Palliative Care for All Cancer? Not Yet...

A study published in the Journal of the American Medical Association (JAMA) reported that although most cancer centers now have a palliative care program, significant gaps and delays in the delivery of care remain.  The study looked at the availability of palliative care at U.S. cancer centers, both those designated as National Cancer Institutes (NCI) and non-NCI centers, as well as executives attitudes towards palliative care.  The results showed that palliative care was more readily available and integrated into National Cancer Institute hospitals than non-NCI cancer centers but that services varied widely.

Palliative care should be a standard cancer treatment, not just a last-ditch effort to promote comfort at the very end of life.  Palliative care is expert pain and symptom management, focusing on the entire person rather than just the illness.  Don't cancer patients deserve this kind of treatment at the time of diagnosis, continuing throughout the trajectory of their illness whatever the outcome?  The American Society of Clinical Oncology has a vision to have full integration of palliative care services as a routine part of cancer care by the year 2020.  We have a long way to go if we are going to meet that goal.  The first step is to recognize palliative care as part of a comprehensive cancer treatment plan, not just as end-of-life care.

The ideal scenario is for a patient to be able to visit a cancer center for expert chemotherapy, radiation, surgery, or any combination of cancer treatment.  While at the center, the patient has a consultation with a palliative care team.  The palliative care team would oversee the patient's physical comfort while going through aggressive treatments, offer emotional and spiritual counseling and support, and be available to discuss end-of-life wishes if and when the time comes.  If cancer treatment is successful, the patient benefits from expert pain and symptom management and support.  If cancer treatment fails, the transition to hospice care is smooth and the patient is more prepared for what lies ahead.

I hope to see more cancer centers and major medical centers alike integrate palliative care into their cancer treatment programs.  Do you have an exciting palliative care program at your hospital?  Share below!