A new study suggests that instead of improving the quality of life of patients with end-stage cancer, palliative chemotherapy can worsen the status of some patients who are still in relatively good shape. The findings, by Holly G. Prigerson and colleagues from Weill Cornell Medical College in New York, were published in the journal JAMA Oncology. 312 patients with advanced cancer (who had a life expectancy of six months or less) were evaluated by the researchers between September 2002 and February 2008. More than half of the patients in the study were undergoing chemotherapy. The patients’ physical fitness status (i.e., their activity level and ability to care for themselves) was assessed and scored. Higher scores indicated poorer physical status. Patients who were in poor physical status with chemotherapy did not have an improved quality of life in the last weeks of life compared to those who did not have chemotherapy. To make matters worse, patients who were in better physical condition but had chemotherapy had a worse quality of life in the last weeks of life compared to those who had no chemotherapy and were in better physical condition. Current ASCO guidelines say that patients with advanced cancer who are in better physical condition can benefit from chemotherapy. Yet this is the opposite of the latest findings. Prigerson and colleagues said, “The findings suggest that the use of chemotherapy for patients with hard-to-treat malignancies is uncertain as to whether there is a benefit for patients.” The ASCO guidelines for the use of chemotherapy in patients with advanced cancer need to be revised to point out the dangers of chemotherapy in patients with malignancies,” they added.