New Palliative Care Cancer Guidelines

Nearly half of all patients with metastatic cancer have incurable disease, but these individuals can live for years after their initial diagnosis. Palliative care can be used during this period to improve quality of life (QOL) for patients and caregivers. Palliative care emphasizes medically appropriate goal setting, honest communication, and meticulous symptom assessment and control. Despite the documented benefits of using palliative care in standard oncologic care, studies indicate that many patients are not referred to these services until near the end of life. Delaying palliative care reduces opportunities for clinicians to address physical symptoms and the emotional, social, and spiritual needs (see also, The Burden of Pain & Depression in Cancer Patients). Potential Benefits of Early Palliative Care Integration In the March 10, 2012 Journal of Clinical Oncology, the American Society of Clinical Oncology (ASCO) issued a provisional clinical opinion (PCO) on integrating palliative care into standard oncology care. The document was prompted by a growing body of research demonstrating the benefits of this integration early in the care of patients with metastatic cancer. Seven randomized controlled trials have shown that providing early palliative care together with standard oncologic care in patients with advanced cancer can be beneficial. These benefits include: Improved symptoms, QOL, and satisfaction. Reduced caregiver burden. More appropriate referral to and use of hospice. Decreased use of futile intensive care. Furthermore, most of these studies demonstrated improved outcomes at a cost lower than that of standard oncologic care alone. No trials to date have demonstrated harm to patients and caregivers or excessive costs from early involvement of palliative care. Hurdles Ahead for Readily Available Palliative...