The European Society for Medical Oncology (ESMO) has released a new position paper on supportive and palliative care that advocates for integrating patient-centered care into overall anticancer treatment by a multi-disciplinary team (MDT).
The paper, “European Society for Medical Oncology (ESMO) position paper on supportive and palliative care,” was published in the journal Annals of Oncology.
About 14.1 million people worldwide are diagnosed with cancer every year. As scientific research has progressed, more people are now cured or living longer with the disease. Nonetheless, a diagnosis of cancer is extremely stressful to patients.
Depending on the cancer diagnosis, patients receive different treatments. Along with those treatments, patients need help to prevent or improve side effects. They also need help coping with the disease. At any stage of cancer diagnosis and treatment, patients need physical, psychological, social, existential and spiritual support, and rehabilitation, the ESMO states.
“New studies in the field of supportive and palliative care show that there may be a gap between what doctors think is important or disturbing for patients, and what patients really need,” Karin Jordan, MD, Department of Medicine V, Haematology, Oncology and Rheumatology, University of Heidelberg, Germany, said in a press release.
The best management of the disease requires patients to be fully involved in decision-making.
“Patients must ‘set the tone’ in supportive and palliative care. We need to make it easy for them to tell us how they feel, what they need and, of course, allow them to be fully involved in decision-making if we are to provide optimal patient-centred care,” Jordan said.
In order to encompass both palliative cancer and supportive care, the EMSO proposes the use of the term “patient-centred care”. As patients go through very different experiences in cancer treatment, their needs also will need to be individualized. Their needs will evolve with treatment over time. So, even though patient-centred care cannot be standardized, there needs to be a framework in place to build on.
The ESMO position paper suggests that for patients to voice their needs, oncologists should include detailed and routine physical and psychological assessments that will allow for patient-centred care to be individualized and added into the continuum of care.
Furthermore, doctors should encourage patient-reported outcomes because requesting them has been associated with better quality of life, reduced hospitalizations, and higher survival.
“Patient-centred interventions should be routinely discussed and evaluated by the MDT, together with tumor-directed treatment, respecting patient preferences and cultural specificities,” the researchers said.
Timely-patient-centred interventions are very important, and different types of interventions are required for different stages of disease. Furthermore, the EMSO suggests that oncologists, along with disease management teams (DMTs), should conduct rehabilitation at time of diagnosis of relapse, rehabilitation during treatment, and survivor care plans for patients recovering well. Special attention also should be paid to patients when their life-prolonging treatment is coming to an end and they require end-of-life care.
The EMSO suggests that MDTs should be composed of medical oncologists, palliative medicine specialists, nurses, tumor origin specialists, radiation oncologists, surgeons, pharmacists, allied healthcare professionals, clerics and volunteers. Furthermore, healthcare resources should be integrated so that patients have access to all services if needed.
“ESMO is committed to increasing awareness and education to bring patient-centred care closer to all professionals; to improving collaboration between healthcare providers for the good of patients; and to promoting research, so that patient-centred interventions are not only integrated, but also based on the best evidence,” said Andrés Cervantes, MD, PhD, and chair of the ESMO Educational Committee.
The paper’s authors end by discussing the need for further research into palliative and supportive care. “Despite growing awareness of the need to develop patient-centred care and recent progress in the field, more and better scientific evidence is required so that effective interventions can be proposed to cancer patients at each stage of their illness,” said Jordan.
Jordan concluded: “ESMO appeals to health authorities in Europe and beyond to ensure that cancer patients have equal access to the best possible patient-centred cancer care that resources allow.”
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