Oncology Research and Treatment

Review Article

 Focus Article

Early Palliative Care: Pro, but Please Be Precise!

Gärtner J.a · Daun M.b · Wolf J.c · von Bergwelt-Baildon M.d · Hallek M.c

Author affiliations

aPalliativzentrum Hildegard, Basel, Switzerland; bKlinik für Hämatologie, Onkologie und Palliativmedizin, Sektionsleitung Palliativmedizin, Rems-Murr-Klinikum, Winnenden, cKlinik I für Innere Medizin, Uniklinik Köln, Centrum für Integrierte Onkologie (CIO) Köln Bonn, Cologne and dMedizinische Klinik und Poliklinik III, Klinikum der Universität München, Munich, Germany

Keywords: Comprehensive cancer careEarly integrationEarly palliative carePalliative carePalliative medicine

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Oncol Res Treat 2019;42:11-18
https://doi.org/10.1159/000496184

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Article / Publication Details

First-Page Preview
Abstract of Review Article

Received: November 07, 2018
Accepted: December 12, 2018
Published online: January 26, 2019
Issue release date: February 2019

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0

ISSN: 2296-5270 (Print)
eISSN: 2296-5262 (Online)

For additional information: https://www.karger.com/ORT

Abstract

Background: By definition, palliative care (PC) is applicable already in early stages of incurable and life-threatening diseases, in conjunction with therapies that are intended to prolong life, such as for example chemo- or radiotherapy. Many patients suffer from distressing symptoms or problems in early phases of such illness. Therefore, it is not a question of “if” PC should be integrated early into oncology, but “how.” General PC is defined as an approach that should be delivered by healthcare professionals regardless of their discipline. This is often referred to as “general” or “primary” PC. For this, routine symptom assessment, expertise concerning basic symptom management, and communication skills are basic requirements. Communication skills include the willingness to engage in discussions concerning patients' fears, worries and end-of-life issues without the fear of destroying hope. Specialist PC is provided by specialist teams regardless of the patients' disease, be it cancer or non-cancer. Such teams should be integrated in the care of PC patients depending on the availability of these services and the patients' needs. Key messages: “Early PC” must not be used synonymously with “early specialist PC” because much of the PC is delivered as basic oncology PC. For the integration of specialist PC, the identification of triggers is warranted in different institutions to facilitate a meaningful and effective cooperation. Such cooperations should be based on patients' needs, but must also account for questions of availability and resources.

