Dying with cancer

: an international perspective

Student thesis: Doctoral Thesis


Cancer is one of the leading causes of death in many countries around the world. Palliative care has been developed traditionally within the cancer group as an approach to “improve the quality of life of patients and their families facing the problem associated with life-threateningillness” and palliative care aims at addressing the various needs ofpatients and their families in a multidisciplinary manner. This thesisaims to understand the provision of cancer palliative care across Europein a input-process-output system. Two international databases and oneBelgian database were used to deal with four challenges identified incontemporary cancer palliative care, namely cross-country cancerpalliative care, care in the last months of life for cancer patients, placeof death and preferences, and quality of life. The thesis is divided intothree parts, on the care provided to cancer patients in the final monthsof life, preferences of place of death of cancer patients according to GPs,and place of death & quality of life of advanced lung cancer patients.The thesis found through a cross-country comparison (Belgium, theNetherlands, Italy, Spain) that the provision of palliative care to cancerpatients, final transitions to place of death as well as the awareness ofplace of death preferences by GPs varied across these countries.Moreover, an international study of place of death revealed thedifferences of place of death between lung cancer and COPD patients,and some patterns were consistent across many countries. Finally, aBelgian study on the quality of life among advanced lung cancer patientsinformed us about the changes in individual patients’ quality of life whichworth attention. Implications from this thesis include more routineassessments among cancer patients, timely communication about endof-life preferences, a public health approach in monitoring palliative careand more future cross-national research using trials or mixed methodsare needed.
Date of Award8 Sep 2015
Original languageEnglish
Awarding Institution
  • Vrije Universiteit Brussel
SupervisorLieve Van den Block (Promotor), Luc Deliens (Co-promotor), Dirk Devroey (Jury), Henri Schots (Jury), Peter Theuns (Jury), Judith Anna Cathari Rietjens (Jury), V. Cocquyt (Jury) & Augusto Caraceni (Jury)


  • cancer
  • death
  • Palliative care

Cite this