Palliative care and hematologic oncology: The promise of collaboration

Attitudes and Beliefs Toward Supportive and Palliative Care Referral Among Hematologic and Solid Tumor Oncology Specialists

“…Our findings are consistent with a recent qualitative study from the United Kingdom and multiple studies examining palliative care referral patterns [9,16,18]. Some of the reasons for delayed referral might include a perceived lack of palliative care needs among these patients, the possibility of cure in the advanced disease setting, heightened expectations regarding treatment outcomes, uncertainty in the disease trajectory, confidence in the provision of supportive care, a strong sense of responsibility to provide care, the stigma associated with palliative care, and the lack of randomized controlled trials to support early palliative care for patients with hematologic malignancies [11,18,19,24,25]. Practice guidelines, decision aids, care pathways, and other methods to integrate hematology and palliative care, such as increased education regarding the role of palliative care, might improve the referral process [26].…”

When and why should patients with hematologic malignancies see a palliative care specialist?

“…8,30,31 In a cross-sectional study of 180 patients with hematologic malignancies, patients had a considerable physical and psychological symptom burden, with an overall mean of 8.8 symptoms. 9 The mean symptom burden was significantly greater in those on treatment, those with poorer performance status, inpatients, and those with more advanced disease.…”

“…Rather, a growing body of evidence highlights that patients with cancer derive many benefits from palliative care including reductions in symptom burden, 2 improvements in quality-of-life and mood, 3,4 improved survival, 4,5 as well as improved caregiver outcomes 6 ; this is true even for those receiving active cancer treatment. However, patients with hematologic malignancies are much less likely to access palliative care services than patients with solid tumors, 7,8 despite growing evidence of many unmet palliative care needs in this population. 9 This discrepancy suggests a need for more education about palliative care in the hematology community, and more efforts to adapt palliative care services to better meet the needs of patients with hematologic malignancies.…”

“…9 This discrepancy suggests a need for more education about palliative care in the hematology community, and more efforts to adapt palliative care services to better meet the needs of patients with hematologic malignancies. 8,10 This article will present a contemporary definition of "palliative care", review the evidence supporting the integration of palliative care into comprehensive cancer care, discuss perceived barriers to palliative care in hematologic malignancies, and suggest opportunities and triggers for earlier and more frequent palliative care referral in this population. …”

Symptom burden and supportive care in patients with acute leukemia

“…There has been recent acknowledgment of the relevance of palliative care for patients with hematological malignancies [10], and accumulating evidence of the benefit of palliative care when provided concurrently with curative or life-prolonging treatment [11][12][13][14][15]. However, there have been no prospective studies assessing referral to palliative care and psychosocial services for patients with acute leukemia and correlating these data with symptom severity.…”