The Medical Oncologist's Role in Palliative Care: AIOM's Position

Zagonel, Vittorina; Cavanna, Luigi; Cetto, Gianluigi; Ciaparrone, Marco; Rocco, Cristiana Di; Franciosi, Vittorio; Maltoni, Marco; Marchetti, Paolo; Martoni, Andrea; Mastromauro, Cataldo; Mazzoli, M.; Moro, Cecilia; Pinto, Carmine; Porzio, Giampiero; Trentin, Leonardo; Boccardo, Francesco; Oncology, Task Force Aiom Palliative Care in

doi:10.1177/030089160909500602

Cited by 16 publications

(20 citation statements)

References 12 publications

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“…1,5,13,[15][16][17][18] The scope of palliative care varies across sites and locations, ranging from only end-of-life care to the management of symptoms and other distress across the full trajectory of disease from first diagnosis. 1,13,18 The most recent definitions of palliative care generally advocate a comprehen-are the end points of supportive care, while the main outcome is patient survival.…”

Section: A Comprehensive Approach To Relieve Sufferingmentioning

confidence: 99%

“…1,13,18 The most recent definitions of palliative care generally advocate a comprehen-are the end points of supportive care, while the main outcome is patient survival. 15 Developing an approach whereby all patients can obtain relief from suffering and have the best possible quality of life at all stages of disease is crucial, regardless of the terminology used to describe the care given.…”

Section: A Comprehensive Approach To Relieve Sufferingmentioning

confidence: 99%

“…6 A paradigm shift has occurred to approaches that integrate disease-directed therapy and palliative care, such that palliative care is given throughout the continuum of disease, with the informed preferences of the patient incorporated into individualized treatment plans. 5,13,[15][16][17][18] ASCO has stated a vision that comprehensive care, with full incorporation of palliative care into standard oncologic care, will be achieved by 2020. 4 Towards this goal, ASCO provided a provisional clinical opinion sive, interdisciplinary approach from an early stage of the disease (Table 1).…”

Section: Integration With Oncologic Care For Early Implementationmentioning

confidence: 99%

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Early Implementation of Palliative Care Can Improve Patient Outcomes

Glare

2013

J Natl Compr Canc Netw

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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. (JNCCN 2013;11(Suppl 1): S3-S9)

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Section: A Comprehensive Approach To Relieve Sufferingmentioning

confidence: 99%

Section: A Comprehensive Approach To Relieve Sufferingmentioning

confidence: 99%

Section: Integration With Oncologic Care For Early Implementationmentioning

confidence: 99%

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Early Implementation of Palliative Care Can Improve Patient Outcomes

Glare

2013

J Natl Compr Canc Netw

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“…5 A medical oncologist, specifically dedicated to supportive and palliative care, plays a central oncology departments. In the former, an instrument called the Distress Thermometer, designed by NCCN and validated in Italy to measure the level of distress and presence of problems, is administered to all patients at admission to the hospital or outpatient clinic ( Figure 1).…”

Section: Approachmentioning

confidence: 99%

Provision of Palliative Care and Pain Management Services for Oncology Patients

Marchetti¹,

Voltz²,

Rubio³

et al. 2013

J Natl Compr Canc Netw

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Early initiation of palliative care to address pain and other symptoms offers the potential to improve quality of life for patients with cancer. The approaches to implementing and delivering palliative care and pain management services vary depending on patient needs, available resources, provider training, and clinical setting. This article describes the experiences in developing programs in which the need for early palliative care or pain management services for patients with cancer was recognized. In each case, collaborative efforts, careful planning, administrative support, and ample time were needed to implement such services. To tailor services based on the available resources, different approaches were taken, including structuring of services within oncology units; creation of an integrated partnership between oncology and palliative care departments; establishment of a multidisciplinary comprehensive service; and incorporation of nurse-based pain services to address acute, chronic, and cancer pain. These examples offer insights into how to optimize delivery of services in a variety of settings with varying resources. (JNCCN 2013;11(Suppl 1): S17-S27) recommends that combined standard oncology and palliative care should be considered early in the disease process for patients with metastatic cancer and/or a high symptom burden. Meanwhile, the European Society for Medical Oncology (ESMO) formalized the relationship between medical oncology and palliative care in a series of policy statements published in 2003. 4 These policies recognize that alleviation of pain and other symptoms should be given a high priority, that medical oncologists must be experts in evaluating and managing these symptoms, and that cancer centers should provide supportive and palliative care as part of their basic services. Provision of Palliative Care and Pain Management Services for Oncology PatientsAlthough agreement exists on the need for early palliative care services for patients with cancer, less guidance is available on optimal ways to develop successful programs. The availability of palliative care and pain management services varies by country and geographic location, and across medical centers. Programs incorporating palliative care services must base their design on the needs of the patients, the training and availability of health care providers, and the resources available.

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“…In 2009, the Italian Association of Medical Oncology (AIOM) identified ESMO's integration model as the best for the needs of cancer patients [5].…”

mentioning

confidence: 99%