ASCO is calling upon the oncology community to help improve the quality of life of patients with advanced cancer.  In a policy statement issued last month, ASCO outlined four priorities for advanced cancer care planning as well as steps to ensure care is individualized to address patients' needs and preferences throughout the course of treatment.

ASCO's policy statement lays out four key priorities for advanced cancer care planning:

• Assess whether the cancer can be treated: Evidence suggests that patients with advanced cancer often receive overly optimistic assessments of prognosis, which may lead them to receive unnecessary treatment.
• Make quality of life an explicit priority throughout the treatment continuum: Patients should understand all potential treatment options; in cases where curative treatment is unlikely to extended survival, palliative therapies should be discussed as an alternative.
• Initiate candid discussions about options soon after diagnosis: Candid conversations about advanced cancer care occur less than 40% of the time.  However, multiple studies have shown that palliative treatment options improve patient and caregiver quality of life, and can even extend life.
• Increase participation in clinical trials: Very few patients with advanced cancer participate in trials due to strict eligibility criteria, and few trials address quality of life issues. Increasing opportunities for patients to potentially benefit from trials should be a high priority.

Significant barriers currently prevent patients with advanced cancer from openly discussing care options. These range from limited educational and training resources for oncologists to a lack of insurance reimbursement for palliative care discussions.

To address these barriers ASCO recommends:

• emphasizing advanced cancer care planning in physician training and education
• providing insurance coverage for advanced care planning discussions
• increasing educational resources for patients with advanced cancer
• increasing opportunities for patients with advanced cancer to participate in clinical research

To help oncologists overcome the barriers related to advanced cancer care planning, ASCO will issue guidance on the integration of palliative care service into oncology practice. ■

© 2011. American Society of Clinical Oncology. All rights reserved.