care delivery. Integrating specialized palliative care early should be adopted as a standard component of comprehensive oncology care.
Keywords: Early Palliative Care, Quality of Life; Advanced Cancer; Systematic Review; Meta-analysis; Oncology; Symptom Burden; Advance Care Planning.

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