1. Integration of Supportive and Palliative Care into Oncology

Authors

O.E. Yri¹, K. Jordan^2,3, S. Kaasa¹

1. European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
2. Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann Potsdam, Potsdam, Germany
3. Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany

Declaration of interest

Introduction

The goal of integration of supportive and palliative care with oncology is to unite two treatment aims: optimal treatment of the tumour – ‘the tumour-directed approach’ – and optimal treatment of the patient who has the tumour – ‘the patient-directed approach’. There is now a growing body of evidence that integration of these two modes of care will provide the optimum patient-centred care. It benefits patients in terms of improved symptom relief, quality of life (QoL), coping, social functioning and also survival. It is time to stop debating if integration should be sought and to focus on how best to accomplish integration of supportive and palliative care with oncology. All oncologists should strive to implement this new organisation into every individual patient care pathway.

The European Society for Medical Oncology (ESMO) position paper on supportive and palliative care states that, besides anticancer treatments, most cancer patients need help to prevent and alleviate side effects related to such treatment, and to cope with symptoms and needs related to the disease itself. Most patients wish to live as long as possible but also as well as possible. Physical, psychological, social, existential and spiritual support is therefore needed at every stage of the cancer pathway and not only if the cancer is incurable.

In a patient-centred care approach, any intervention is introduced both at the appropriate time and according to the patient’s needs. To facilitate integration, steps must be taken in several areas, as described below. One major challenge is how to systematically implement supportive and palliative care in routine oncology care. In this regard, the multidisciplinary team (MDT) plays a vital role.

Declaration of Interest:
Dr Yri has reported no potential conflicts of interest.
Dr Jordan has reported no potential conflicts of interest.
Dr Kaasa has reported no potential conflicts of interest.