Integrating palliative care in oncology.

摘要

BACKGROUND: Cancer is the second leading cause of death among Americans. The World Health Organization has mandated an integrated approach to palliative care in the treatment of patients with cancer. However, medical decision making in the setting of life-threatening disease remains complicated. METHODS: An integrated palliative care approach depends on the skillful blend of antineoplastic, supportive, and palliative interventions. For standardizing care plans, documenting palliative interventions, and tracking and improving outcomes, palliative care elements are defined. At our institute, medical symptom management, psychosocial support, and advance care planning are incorporated into routine cancer care. RESULTS: Although progress is being made toward integrating palliative care in the field of oncology, further efforts are needed to ensure that cancer patients and their families who need palliative care receive it. CONCLUSIONS: If fully implemented, the integrated palliative care approach will result in quaternary prevention, ie, the prevention of suffering.