Evidence for integration of palliative care into surgical oncology practice and education

Abstract

High-quality data support multiple clinical benefits of integrating palliative care into routine oncology care. Though these data come largely from the medical oncology literature, data from surgical oncology populations support similar associations between palliative care integration and improved clinical outcomes, all without compromise in survival. This paper will review data supporting palliative care integration into oncology care, with a focus on surgical populations and recommendations for incorporating palliative care into surgical oncology. K E Y W O R D S education, palliative care, surgical oncology

Characteristics and fate of patients with rectal cancer not entering a curative-intent treatment pathway: A complete nationwide registry cohort of 3,304 patients

“…However, national cancer registries responsible for all cancer patients should be encouraged to collect relevant data for treatment aspects beyond curative intention. Modern palliative care provides a broad spectrum of options to improve and maintain quality of life or optimise end-of-life care [28]. Hopefully, the increased focus on patient-reported outcomes (PROM) will enable cancer registries to provide data to evaluate treatments from the patient perspective [29].…”

The Need for Accurate Risk Assessment in a High-Risk Patient Population: A NSQIP Study Evaluating Outcomes of Cholecystectomy in the Patient With Cancer

“…In addition to a collaborative approach and optimization of underlying conditions, studies have also shown that early palliative care consultation can lead to improvements in symptom management, quality of life, and spiritual satisfaction, and should be considered in all patients with advanced malignancy. 41,42 The lack of preoperative guidelines for patients with cancer underscores the need for more research focusing on this high-risk population. Treatment strategies should focus on timely diagnostic evaluation, early surgeon consultation, the inclusion of a comprehensive treatment team, and individualized treatment decisions based on a multidisciplinary approach.…”

Integrative oncology and patient-centered care: does palliative surgery have a role in these two concepts?

“…Although it is true that most part of the literature that shows evidence on the integration of palliative care to cancer treatment originates from studies in the field of clinical oncology, there is also evidence on the benefits of palliative care in surgical oncology units, including an improvement in patient-reported outcomes and a decrease in the use of resources, without survival being compromised 10 . For example, in a study that evaluated 34,000 patients who died in a surgical unit for several types of cancer over a 10-year period, those patients who had access to palliative care were shown to have a significant decrease in end-of-life aggressive care such as chemotherapy, emergency room visits, hospitalizations, and intensive care unit admissions within the past 30 days before death, and in-hospital death 11 .…”