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Early Integration of Palliative Care into Standard Oncology Care –  Benefits, Limitations, Barriers and Types of Palliative Care


Authors: M. Sochor 1;  O. Sláma 2;  M. Loučka 3
Authors‘ workplace: Komplexní onkologické centrum, Krajská nemocnice Liberec, a.  s. 1;  Ambulance podpůrné a paliativní péče, Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno 2;  Centrum paliativní péče, Praha 3
Published in: Klin Onkol 2015; 28(3): 171-176
Category: Reviews
doi: https://doi.org/10.14735/amko2015171

Overview

Patients with advanced cancer experience a significant number of physical symptoms and psychological distress, which worsen their quality of life (QOL). Palliative care is oriented to prevent and relieve suffering and promote QOL of patients with advanced cancer. In oncology, the role of palliative care is traditionally perceived to be the treatment after the antineoplastic therapy is finished. A concept of early integration of palliative care into standard oncology practice has been recently introduced. There is a lot of data supporting this concept of parallel application of both oncology care and palliative care. Early palliative care has been shown to provide benefits in QOL, mood, symptoms, health care utilization and survival. In this review, we summarize published data about benefits and difficulties of early palliative care. We also discuss the model of general and specialized palliative care integrated into oncological practice, their differences and consequences.

Key words:
palliative care –  supportive care –  oncology –  advanced cancer–  survival –  quality of life

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
3. 9. 2014

Accepted:
14. 3. 2015


Sources

1. Gaertner J, Wolf J, Voltz R. Early palliative care for patients with metastatic cancer. Curr Opin Oncol 2012; 24(4): 357– 362. doi: 10.1097/ CCO.0b013e328352ea20.

2. Parikh RB, Kirch RA, Smith TJ et al. Early specialty palliative care –  translating data in oncology practice. N Engl J Med 2013; 369(24): 2347– 2351. doi: 10.1056/ NEJMsb1305469.

3. Von Roenn JH, Cleeland CS, Gonin R et al. Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group. Ann Intern Med 1993; 119(2): 121– 126.

4. Breuer B, Fleishman SB, Cruciani SA et al. Medical oncologists’ attitudes and practice in cancer pain management: a national survey. J Clin Oncol 2011; 29(36): 4769– 4775. doi: 10.1200/ JCO.2011.35.0561.

5. Balboni TA, Paulk ME, Balboni MJ et al. Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. J Clin Oncol 2010; 28(3): 445– 452. doi: 10.1200/ JCO.2009.24.8005.

6. Mack JW, Wolfe J, Cook EF et al. Hope and prognostic disclosure. J Clin Oncol 2007; 25(35): 5636– 5642.

7. Wright AA, Zhang B, Ray A et al. Associations between end-of-life discussions: patient mental health, medical care near death, and caregiver bereavement adjustments. JAMA 2008; 300(14): 1665– 1673. doi: 10.1001/ jama.300.14.1665.

8. Weeks JC, Catalano PJ, Cronin A et al. Patients’ expectations about effects of chemotherapy for advanced cancer. N Engl J Med 2012; 367(17): 1616– 1625. doi: 10.1056/ NEJMoa1204410.

9. Mack JW, Weeks JC, Wright AA et al. End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care constistent with preferences. J Clin Oncol 2010; 28(7): 1203– 1208. doi: 10.1200/ JCO.2009.25.4672.

10. 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(8): 733– 742. doi: 10.1056/ NEJMoa1000678.

11. Bakitas M, Lyons KD, Hegel MT et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE a randomized controlled trial. JAMA 2009; 302(7): 741– 749. doi: 10.1001/ jama.2009.1198.

12. Zimmermann C, Swami N, Krzyzanowska M et al. Early palliative care for patients with advanced cancer: a cluster- randomised controlled trial. Lancet Oncol 2014; 383(9930): 1721– 1730. doi: 10.1016/ S0140- 6736(13)62416- 2.

13. Maione P, Perrone F, Gallo C et al. Pretreatment quality of life and functional status assessment significantly predict survival in elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the Multicenter Italian Lung Cancer in the Elderly study. J Clin Oncol 2005; 23(28): 6865– 6872.

14. Bonomi P, Kim K, Fairclough D et al. Comparison of survival and quality of life in advanced non-small-cell lung cancer patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: results of Eastern Cooperative Oncology Group trial. J Clin Oncol 2000; 18(3): 623– 631.

15. Zimmermann C, Riechelmann R, Krzyzanowska M et al. Effectiveness of specialized palliative care: a systematic review. JAMA 2008; 299(14): 1698– 1709. doi: 10.1001/ jama.299.14.1698.

16. El- Jawahri A, Green JA, Temel JS. Does palliative care improve outcomes for patients with incurable illness? A review of the evidence. J Support Oncol 2011; 9(3): 87– 94.

17. Higginson IJ, Evans CJ. What is the evidence that palliative care teams improve outcomes for cancer patients and their families? Cancer J 2010; 16(5): 423– 435. doi: 10.1097/ PPO.0b013e3181f684e5.

18. World Health Organization [homepage on the Internet]. WHO Definition of Palliative Care. Available from: http:/ / www.who.int/ cancer/ palliative/ definition/ en/ .

19. Smith TJ, Temin S, Alesi ER et al. American Society od Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol 2012; 30(8): 880– 887. doi: 10.1200/ JCO.2011.38.5161.

20. Zagonel V, Cavanna L, Cetto G et al. The medical oncologist’s role in palliative care: AIOM’s position. Tumori 2009; 95(6): 652– 654.

