Palliative Care

Mh, Levy; Back, Anthony L.; Benedetti, Costantino; Ja, Billings; Block, Shannon; Boston, Barry; Bruera, E.; S, Dy; Eberle, Carolyn E.; Foley, KM; Sb, Karver; Sj, Knight; Misra, Sumathi; Cs, Ritchie; Spiegel, Daphna Y.; Sutton, Lucy Porter; Urba, Susan G.; Jh, Von Roenn; Sm, Weinstein

doi:10.6004/jnccn.2009.0031

Cited by 181 publications

(40 citation statements)

References 45 publications

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“…Cancer Network and European Society of Medical Oncology have issued clinical opinions recommending the use of palliative care earlier in the course of disease based on evidence of benefit to patients or their caregivers and no evidence that early palliative care increases patient costs or causes patient or caregiver harm [Cherny et al 2003;Levy et al 2012;Smith et al 2012]. This review discusses the evidence supporting these recommendations, how this information might translate into clinical practice, and directions for future research.…”

Section: Introductionmentioning

confidence: 99%

Early palliative care in cancer treatment: rationale, evidence and clinical implications

Howie

Peppercorn²

2013

Ther Adv Med Oncol

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Abstract:Patients with advanced cancer often experience symptoms of disease and treatment that contribute to distress and diminish their quality of life (QOL). Care that is aimed at control of these symptoms, whether or not the patient is undergoing ongoing disease-directed therapy to control the cancer, is thus a key feature of high-quality patient-centered care. In standard oncology practice, it is easy for focus on this type of care to be obscured by discussions and management of anticancer therapy and adequate attention to QOL, patient preferences, and goals of care often occur only days to weeks from the patient's death. The initiation of palliative care and discussion of the patients' goals and preferences earlier in the course of disease can lead to improved symptom control, reduced distress throughout the disease-directed therapy, and care delivery that matches the patients' preferences. This review discusses the evolving evidence for early initiation of palliative care in patients with advanced cancer and ongoing barriers to care in this setting. We highlight challenges for research and care delivery and the potential for broader awareness of the demonstrated benefits of palliative care to help translate known benefits into improved outcomes for patients facing advanced cancer.

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Section: Introductionmentioning

confidence: 99%

Early palliative care in cancer treatment: rationale, evidence and clinical implications

Howie

Peppercorn²

2013

Ther Adv Med Oncol

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“…In fact, the National Comprehensive Cancer Network's Guidelines for Palliative Care references a life expectancy of less than 6 months as a trigger to more actively engage palliative care, for which SVCS is one indicator [ 50 ]. However, additional factors must be taken into account, including the underlying malignancy that has caused the SVCS, the patient's performance status, and the patient's wishes.…”

Section: Palliative Care Discussionmentioning

confidence: 99%

Superior Vena Cava Syndrome (SVCS)

Manthey

Ellis

2016

Oncologic Emergency Medicine

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“…Patients are referred to these programs late, if at all, because health care providers may not be fully informed about the scope of palliative care and may fear taking away patients’ hope [3-6]. Consequently, patients often receive only a fraction of the services offered by palliative care, and there is a missed opportunity to address a spectrum of needs beginning early in the care trajectory [7]. Thus, care provided to seriously ill patients is inadequate and may have a negative impact on the physical, personal, and social situations of patients and their families [8].…”

Section: Introductionmentioning

confidence: 99%

Integrating palliative care into self-management of breast cancer: Protocol for a pilot randomized controlled trial

Linsky

Jeon

Kapo

et al. 2016

Contemporary Clinical Trials

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Background Despite evidence that palliative care increases quality and length of life, many patients and families remain uninformed about its nature and benefits. The purpose of this study is to test a psycho-educational intervention, Managing Cancer Care: A Personal Guide (MCC), intended to improve breast cancer patients’ knowledge of palliative care and to facilitate its timely integration into cancer self-management. Methods Aims are to: 1) evaluate the effects of MCC on patients’ knowledge of palliative care; 2) examine preliminary effects of MCC on patients’ behaviors (role in self-management, engagement in goals of care conversations, medical communication, management of transitions, health care utilization), and feelings (self-efficacy, anxiety, depression, uncertainty); and 3) evaluate protocol feasibility and acceptability. An exploratory aim is to investigate how demographic and clinical factors may moderate intervention effects, with emphasis on differences in use and outcomes among minority participants. We plan to enroll 60 patients and their family caregivers with 50% minority participation. The intervention group receives MCC; the attention-control group receives a symptom management toolkit. We collect data at baseline, one, and three months. Discussion This study will inform a large scale trial of MCC. It is challenging for patients with breast cancer, their family caregivers, and providers to make choices that include palliation alone or in combination with potentially curative treatment. MCC may help address this challenge by giving patients the information, skills, and confidence to better self-manage breast cancer. Results may help to establish palliative care as a mainstay of self-management interventions targeting serious illness.

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Palliative Care

Cited by 181 publications

References 45 publications

Early palliative care in cancer treatment: rationale, evidence and clinical implications

Early palliative care in cancer treatment: rationale, evidence and clinical implications

Superior Vena Cava Syndrome (SVCS)

Integrating palliative care into self-management of breast cancer: Protocol for a pilot randomized controlled trial

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