Online citations, reference lists, and bibliographies.
← Back to Search

Early Palliative Care And Its Translation Into Oncology Practice In Canada: Barriers And Challenges.

K. Fassbender, S. Watanabe
Published 2015 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
This article reviews the progress Canada has made integrating palliative care into oncologic practice. Key clinical practice guidelines (CPGs) have influenced and have been translated into Canadian oncology policy and operations. Comprehensive accreditation standards exist to guide oncology practice in institutional and ambulatory care settings. Common barriers and challenges are discussed: education and attitudes, compassion fatigue, terminology, paucity of research, aggressive cancer care, and organization and operational considerations. As a result, eight made-in-Canada innovations emerged and are described. Lessons learned and recommendations describe a plan for action.
This paper references
Hospice Palliative Care Study: Final Report, The GlaxoSmithKline Foundation and the Canadian Hospice Palliative Care Association, 2004:31
Ipsos-Reid Survey (2004)
Integrating palliative care: when and how?
J. Shin (2013)
Managing Continuity through Collaborative Care Plans: A Study of Palliative Care Patients. Kingston (ON): Canadian Health Services Research Foundation
D Dudgeon (2004)
Early palliative care for patients with metastatic non-small-cell lung cancer.
J. Temel (2010)
American Society of Clinical Oncology NCCN Annual Report 2014
GP Browman (2002)
A panCanadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancerrelated fatigue
D Howell (2013)
Integration of oncology and palliative care: a systematic review.
D. Hui (2015)
Beyond palliative radiotherapy: 149 © Annals of Palliative Medicine
B Danielson (2012)
Multidisciplinary team contributions within a dedicated outpatient palliative radiotherapy clinic: a prospective descriptive study.
E. Pituskin (2010)
Beyond palliative radiotherapy: a pilot multidisciplinary brain metastases clinic
B. Danielson (2011)
Concepts and definitions for “supportive care,” “best supportive care,” “palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks
D. Hui (2012)
Early integration of palliative care services with standard oncology care for patients with advanced cancer
J. Greer (2013)
Early palliative care and oncology practice in Canada © Annals of Palliative Medicine
Fassbender (2014)
Palliative care inpatient service in a comprehensive cancer center: clinical and financial outcomes.
A. Elsayem (2004)
Conceptual models for integrating palliative care at cancer centers.
E. Bruera (2012)
Family Practice Oncology Network
BC Cancer Agency (2015)
Pallium Canada Interprofessional Education in palliative and end-of-life care
Family physicians who have focused practices in oncology: results of a national survey.
J. Sisler (2013)
Integrating psychosocial care into cancer services.
J. Fann (2012)
NCCN clinical practice guidelines in oncology: palliative care.
M. Levy (2009)
Highlights in Investment in Palliative End-of-Life Care Cancer research in Canada, 2005-2010
Fassbender (2010)
Pallium Canada Interprofessional Education in palliative and end-of-life care. Available online:, accessed 1 May
K Fassbender (2015)
Canadian Partnership Against Cancer
TJ Smith
Integration of Palliative Medicine Into Routine Oncological Care: What Does the Evidence Show Us?
S. Stone (2011)
Multinational Association of Supportive Care in Cancer
S. Bošnjak (2008)
Patterns of practice in palliative radiotherapy for painful bone metastases: impact of a regional rapid access clinic on access to care.
J. Wu (2010)
The changing model of palliative care
F. Graham (2008)
The problem of caring for the dying in a general hospital; the palliative care unit as a possible solution.
B. Mount (1976)
The Vancouver rapid access clinic for palliative lung radiation, providing more than just rapid access
S. Lefresne (2014)
Managing Continuity through Collaborative Care Plans: A Study of Palliative Care Patients
D Dudgeon (2004)
Palliative care and oncology: integration leads to better care.
M. Levy (2011)
Early integration of palliative and supportive care in the cancer continuum: challenges and opportunities.
M. Davis (2013)
Clinical findings of a palliative care consultation team at a comprehensive cancer center.
