NCCN Guidelines Insights: Palliative Care, Version 2.2017

Dans, Maria; Smith, Thomas J.; Back, Anthony L.; Baker, Justin N.; Bauman, Jessica R.; Beck, Anna; Block, Susan D.; Campbell, Toby C.; Case, Amy A.; Dalal, Shalini; Edwards, H. Berryman; Fitch, Thomas R.; Kapo, Jennifer; Kutner, Jean S.; Kvale, Elizabeth; Miller, Charles M.; Misra, Sumathi; Mitchell, William; Portman, Diane; Spiegel, David; Sutton, Linda; Szmuilowicz, Eytan; Temel, Jennifer S.; Tickoo, Roma; Urba, Susan G.; Weinstein, Elizabeth; Zachariah, Finly; Bergman, Mary Anne; Scavone, Jillian L.

doi:10.6004/jnccn.2017.0132

Cited by 111 publications

(97 citation statements)

References 35 publications

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“…Honest, empathetic and truthful disclosure is associated with hope, even if the news is bad or the prognosis is poor [23,24] . Physicians must not confuse hope with supporting false expectations or denial by conveying the impression of disease "control" [19] . Instead, realistic treatment goals and information about the availability of hospice or PC services can be understood as "double awareness" [25] .…”

Section: Communication Identification Of Fears and Advance Care Planmentioning

confidence: 99%

“…Although diseasemodifying treatments such as chemo-or radiotherapy are of utmost importance for relieving symptoms, especially in early stages of the disease, oncologists must hold adequate knowledge for basic treatment algorithms for cancer pain, dyspnoea, and other symptoms. For this, concise recommendations and evidence-based consensus guidelines have been made available [19,26] .…”

Section: Basic Symptom Control: Questions Arising In Times Of the Opimentioning

confidence: 99%

“…For the National Comprehensive Cancer Centre Network (NCCN), "hope" in the context of incurable and life-threatening cancer is setting realistic goals, such as being free of pain or not feeling alone [19] . Honest, empathetic and truthful disclosure is associated with hope, even if the news is bad or the prognosis is poor [23,24] .…”

Section: Communication Identification Of Fears and Advance Care Planmentioning

confidence: 99%

“…Guidelines (i.e. [14,19] ) recommend the use of simple tools, e.g. based on the Edmonton Symptom Assessment Scale.…”

Section: General Pc: Key Tenetsmentioning

confidence: 99%

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Early Palliative Care: Pro, but Please Be Precise!

Gärtner¹,

Daun

Wolf

et al. 2019

Oncol Res Treat

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Background: By definition, palliative care (PC) is applicable already in early stages of incurable and life-threatening diseases, in conjunction with therapies that are intended to prolong life, such as for example chemo- or radiotherapy. Many patients suffer from distressing symptoms or problems in early phases of such illness. Therefore, it is not a question of “if” PC should be integrated early into oncology, but “how.” General PC is defined as an approach that should be delivered by healthcare professionals regardless of their discipline. This is often referred to as “general” or “primary” PC. For this, routine symptom assessment, expertise concerning basic symptom management, and communication skills are basic requirements. Communication skills include the willingness to engage in discussions concerning patients' fears, worries and end-of-life issues without the fear of destroying hope. Specialist PC is provided by specialist teams regardless of the patients' disease, be it cancer or non-cancer. Such teams should be integrated in the care of PC patients depending on the availability of these services and the patients' needs. Key messages: “Early PC” must not be used synonymously with “early specialist PC” because much of the PC is delivered as basic oncology PC. For the integration of specialist PC, the identification of triggers is warranted in different institutions to facilitate a meaningful and effective cooperation. Such cooperations should be based on patients' needs, but must also account for questions of availability and resources.

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Section: Communication Identification Of Fears and Advance Care Planmentioning

confidence: 99%

Section: Basic Symptom Control: Questions Arising In Times Of the Opimentioning

confidence: 99%

Section: Communication Identification Of Fears and Advance Care Planmentioning

confidence: 99%

“…Guidelines (i.e. [14,19] ) recommend the use of simple tools, e.g. based on the Edmonton Symptom Assessment Scale.…”

Section: General Pc: Key Tenetsmentioning

confidence: 99%

See 2 more Smart Citations

Early Palliative Care: Pro, but Please Be Precise!

Gärtner¹,

Daun

Wolf

et al. 2019

Oncol Res Treat

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“…15,16 Reduction in symptom severity is important for patients 17 and is in line with best clinical practice guidelines, 15 but may not be sufficient for maintaining or improving overall quality of life for advanced cancer patients because symptoms are likely to fluctuate and are expected to worsen toward end of life. 15,16 Reduction in symptom severity is important for patients 17 and is in line with best clinical practice guidelines, 15 but may not be sufficient for maintaining or improving overall quality of life for advanced cancer patients because symptoms are likely to fluctuate and are expected to worsen toward end of life.…”

Section: Introductionmentioning

confidence: 91%

A feasible and acceptable multicultural psychosocial intervention targeting symptom management in the context of advanced breast cancer

Teo

Vilardaga²,

Tan

et al. 2019

Psycho-Oncology

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Objective: Advanced breast cancer patients around the world experience high symptom burden (ie, distress, pain, and fatigue) and are in need of psychosocial interventions that target symptom management. This study examined the feasibility, acceptability, and engagement of a psychosocial intervention that uses cognitive-behavioral strategies along with mindfulness and values-based activity to enhance patients' ability to manage symptoms of advanced disease in a cross-cultural setting (United States and Singapore). Pre-treatment to post-treatment outcomes for distress, pain, and fatigue were compared between intervention recipients and waitlisted controls.Methods: A pilot randomized controlled trial included women with advanced breast cancer (N = 85) that were recruited in the United States and Singapore.Participants either received the four session intervention or be put on waitlist.Descriptive statistics and effect size of symptom change were calculated.Results: The psychosocial intervention was found to be feasible as indicated through successful trial accrual, low study attrition (15% ), and high intervention adherence (77% completed all sessions). Acceptability (ie, program satisfaction and cultural sensitivity) and engagement to the study intervention (ie, practice of skills taught) were also high. Anxiety, depression, and fatigue scores remained stable or improved among intervention participants while the same symptoms worsened in the control group. In general, effect sizes are larger in the US sample compared with the Singapore sample. Conclusions:The cognitive-behavioral, mindfulness, and values-based intervention is feasible, acceptable, and engaging for advanced breast cancer patients in a crosscultural setting and has potential for efficacy. Further larger-scaled study of intervention efficacy is warranted.

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