Palliative and hospice care in prostate cancer: A scoping review

Advanced prostate cancer presents therapeutic and prognostic challenges at the end of life. Palliative and hospice care improve quality of life, reduce hospitalizations, and enhance patient-centered decision-making. This scoping review emphasizes therapy and prognosis by evaluating the utilization, timing, and clinical impact of palliative and hospice care in prostate cancer. We systematically searched MEDLINE (PubMed), CINAHL, Embase, APA PsycInfo, Scopus, and Web of Science for English-language studies published between January 2014 and March 2024. Eligible studies included adults with prostate cancer that assessed exposure to palliative or hospice care and reported patient-reported or clinical outcomes. The population included men with localized or metastatic prostate cancer; the intervention was palliative and/or hospice care; no comparator was required. Outcomes of interest included quality of life, hospitalization patterns, cost savings, and end-of-life treatment after palliative care involvement. Quantitative, qualitative, and mixed-methods studies were included. Four reviewers independently screened records and extracted data using standardized criteria. Of 3,152 articles screened, 24 met inclusion criteria. On average, 40.4% of patients received palliative care, 14.74% hospice, and 1.3% received both. Early integration was associated with better quality of life, fewer hospital admissions, reduced aggressive interventions, and increased cost savings. Most referrals occurred late in the disease trajectory. Limitations included study heterogeneity, inconsistent outcome reporting, lack of formal quality appraisal, and exclusion of non-English literature. Palliative care in prostate cancer is highly beneficial and often delayed. Future research should focus on barriers to timely referral and evaluate their effects on clinical and economic outcomes in prostate cancer.