Laura Finn1, Alva Roche Green2, Sonia Malhotra3,4. 1. Division of Hematology and Bone Marrow Transplant, Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA. 2. Division of Palliative Medicine, Department of Family Medicine, Mayo Clinic, Jacksonville, FL. 3. Section of Palliative Medicine, Department of Pulmonary and Critical Care, Ochsner Clinic Foundation, New Orleans, LA. 4. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Abstract
BACKGROUND: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. METHODS: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines. In this review, we describe the role of palliative medicine in oncology, including the timing of palliative medicine consultation, models of care delivery, and improvements in patient outcomes. RESULTS: Randomized controlled trials and national guidelines support early referral of patients with cancer to palliative medicine. Palliative medicine has a fundamental role in symptom management, distress relief, family and caregiver support, and advance care planning. Integration of palliative medicine in oncology improves patient outcomes and decreases healthcare costs. Early involvement of palliative medicine after the cancer diagnosis is supported by national guidelines, but barriers include variable referral patterns among oncologists and the need for an expanded palliative medicine workforce. CONCLUSION: Palliative medicine has a wide-ranging role in the spectrum of comprehensive cancer care-from patient diagnosis to survivorship. The entire multidisciplinary care team has a role in providing palliative care in inpatient and outpatient settings. An effective palliative medicine and oncology collaboration improves patient care and quality of life, has broad research and guideline support, and is cost effective.
BACKGROUND: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. METHODS: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines. In this review, we describe the role of palliative medicine in oncology, including the timing of palliative medicine consultation, models of care delivery, and improvements in patient outcomes. RESULTS: Randomized controlled trials and national guidelines support early referral of patients with cancer to palliative medicine. Palliative medicine has a fundamental role in symptom management, distress relief, family and caregiver support, and advance care planning. Integration of palliative medicine in oncology improves patient outcomes and decreases healthcare costs. Early involvement of palliative medicine after the cancer diagnosis is supported by national guidelines, but barriers include variable referral patterns among oncologists and the need for an expanded palliative medicine workforce. CONCLUSION: Palliative medicine has a wide-ranging role in the spectrum of comprehensive cancer care-from patient diagnosis to survivorship. The entire multidisciplinary care team has a role in providing palliative care in inpatient and outpatient settings. An effective palliative medicine and oncology collaboration improves patient care and quality of life, has broad research and guideline support, and is cost effective.
Entities:
Keywords:
Cancer pain; cost-benefit analysis; medical oncology; palliative medicine; surgical oncology
Authors: Seon Hee Kim; In Cheol Hwang; Ki Dong Ko; Young Eun Kwon; Hong Yup Ahn; Nan Young Cho; Seung Jin Kim Journal: Palliat Support Care Date: 2015-06-11
Authors: Betty R Ferrell; Jennifer S Temel; Sarah Temin; Erin R Alesi; Tracy A Balboni; Ethan M Basch; Janice I Firn; Judith A Paice; Jeffrey M Peppercorn; Tanyanika Phillips; Ellen L Stovall; Camilla Zimmermann; Thomas J Smith Journal: J Clin Oncol Date: 2016-10-28 Impact factor: 44.544
Authors: Lindsay A Dow; Robin K Matsuyama; V Ramakrishnan; Laura Kuhn; Elizabeth B Lamont; Laurel Lyckholm; Thomas J Smith Journal: J Clin Oncol Date: 2009-11-23 Impact factor: 44.544
Authors: Peter May; Melissa M Garrido; J Brian Cassel; Amy S Kelley; Diane E Meier; Charles Normand; Lee Stefanis; Thomas J Smith; R Sean Morrison Journal: Health Aff (Millwood) Date: 2016-01 Impact factor: 6.301
Authors: Eva K Masel; Matthias Unseld; Feroniki Adamidis; Sophie Roider-Schur; Herbert H Watzke Journal: Wien Klin Wochenschr Date: 2018-02-23 Impact factor: 1.704