21. Cherny N, Catane R, Schrijvers D et al. European Society for Medical Oncology (ESMO) Program for the integration of oncology and palliative care: a 5-year review of the Designated Centers’ incentive program. Ann Oncol 2010; 21(2): 362– 369. doi: 10.1093/ annonc/ mdp318.

22. Rummans TA, Clark MM, Sloan JA et al. Impacting quality of life in patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. J Clin Oncol 2006; 24(4): 635– 642.

23. Brumley D, Enguidanos S, Jamison P et al. Increased satisfaction with care and lower costs: results of a randomized trial of in-home palliative care. J Am Geriatr Soc 2007; 55(7): 993– 1000.

24. Gade G, Venohr T, Conner D et al. Impact of an inpatient palliative care team: a randomized controlled trial. J Palliat Med 2008; 11(2): 180– 190. doi: 10.1089/ jpm.2007.0055.

25. Pantilat SZ, O’Riordan DL, Dibble SL et al. Hospital-based palliative medicine consultation: A randomized controlled trial. Arch Intern Med 2010; 170(22): 2038– 2040. doi: 10.1001/ archinternmed.2010.460.

26. Rabow MW, Dibble SL, Pantilat SZ et al. The comprehensive care team: a controlled trial of outpatient palliative medicine consultation. Arch Intern Med 2004; 164(1): 83– 91.

27. National Cancer Institute at the National Institutes of Health [homepage on the Internet]. PDQ Supportive and Palliative Care Editorial Board. Available from: http:/ / www.cancer.gov/ cancertopics/ pdq/ supportive- care-board.

28. Gaertner J, Wolf J, Hallek M et al. Standardizing integration of palliative care into comprehensive cancer therapy –  a disease specific approach. Support Care Cancer 2011; 19(7): 1037– 1043. doi: 10.1007/ s00520-011- 1131- y.

29. Weismann DE. Identifying patients in need of palliative care assessment in a hospital setting: a consenus report from the Center to Advance Palliative Care. J Palliat Med 2011; 14(1): 17– 23. doi: 10.1089/ jpm.2010.0347.

30. Rangachari D, Smith TJ. Integrating palliative care in oncology. The oncologist as a primary palliative care provider. Cancer J 2013; 19(5): 373– 378. doi: 10.1097/ PPO.0b013e3182a76b9c.

31. Gaertner J, Weingartner V, Wolf J et al. Early palliative care for patients with advanced cancer: how to make it work? Curr Opin Oncol 2013; 25(4): 342– 352. doi: 10.1097/ CCO.0b013e3283622c5e.

32. Hoffman MA, Raftopoulos H, Roy R. Oncologists as primary palliative care providers. J Clin Oncol 2012; 30(22): 2801– 2802. doi: 10.1200/ JCO.2012.42.4655.

33. Von Gunten CF, Twaddle M, Preodor M et al. Evidence of improved knowledge and skills after an elective rotation in a hospice and palliative care program for internal medicine residents. Am J Hosp Palliat Care 2005; 22(3): 195– 203.

34. Barth J, Lannen P. Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis. Ann Oncol 2011; 22(5): 1030– 1040. doi: 10.1093/ annonc/ mdq441.

35. NICE. Improving supportive and palliative care for adults with cancer. London: NICE 2004.

36. 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(2): e58– e68. oi: 10.1016/ S1470- 2045(12)70040- 2.

37. Smith TJ, Coyne PJ, Cassel JB. Practical guidelines to developing new palliative care services: resource management. Ann Oncol 2012; 23 (Suppl 3): 70– 75. doi: 10.1093/ annonc/ mds092.

38. Barbour I, Cohen S, Jackson V et al. Models for palliative care outside the hospital setting: a technical assistance monograph from IPAL- OP project [monograph on the Internet]. New York: Center to Advance Palliative Care 2012. Available from: Ipal.capc.org/ downloads/ overview- of-outpatients- palliative- care-models.pdf.

39. Bruera E, Hui D. Conceptual models for integrating palliative care at cancer centers. J Palliat Med 2012; 15: 1261– 1269. doi: 10.1089/ jpm.2012.0147.

40. Kamal AH, Currow DC, Richie CS et al. Community-based palliative care: the natural evolution for palliative care delivery in the US. J Pain Symptom Manage 2013; 46(2): 254– 264. doi: 10.1016/ j.jpainsymman.2012.07.018.

41. Von Roenn JH, Voltz R, Serrie A. Barriers and approaches to the successful integration of palliative care and oncology practice. J Natl Compr Canc Netw 2013; 11 (Suppl 1): S11– S16.

42. Quill TE, Abernethy AP. Generalist plus specialist palliative care-creating a more sustainable model. N Engl J Med 2013; 368(13): 1173– 1175. doi: 10.1056/ NEJMp1215620.

43. Bruera E, Hui D. Integrating supportive and palliative care in the trajectory of cancer: establishing goals and models of care. J Clin Oncol 2010; 28(25): 4013– 4017. doi: 10.1200/ JCO.2010.29.5618.

44. Johnson CE, Girgis A, Paul CL et al. Cancer specialists’ palliative care referral practices and perceptions: results of a national survey. Palliat Med 2008; 22(1): 51– 57. doi: 10.1177/ 0269216307085181.

45. Zimmermann C, Swami N, Rodin G et al. Cluster- randomized trial of early palliative care for patients with metastatic cancer. Presented at the 2012 American Society for Clinical Oncology Annual Meeting, Chicago, June 1– 5, 2012, abstract.

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