As reported by Betty R. Ferrell, PhD, of the City of Hope Medical Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline update on the integration of palliative care into standard oncology care. This update of a 2012 ASCO provisional clinical opinion is based on an expert panel systematic review of data reported between 2010 and January 2016; nine randomized trials, one quasi-experimental trial, and five secondary analyses of randomized trials used for the 2012 provisional statement provided data for the update. The panel was co-chaired by Dr. Ferrell; Thomas J. Smith, MD, of The Sidney Kimmel Comprehensive Cancer Center; and Jennifer S. Temel, MD, of Massachusetts General Hospital.
The updated recommendations are summarized/reproduced here. The type of recommendation, evidence quality, and strength of recommendation are shown in brackets.
Key Recommendation
Specific Recommendations
Rapport and relationship building with patients and family caregivers;
Symptom, distress, and functional status management (eg, pain, dyspnea, fatigue, sleep disturbance, mood, nausea, or constipation);
Exploration of understanding and education about illness and prognosis;
Clarification of treatment goals;
Assessment and support of coping needs (eg, provision of dignity therapy);
Assistance with medical decision-making;
Coordination with other care providers;
Provision of referrals to other care providers as indicated.
For newly diagnosed patients with advanced cancer, the expert panel suggests early palliative care involvement within 8 weeks of diagnosis. [type: informal consensus, benefits outweigh harms; evidence quality: intermediate; strength of recommendation: moderate]
The panel notes that the guideline uses the National Consensus Project definition of palliative care: “Palliative care means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.”
The panel further states: “ASCO believes that cancer clinical trials are vital to inform medical decisions and improve cancer care and that all patients should have the opportunity to participate. Patients in clinical trials may benefit from the support of palliative care.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.