Making the Case for Early Palliative Care

Throughout the United States, palliative care (PC) is becoming a more established and integral component of comprehensive cancer care for patients with advanced disease. “Published research has shown that PC is associated with better quality of life and mood, improved symptom control, and more appropriate health resource use,” explains Jennifer S. Temel, MD. “It has also been linked to increased patient and caregiver satisfaction, healthcare savings, and survival.” Clinical guidelines recommend that all patients with metastatic cancer be offered PC services early in the course of the disease. Currently, many cancer centers have some form of PC services, such as inpatient consultative services and acute inpatient units. PC clinics, on the other hand, are scarcer entities. Recent analyses have suggested that integrating PC early in the ambulatory care setting is feasible and can improve patient-reported outcomes as well as several key measures of quality end-of-life care and resource use. Early integration of PC with cancer care improves patients’ understanding of their disease and prognosis, leads to more timely transitions to hospice care, and decreases chemotherapy use near the end of life. Looking Closer at Early Palliative Care According to Dr. Temel, more information about the nature and elements of early PC in ambulatory care is needed. “The integration of PC with standard oncologic care may have a different emphasis and focus than traditional inpatient or consultative PC,” she says. Earlier and longer collaborative relationships between PC clinicians and patients may allow the time and opportunity to face complex issues like treatment decisions and advanced care planning rather than focus mostly on acute symptom management and imminent death. A study...