Attitudes of medical oncologists toward palliative care for patients with advanced and incurable cancer

180

112

Palliative care and rehabilitation practitioners are important collaborative referral sources for each other who can work together to improve the lives of cancer patients, survivors, and caregivers by improving both quality of care and quality of life. Cancer rehabilitation and palliative care involve the delivery of important but underutilized medical services to oncology patients by interdisciplinary teams. These subspecialties are similar in many respects, including their focus on improving cancer-related symptoms or cancer treatment-related side effects, improving health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision-making. They also aim to improve healthcare efficiencies and minimize costs by means such as reducing hospital lengths of stay and unanticipated readmissions. Although their goals are often aligned, different specialized skills and approaches are used in the delivery of care. For example, while each specialty prioritizes goal-concordant care through identification of patient and family preferences and values, palliative care teams typically focus extensively on using patient and family communication to determine their goals of care, while also tending to comfort issues such as symptom management and spiritual concerns. Rehabilitation clinicians may tend to focus more specifically on functional issues such as identifying and treating deficits in physical, psychological, or cognitive impairments and any resulting disability and negative impact on quality of life. Additionally, although palliative care and rehabilitation practitioners are trained to diagnose and treat medically complex patients, rehabilitation clinicians also treat many patients with a single impairment and a low symptom burden. In these cases, the goal is often cure of the underlying neurologic or musculoskeletal condition. This report defines and describes cancer rehabilitation and palliative care, delineates their respective roles in comprehensive oncology care, and highlights how these services can contribute complementary components of essential quality care. An understanding of how cancer rehabilitation and palliative care are aligned in goal setting, but distinct in approach may help facilitate earlier integration of both into the oncology care continuum-supporting efforts to improve physical, psychological, cognitive, functional, and quality of life outcomes in patients and survivors.

Section: Advancing Collaborative Interdisciplinary Care Coordinationmentioning

confidence: 98%

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Silver

Raj

et al. 2015

180

112

“…The increasing tendency to treat advanced cancer patients until the last part of life and to refer them too late to palliative care services has recently been identified as an index of poor quality of care [15,16]. Such a habit is frequent among American and European oncologists [12,40] and makes the integration between primary anticancer treatments and supportive and palliative care quite hard [11,13,17,24,35]. Many controversial issues interfere with the choice of treating/ nontreating advanced cancer patients, and the balance between the benefit of further anticancer treatments and the opportunity of a comprehensive palliative approach is not well defined nor based on sound evidences [19,23,25,26,33,41,42].…”

Section: Introductionmentioning

confidence: 99%

The palliative prognostic score and survival in patients with advanced solid tumors receiving chemotherapy

Tassinari

Montanari

Maltoni³

et al. 2007

The PaP score seems to discriminate patients who could benefit by palliative chemotherapy from those who could better benefit by supportive and palliative approach. However, the data are insufficient to validate the use of the PaP score in patients to be treated with palliative chemotherapy, and further trials should be planned to assess its ability to improve the quality of care in oncology and the appropriateness in the choice of palliative chemotherapy.

“…In 2003, a survey performed on 895 members of the European Society of Medical Oncology (ESMO) demonstrated that 88.1% of the physicians interviewed believe that medical oncologists should be experts in the management of physical and psychological symptoms [1]. In the same year, the ESMO took a stand on supportive and palliative care, suggesting that "supportive and palliative care should be initiated during the active treatment phase, that medical oncologists should be expert in the management of symptoms and that cancer centers should provide supportive and palliative care as part of the basic basket of services" [2].…”

Section: Introductionmentioning

confidence: 99%

Assessment and treatment of symptoms among Italian medical oncologists

Porzio

Valenti

Aielli

et al. 2005