Early Implementation of Palliative Care Can Improve Patient Outcomes

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Patients with cancer experience many complex issues throughout the trajectory of the disease. These range from the physical consequences of cancer and treatment to the psychological, social, and spiritual issues associated with living with the disease. An individualized, comprehensive, and interdisciplinary approach is needed to reduce patient suffering and ensure appropriate symptom management and support from the time of first diagnosis to end of life. Data from randomized clinical trials prove that patients provided with early palliative care can experience relief of symptoms and improvements in quality of life, mood, satisfaction, resource use, and advanced care planning. Professional organizations such as ASCO have begun to develop recommendations that integrate palliative care into standard oncologic care from the time a person is diagnosed with metastatic or advanced cancer. NCCN has a palliative care guideline that recommends early and ongoing assessment of palliative care needs and referral to specialist palliative care services in more complex cases. In turn, oncologists need to consider how best to screen patients and integrate early palliative care with routine oncologic care, within the context of their busy clinics, to ensure that patients, families, and caregivers receive timely support.

Correspondence: Paul A. Glare, MD, Chief, Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Email: glarep@mskcc.orgDr. Glare has received consulting fees, honoraria, and travel support from Archimedes Pharma. His institution received a grant from the Mayday Fund to evaluate the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) on palliative care screening. The roundtable discussion that shaped the content of this article was supported by Archimedes Development Ltd., Nottingham, UK.
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