N. Dhillon (2008)
College and Association of Registered Nurses of Alberta
Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial
C. Zimmermann (2014)
What are patients' expectations about the effects of chemotherapy for advanced cancer?
T. Pawlik (2014)
The Canadian Virtual Hospice .
H. Chochinov (2004)
Cancer Action Journey Group. Guide to Implementing Screening for Distress, the 6th Vital Sign: Moving Towards PersonCentered Care. Part A. Background, recommendations and implementation
Palliative care, Version 1.2014. Featured updates to the NCCN Guidelines.
M. Levy (2014)
WHO Definition of Palliative Care
Edmonton, Canada: a regional model of palliative care development.
R. Fainsinger (2007)
The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic
A. Fairchild (2008)
What Canadians Say: The Way Forward Survey Report
Oncologists' perspectives on concurrent palliative care in a National Cancer Institute-designated comprehensive cancer center.
Marie Bakitas (2013)
Hospice Palliative Care Study: Final Report, The GlaxoSmithKline Foundation and the Canadian Hospice Palliative Care Association
Ipsos-Reid Survey (2004)
Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment.
A. Wright (2008)
Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: report of a pilot project
S. Watanabe (2012)
What do Canadians think of advanced care planning? Findings from an online opinion poll
A. A. Teixeira (2013)
Rehabilitation for patients with advanced cancer
M. Chasen (2014)
Integrating palliative medicine into an oncology practice
M. Davis (2005)
Administrative outcomes five years after opening an acute palliative care unit at a comprehensive cancer center.
J. Bryson (2010)
The interface of oncology and palliative care in tertiary hospitals. Cancer Council Australia
P Glare
Palliative Care: Five Things Physicians and Patients Should Question. Canadian Society of Palliative Care Physicians
Choosing Wisely Canada (2015)
Canadian Partnership Against Cancer. Canadian Electronic Library (Firm). eds. Cancer and palliative care: Integration and continuity of care. Toronto: Canadian Partnership Against Cancer
J Dunbrack (2009)
Regional Models of Care for Palliative Cancer Care: Recommendations for the Organization and Delivery of Palliative Cancer Care in Ontario. Provincial Palliative Care Program. The Association
Cancer Care Ontario (2009)
Palliative care 147 © Annals of Palliative Medicine
A Elsayem (2008)
Palliative care and the cancer patient: current state and state of the art.
J. H. Roenn (2011)
Sleep disturbance in adults with cancer: a systematic review of evidence for best practices in assessment and management for clinical practice.
D. Howell (2014)
The interface of oncology and palliative care in tertiary hospitals: a concept in evolution
S. Clarke (2002)
Trends in the aggressiveness of end-of-life cancer care in the universal health care system of Ontario, Canada.
T. H. Hồ (2011)
Highlights in Investment in Palliative End-of-Life Care Cancer research in Canada
Ontario's Palliative Care Integration Project. Cancer Care Ontario
S King (2007)
National comprehensive cancer network.
F. Detterbeck (2013)
CPD and maintenance of certification in the Royal College of Physicians and Surgeons of Canada
J. Parboosingh (1930)
The integration of early palliative care with oncology care: the time has come for a new tradition.
J. Bauman (2014)
Quality improvement in cancer symptom assessment and control: the Provincial Palliative Care Integration Project (PPCIP).
J. Gilbert (2012)
Improving the quality of cancer care: implications for palliative care.
B. Ferrell (2014)
Ipsos Healthcare -The Healthcare Research Specialists, Canadian Hospice Palliative Care Association. Advance Care Planning Poll
Edmonton Zone Palliative Care Program
Best supportive care.
N. Macdonald (1998)
Developing a service model that integrates palliative care throughout cancer care: the time is now.
A. Partridge (2014)
Phase II study of an outpatient palliative care intervention in patients with metastatic cancer.
M. Follwell (2009)
Ebrary CEL - York University. Canadian Partnership Against Cancer. Canadian Electronic Library (Firm). eds. Cancer and palliative care: Integration and continuity of care
J Dunbrack (2009)
Pain Practices: A Cross-Canada Survey of Pediatric Oncology Centers
J. Ellis (2003)
Integrating palliative care into comprehensive cancer care.
