Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update

Ferrell, Betty; Temel, Jennifer S.; Temin, Sarah; Alesi, Erin R.; Balboni, Tracy A.; Basch, Ethan; Firn, Janice; Paice, Judith A.; Peppercorn, Jeffrey; Phillips, Tanyanika; Stovall, Ellen; Zimmermann, Camilla; Smith, Thomas J.

doi:10.1200/jco.2016.70.1474

Cited by 1,668 publications

(1,402 citation statements)

References 67 publications

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“…32 Integrating early enhanced supportive care for people with advanced cancer into standard oncology care has been recommended by the American Society of Clinical Oncology, which, after conducting a systematic review of clinical trials concluded there is strong evidence that early palliative care improves quality of life, reduces depression and improves satisfaction with care; however, there was less evidence to show that it improves survival. 33 Integrated palliative care and oncology services vary by hospital in the UK as no national guidance exists. This integration is arguably a more cost-efficient use of resources than approving use of some of the systemic targeted treatments as not a single trial of enhanced supportive care has demonstrated a cost increase over routine care.…”

Section: Supportive and Palliative Carementioning

confidence: 99%

Recent advances in the management of lung cancer

2018

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Thoracic surgery is considered the standard of care for people with early stage lung cancer who are deemed fit enough. Modern Historically, the prognosis for individuals diagnosed with lung cancer has been bleak. However, the past 10 years have seen important advances in treatment and diagnosis which have translated into the fi rst improvements seen in lung cancer survival. This review highlights the major advances in treatments with curative intent, systemic targeted therapies, palliative care and early diagnosis in lung cancer. We discuss the pivotal research that underpins these new technologies/strategies and their current position in clinical practice. KEYWORDS : Lung cancer , curative treatment , targeted therapies , early diagnosis , lung cancer management IntroductionFor several decades lung cancer has been the most common cancer in the world.1 In 2014 there were 46,403 new cases of lung cancer diagnosed in the UK. 2 It is the third most common cancer after breast and prostate, but has the largest proportion of all cancer-related deaths (22%). 2 The overall age standardised incidence has declined slightly over the past 40 years, which is a combination of a marked decline among men and an increase for women (Fig 1 ). Approximately 62% of people have advanced stage disease at diagnosis. 3 When combining all stages of lung cancer in England, 1-year survival has improved from 24.5% in 1995-9 to 36.7% currently. 4 Much of this improvement has occurred since 2010 and is attributed to developments in lung cancer care. StagingIt is important to accurately stage patients with lung cancer as this contributes to treatment options and prognosis. Better access to positron emission tomography with computed tomography (PET-CT) scanning and endobronchial ultrasound (EBUS) for mediastinal lymph node sampling have increased the accuracy of staging for lung cancer. ABSTRACTAuthors:

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Section: Supportive and Palliative Carementioning

confidence: 99%

Recent advances in the management of lung cancer

2018

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“…3,[11][12][13][14][15][16] Palliative care should be initiated by the primary oncology team (including physicians, nurses, social workers, mental health professionals, chaplains, physician assistants, pharmacists, and dietitians) and then augmented via collaboration with an interdisciplinary team of palliative care experts to address intractable symptoms and/or complex psychosocial issues. When further anticancer therapy is unlikely to provide additional benefit or is expected do more harm than good, palliative care becomes the predominant care offered to patients with advanced cancer.…”

Section: Introductionmentioning

confidence: 99%

NCCN Guidelines Insights: Palliative Care, Version 2.2017

Dans¹,

Smith²,

Back³

et al. 2017

J Natl Compr Canc Netw

112

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“…Mrs. X was treated within the French Health care system. However the disease progressed and the patient entered a phase of purely palliative treatment, which corresponded to current guidelines [20]. Difficulties were encountered due to the patient's status as an illegal immigrant, her poverty, absence of supportive family structure, and non-European culture.…”

Section: Resultsmentioning

confidence: 99%

Palliative Care and Socio-Cultural Interactions in French Guiana: A Case Report and Discussion

Droz¹

2017

PMCOA

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Context : Palliative care involves global management of the patient at the end of life. In the practice of oncology, important cultural aspects of this care are not always adequately taken in account.Objective: To describe social, familial, economic and cultural aspects of end of life care through a case report of a patient with cancer of the cervix living in a multicultural setting.Data Acquisition: Mrs. X, whose case is reported, was one of the 594 patients managed at the Cayenne Oncology Unit in French Guiana between January 2010 and December 2012. Mrs. X's trusted representative in confidential matters was her 21-year-old sister, who gave oral permission for anonymized data relating to the case to be published. The search for relevant references was guided by the nature of the data and discussion between authors.Findings: Mrs. X's clinical presentation was typical for cancer of the cervix. Initial treatment was with curative intent led to incomplete resection. However, disease progression quickly made her case one of palliative management, and this raised many social, economic, family and cultural issues. These included illegal immigration, poverty, lack of structured family support, and aspects of indigenous cultural practice. The first three aspects were effectively managed by social workers. Cultural aspects, however, were not well understood. The objective was that the patient should die in her home surroundings and receive appropriate cultural death rites. This Native American patient was thought to belong to a cultural group whose death rites have disappeared. In fact, she belonged to a different group that had also lost its cultural identity. Conclusions:Knowing patients' medical history is essential to planning effective palliative care. But it is also important to understand as fully as possible their social, familial and cultural circumstances. In relation to a patient's culture, we must not rely on general assumptions but should seek to understand the specific circumstances relevant to a particular individual.

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Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update

Cited by 1,668 publications

References 67 publications

Recent advances in the management of lung cancer

Recent advances in the management of lung cancer

NCCN Guidelines Insights: Palliative Care, Version 2.2017

Palliative Care and Socio-Cultural Interactions in French Guiana: A Case Report and Discussion

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