Palliative and end-of-life care for the older adult with cancer

Abstract

Purpose of review Despite established benefits of palliative care in the oncology population, it remains an underutilized resource particularly among older adults. The illness trajectory and needs of an older adult with cancer are unique. The purpose of this paper is to review the current literature on providing comprehensive palliative and end-of-life care for the older adult with cancer. Recent findings Though the difficulties of applying traditional palliative care principles in the older patients with cancer have been discussed, this review reveals a clear gap in the literature in discussing the provision of comprehensive palliative and end-of-life care in this population. Very few articles have been published in this domain with even fewer published within the past 18 months. Summary As such, this article reviews key aspects of palliative and geriatric medicine that need to be considered and integrated in order to provide comprehensive palliative care to the older adult with cancer. This includes a discussion of proper pain and symptoms assessment, performance status assessment, advance care planning, and end-of-life care while considering the nuances of geriatric syndromes.

End-of-life care in cancer patients: how much drug therapy and how much palliative care? Record linkage study in Northern Italy

“…Aggressive treatments, facilitated by the availability of newer anticancer agents that have fewer side effects,3 often do not alleviate patients’ condition or provide hope for extending significantly life of decent quality. Focus on clinically irrelevant treatments may lead to the underuse of palliative care,4–6 defined by WHO as ‘an approach that improves the quality of life (QoL) of patients and their families facing the problem associated with life-threatening illness, through … assessment and treatment of pain and other problems, physical, psychosocial and spiritual’ 7. Palliative care is generally provided in dedicated hospices or as home care services by a specially trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support 8 9.…”

Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan

“…2 End-of-life care requires multidisciplinary care to alleviate various types of distress, including physical, psychological, social, and spiritual burdens. 3–5 Moreover, health care professionals are expected to interact with patients and their families to discuss the treatment plan, place of care, and wishes for life-prolonging treatment. 6–8 Accordingly, health care professionals, including physicians, are required to show dedicated and thoughtful behavior and care toward patients and their caregivers.…”

Development of a national health policy logic model to accelerate the integration of oncology and palliative care: a nationwide Delphi survey in Japan

“…Cancer is the world's leading cause of death, accounting for approximately 10.0 million deaths each year, and one in six deaths [1]. In addition, cancer is known to cause severe distress (e.g., physical, psychological and social) in patients and their caregivers [2][3][4]. Strategies are needed to deliver quality care for people suffering from cancer across a comprehensive range of settings including hospitals, local communities, and societies.…”