© 2019 S. Karger AG, Basel



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References

  1. Peters TJ: Thriving on chaos: Handbook for a management revolution. Harper Perennial, 1991.
  2. Parikh RB, Kirch RA, Smith TJ, Temel JS: Early specialty palliative care - Translating data in oncology into practice. N Engl J Med 2013;369:2347-2351.
  3. WHO: Definition of Palliative Care. Http://wwwWhoInt/Cancer/Palliative/Definition/En/# 2015;DOI: http://www.who.int/cancer/palliative/definition/en/.
  4. Ferrell BR, Temel JS, Temin S, et al.: Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2017;35:96-112.
  5. McDonald J, Swami N, Pope A, et al.: Caregiver quality of life in advanced cancer: Qualitative results from a trial of early palliative care. Palliat Med 2018;32:69-78.
  6. Zimmermann C, Swami N, Krzyzanowska M, et al.: Perceptions of palliative care among patients with advanced cancer and their caregivers. Can Med Assoc J 2016;188:E217-E227.
  7. Peppercorn JM, Smith TJ, Helft PR, et al.: American Society of Clinical Oncology statement: Toward individualized care for patients with advanced cancer. J Clin Oncol 2011;29:755-760.
  8. Mack JW, Smith TJ: Reasons why physicians do not have discussions about poor prognosis, why it matters, and what can be improved. J Clin Oncol 2012;30:2715-2717.
  9. Prod'homme C, Jacquemin D, Touzet L, et al.: Barriers to end-of-life discussions among hematologists: A qualitative study. Palliat Med 2018;32:1021-1029.
  10. Kaasa S, Loge JH, Aapro M, et al.: Integration of oncology and palliative care: A Lancet Oncology Commission. Lancet Oncol 2018;19:e588-e653.
  11. Rangachari D, Smith TJ: Integrating palliative care in oncology: The oncologist as a primary palliative care provider. Cancer J 2013;19:373-378.
  12. Sullivan AM, Lakoma MD, Billings JA, et al.: Teaching and learning end-of-life care: Evaluation of a faculty development program in palliative care. Acad Med 2005;80:657-668.
  13. Gaertner J, Weingärtner V, Wolf J, Voltz R: Early palliative care for patients with advanced cancer. Curr Opin Oncol 2013;25:342-452.
  14. S3-Leitlinie Palliativmedizin für Patienten mit einer nicht heilbaren Krebserkrankung-Langversion. 2015. Available from: https://www.awmf.org/.../tx_szleitlinien/128-001OLl_S3_Palliativmedizin_2015-07.pdf.
  15. Basch E, Deal AM, Kris MG, et al.: Symptom monitoring with patient-reported outcomes during routine cancer treatment: A randomized controlled trial. J Clin Oncol 2016;34:557-565.
  16. Basch E, Deal AM, Dueck AC, et al.: Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 2017;318:197-198.
  17. Velikova G, Keding A, Harley C, et al.: Patients report improvements in continuity of care when quality of life assessments are used routinely in oncology practice: Secondary outcomes of a randomised controlled trial. Eur J Cancer 2010;46:2381-2388.
  18. Benze G, Nauck F, Alt-Epping B, et al.: PROutine: A feasibility study assessing surveillance of electronic patient reported outcomes and adherence via smartphone app in advanced cancer. Ann Palliat Med 2017;6:705-705.
  19. Dans M, Smith T, Back A, et al.: NCCN guidelines insights: Palliative care, Version 2.2017. J Natl Compr Canc Netw 2017;15:989-997.
  20. Bakitas MA, El-Jawahri A, Farquhar M, et al.: The TEAM approach to improving oncology outcomes by incorporating palliative care in practice. J Oncol Pract 2017;13:557-566.
  21. Del Río MI, Shand B, Bonati P, et al.: Hydration and nutrition at the end of life: A systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff. Psychooncology 2012;21:913-921.
  22. Gaertner J, Wolf J, Smith TJ: Early Palliative Care; in Alt-Epping B, Nauck F (eds): Palliative Care in Oncology. Berlin, Heidelberg, 2015, p 308.
  23. Smith TJ, Dow LA, Virago E, et al.: Giving honest information to patients with advanced cancer maintains hope. Oncology (Williston Park), 2010;24:521-525.
  24. Mack JW, Wolfe J, Cook EF, et al.: Hope and prognostic disclosure. J Clin Oncol 2007;25:5636-5642.
  25. Colosimo K, Nissim R, Pos AE, et al.: “Double awareness” in psychotherapy for patients living with advanced cancer. J Psychother Integr 2018;28:125-140.
  26. Caraceni A, Hanks G, Kaasa S, et al.: Use of opioid analgesics in the treatment of cancer pain: Evidence-based recommendations from the EAPC. Lancet Oncol 2012;13:e58-68.
  27. Kuehn B: NIH strategy to combat opioid crisis. JAMA 2017;318:2418.
  28. Oquendo MA, Volkow ND: Suicide: A silent contributor to opioid-overdose deaths. N Engl J Med 2018;378:1567-1569.
  29. Comerci G, Katzman J, Duhigg D: Controlling the swing of the opioid pendulum. N Engl J Med 2018;378:691-693.
  30. Jovey RD: Opioids, pain and addiction - practical strategies. Br J Pain 2012;6:36-42.
  31. Moberly T: BMA annual meeting: Pregabalin must be made a controlled drug, BMA says. BMJ 2017;57:j3151.
  32. McCartney M: Palliative care can provide a better death and even prolong life. 2014;Available from: https://www.theguardian.com/science/blog/2014/nov/25/palliative-care-can-provide-a-better-death-and-even-a-longer-life.
  33. Temel JS, Greer JA, Muzikansky A, et al.: Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733-742.
  34. Kavalieratos D, Corbelli J, Zhang D, et al.: Association between palliative care and patient and caregiver outcomes: A systematic review and meta-analysis. JAMA 2016;316:2104-2114.
  35. Haun MW, Estel S, Rücker G, et al.: Early palliative care for adults with advanced cancer. Cochrane database Syst Rev 2017;6:CD011129.
  36. Gaertner J, Siemens W, Meerpohl JJ, et al.: Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: Systematic review and meta-analysis. BMJ 2017;357:j2925.
  37. Gaertner J, Siemens W, Daveson BA, et al.: Of apples and oranges: Lessons learned from the preparation of research protocols for systematic reviews exploring the effectiveness of specialist palliative care. BMC Palliat Care 2016;15:43.
  38. Vanbutsele G, Pardon K, Van Belle S, et al.: Effect of early and systematic integration of palliative care in patients with advanced cancer: A randomised controlled trial. Lancet Oncol 2018;19:394-404.
  39. May P, Normand C, Cassel JB, et al.: Economics of palliative care for hospitalized adults with serious illness: A meta-analysis. JAMA Intern Med 2018;178:820-829.
  40. Srivastava R: Critical conversations: Navigating between hope and truth. Lancet 2011;378:1213-1214.
  41. Zafar SY, Peppercorn JM, Schrag D, et al.: The financial toxicity of cancer treatment: A pilot study assessing out-of-pocket expenses and the insured cancer patient's experience. Oncologist 2013;18:381-390.
  42. Breuer B, Fleishman SB, Cruciani RA, Portenoy RK: Medical oncologists' attitudes and practice in cancer pain management: A national survey. J Clin Oncol 2011;29:4769-4775.
  43. Bakitas M, Lyons KD, Hegel MT, Ahles T: Oncologists' perspectives on concurrent palliative care in a National Cancer Institute-designated comprehensive cancer center. Palliat Support Care 2013;11:415-423.
  44. Morita T, Akechi T, Ikenaga M, et al.: Communication about the ending of anticancer treatment and transition to palliative care. Ann Oncol 2004;15:1551-1557.
  45. Braga S: Why do our patients get chemotherapy until the end of life? Ann Oncol 2011;22:2345-2348.
  46. Hui D, Bruera E: Models of integration of oncology and palliative care. Ann Palliat Med 2015;89-98.
  47. Wentlandt K, Krzyzanowska MK, Swami N, et al.: Referral practices of pediatric oncologists to specialized palliative care. Support Care Cancer 2014;22:2315-2322.
  48. Hui D, Bansal S, Strasser F, et al.: Indicators of integration of oncology and palliative care programs: An international consensus. Ann Oncol 2015;26:1953-1959.
  49. Hui D, Bruera E: Integrating palliative care into the trajectory of cancer care. Nat Rev Clin Oncol 2016;13:159-171.
  50. Hui D, Meng Y-C, Bruera S, et al.: Referral criteria for outpatient palliative cancer care: A systematic review. Oncologist 2016;21:895-901.

Article / Publication Details

First-Page Preview
Abstract of Review Article

Received: November 07, 2018
Accepted: December 12, 2018
Published online: January 26, 2019
Issue release date: February 2019

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0

ISSN: 2296-5270 (Print)
eISSN: 2296-5262 (Online)

For additional information: https://www.karger.com/ORT

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2019, Vol.42, No. 1-2

February 2019

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