J. Abrahm (2012)
Multidisciplinary symptom control clinic in a cancer center: a retrospective study
E. Bruera (2014)
Recommending early integration of palliative care — does it work?
J. Gaertner (2011)
Availability and integration of palliative care at US cancer centers.
D. Hui (2010)
Ontario’s Palliative Care Integration Project
S King (2007)
National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology
D. Pfister (2012)
Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center.
F. Braiteh (2007)
Canadian Hospice Palliative Care Association. Innovative Models of Integrated Hospice Palliative Care. The Way Forward Initiative: an Integrated Palliative Approach to Care
Palliative care and the cancer patient: current state and state of the art.
J. V. Von Roenn (2011)
Practitioners as experts: the influence of practicing oncologists "in-the-field" on evidence-based guideline development.
G. Browman (2005)
Referral practices of oncologists to specialized palliative care.
K. Wentlandt (2012)
Advance Care Planning: Ensuring That the Patient's Voice Is Heard
J. H. Roenn (2013)
Health care costs in the last week of life: associations with end-of-life conversations.
B. Zhang (2009)
Supportive versus palliative care: What's in a name?
N. Fadul (2009)
Advance care planning: ensuring that the patient's voice is heard.
J. V. Von Roenn (2013)
A prospective evaluation of an interdisciplinary nutrition-rehabilitation program for patients with advanced cancer.
B. Gagnon (2013)
Early palliative care for patients with advanced cancer: how to make it work?
J. Gaertner (2013)
Canadian Partnership Against Cancer. The 2012 Cancer System Performance Report
The British Columbia Cancer Agency: a comprehensive and integrated system of cancer control.
D. R. Carlow (2000)
information/cancer%20101/Canadian%20cancer%20 statistics/Canadian-Cancer-Statistics-2014-EN.pdf 2. World Health Organization. WHO Definition of Palliative Care
American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care.
T. Smith (2012)
Continued success in providing timely palliative radiation therapy at the Rapid Response Radiotherapy Program: a review of 2008-2012.
N. Thavarajah (2013)
End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences.
J. Mack (2010)
Integrating Palliative Care in Oncology: The Oncologist as a Primary Palliative Care Provider
Deepa Rangachari (2013)
Managing brain metastases patientswith and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic
Hellen Jung (2013)
A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue.
D. Howell (2013)
Palliative care.
M. Levy (2012)
A comprehensive cancer control program for BC
BC Cancer Agency (2015)
A comprehensive cancer control program for BC Cancer Care Ontario Canadian Virtual Hospice Cancer Strategic Clinical Network Edmonton Zone Palliative Care Program Fraser Health
D Howell (2014)

This paper is referenced by
Palliative care: renaming as supportive care and integration into comprehensive cancer care
A. J. Caprio (2016)
Opportunity is the greatest barrier to providing palliative care to advanced colorectal cancer patients: a survey of oncology clinicians.
M. Earp (2018)
Quality-of-Life Assessment in Patients Receiving Palliative Chemotherapy: Call for Action
Maheswari Senthil (2020)
Cancer patients’ perceptions of palliative care
B. Chosich (2019)
Supporting Patients With Incurable Cancer: Backup Behavior in Multidisciplinary Cross-Functional Teams.
F. Huang (2016)
Early palliative care: philosophy vs. reality.
J. Gaertner (2015)
Ultrapassar barreiras no encaminhamento para cuidados paliativos: o papel das estratégias de marketing
Marina Sevilha Balthazar dos Santos (2019)
Early palliative care and integration of palliative care models in modern oncology practices.
C. Simone (2015)
Access to palliative care by disease trajectory: a population-based cohort of Ontario decedents
H. Seow (2018)
Development and Validation of a Prognostic Survival Model With Patient-Reported Outcomes for Patients With Cancer
H. Seow (2020)
Atención paliativa en pacientes con neoplasias hematológicas: un nuevo modelo de atención basado en la evaluación precoz de necesidades.
Deborah Moreno Alonso (2018)
Semantic Scholar Logo Some data provided by SemanticScholar