ASCO Supports Concurrent Palliative Care for People with Advanced Cancer

by Christian SinclairTheAmerican Society of Clinical Oncology recentlypublished the strongest call for concurrent palliative care in oncology. Released online on Halloween 2016, and published in the Journal of Clinical Oncology just last month, this Clinical Practice Guideline (CPG) should be in the pocket of every palliative care team as they meet with their oncology colleagues to collaborate on better care for patients.The guideline holds more weight and expands the scope compared to the 2012 Provisional Clinical Opinion which emerged after the Temel article. In 2010,NEJM published a randomized control trial (RCT) of palliative care in metastatic non-small cell lung cancer (NSCLC). Many people (outside of palliative care and within the field) focused on the secondary outcome that palliative care might prolong life. That mania often overshadowed the primary outcome which demonstrated that palliative care provided concurrently could improve the quality of life (QOL) of patients, dispelling the common barrier because oncologists ‘already do this.’ (See Lyle Fettig ’s excellent analysis here.)So what changed between 2012 and 2016?The 2012 PCO focused more on symptom burden and QOL, Instead of focusing on the survival benefit secondary outcome of Temel, they emphasized lack of harm. They did pull from other key studies including Bakitas (ENABLE), Brumley (in-home PC), Meyers (patient/caregiver dyads), and Rabow (outpatient clinics). The 2016 Expert Panel looked at 16 total...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: ASCO guidelines non-pain symptoms oncology sinclair Source Type: blogs