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Integrating Palliative Care Into Comprehensive Cancer Care.
Published 2012 · Medicine
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While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care.
This paper references
Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non-small-cell lung cancer: results of a randomized study of early palliative care.
J. Temel (2011)
A Mindfulness-Based Stress Reduction Workbook
B. Stahl (2010)
Time for better integration of oncology and palliative care.
A. Abernethy (2011)
MASCC/ESMO antiemetic guideline
RJ Gralia (2011)
Anti-emetics: ASCO clinical practice guideline update
E Basch (2011)
Best Supportive Care - do we know what it is?
Angela Boland (2007)
A study of oncology fellows' training in end-of-life care.
M. Buss (2007)
「緩和ケア」として行われた介入と副次的評価項目であることの限界 (論文を読み,理解する--Early palliative care for patients with metastatic non-small-cell lung cancer)
森田 達也 (2011)
Self-care of physicians caring for patients at the end of life: "Being connected... a key to my survival".
M. K. Kearney (2009)
Perspectives from the other side: a physician and cancer survivor.
S. Stone (2011)
Palliative cancer care a decade later: accomplishments, the need, next steps -- from the American Society of Clinical Oncology.
F. Ferris (2009)
Tough talk: helping doctors approach difficult conversations
K Fryer-Edwards (2012)
Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.
Lindsay A. Dow (2010)
Oncologist burnout: causes, consequences, and responses.
T. Shanafelt (2012)
The impact of a hospice consultation team on the care of veterans with advanced cancer.
J. Abrahm (1996)
Oncologist communication about emotion during visits with patients with advanced cancer.
K. Pollak (2007)
Compassion fatigue: how to avoid it
B. Wright (2004)
The inner life of physicians and care of the seriously ill.
D. Meier (2001)
Medical oncologists' attitudes and practice in cancer pain management: a national survey.
B. Breuer (2011)
A prospective study of prolonged central venous access in leukemia.
J. Abrahm (1982)
Discussing prognosis: "how much do you want to know?" talking to patients who are prepared for explicit information.
A. Back (2006)
Efficacy of communication skills training for giving bad news and discussing transitions to palliative care.
A. Back (2007)
New clinical-practice guidelines for the management of pain in patients with cancer.
A. Jacox (1994)
Working With a Palliative Care Team
L. Wiebe (2010)
The integration of palliative care and oncology: the evidence.
J. V. Von Roenn (2011)
Integration of Palliative Medicine Into Routine Oncological Care: What Does the Evidence Show Us?
S. Stone (2011)
Calibrating the Physician: Personal Awareness and Effective Patient Care
D. Novack (1997)
Faculty development to change the paradigm of communication skills teaching in oncology.
A. Back (2009)
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines
Hodgkin Lymphoma (2014)
Discussing prognosis: "how much do you want to know?" talking to patients who do not want information or who are ambivalent.
A. Back (2006)
EPEC-O Education in Palliative and End-of-Life Care for Oncology
J von Roenn (2012)
Availability and integration of palliative care at US cancer centers.
D. Hui (2010)
Teaching communication skills to medical oncology fellows.
A. Back (2003)
Guideline for the Management of Cancer Pain in Adults and Children
C Miaskowski (2005)
When do we stop talking about curative care?
T. Gilligan (2003)
The Care People Need and the Education of Physicians
J. H. Roenn (2011)
Mastering Communication with Seriously Ill Patients: INDEX
A. Back (2009)
The ACGME outcome project: retrospective and prospective
S. Swing (2007)
How to break bad news : a guide for health care professionals
R. Buckman (1992)
A Physician’s Guide to Pain and Symptom Management in Cancer Patients, 2nd edition
Janet L. Abrahm (2008)
This paper is referenced by
The ‘critical mass’ survey of palliative care programme at ESMO designated centres of integrated oncology and palliative care
D. Hui (2017)
Integrating Palliative Care in Oncology: The Oncologist as a Primary Palliative Care Provider
Deepa Rangachari (2013)
Improvements in Patient and Health System Outcomes Using an Integrated Oncology and Palliative Medicine Approach on a Solid Tumor Inpatient Service.
R. Riedel (2017)
Is early integration of palliative care feasible and acceptable for advanced respiratory and gastrointestinal cancer patients? A phase 2 mixed-methods study
M. Costantini (2018)
Integration of oncology and palliative care: a systematic review.
D. Hui (2015)
Recommending early integration of palliative care — does it work?
J. Gaertner (2011)
Attitudes and referral patterns of lung cancer specialists in Europe to Specialized Palliative Care (SPC) and the practice of Early Palliative Care (EPC)
H. Charalambous (2014)
The study of palliative care and its relationship with quality of life in patients with chronic heart failure. in 2014-2015
Raziyeh Sadat Bahador (2017)
Doing palliative care in the oncology office.
M. Cheng (2013)
Improving Cancer Care through Health Information Technology : Ethics and Practicality CHAIR
L. Shulman (2013)
NCCN Guidelines Insights: Palliative Care, Version 2.2017.
M. Dans (2017)
Integration of oncology and palliative care: a Lancet Oncology Commission.
S. Kaasa (2018)
Integrating palliative medicine in oncology care: the Hong Kong experience.
M. W. R. Yeung (2020)
Feasibility of using algorithm-based clinical decision support for symptom assessment and management in lung cancer.
M. Cooley (2015)
Evidence-Based Practice: Community-Based Palliative Cancer Care
Jajang Ganjar Waluya (2019)
Attitudes and Beliefs Toward Supportive and Palliative Care Referral Among Hematologic and Solid Tumor Oncology Specialists.
D. Hui (2015)
The impact of palliative care training for oncologists and integrative palliative service in a public-funded hospital cluster—a retrospective cohort study
Pak-Lun Lam (2017)
Improving Palliative Cancer Care
Catherine Del Ferraro (2014)
Cultural Aspects of Palliative Cancer Care in Iran
S. Fallahi (2017)
Trends and Social Barriers for Inpatient Palliative Care in Patients With Metastatic Bladder Cancer Receiving Critical Care Therapies.
E. Mazzone (2019)
Temporal trends and social barriers for inpatient palliative care delivery in metastatic prostate cancer patients receiving critical care therapies
E. Mazzone (2019)
The lung cancer patient, the pneumologist and palliative care: a developing alliance
T. Blum (2014)
Perception of Iranian nurses regarding ethics-based palliative care in cancer patients
M. M. Hamooleh (2013)
Perspective of Lebanese oncologists on the symptom burden among adult cancer patients.
H. Rafei (2016)
تاثیر تیپینگ ساق پا بر پارامترهای منحنی فراخوانی رفلکس H: مقایسه میزان تاثیرپذیری موتورنورون های عضله سولئوس و گاستروکنمیوس خارجی
رسول باقری (2012)
Structural Challenges of Providing Palliative Care for Patients with Breast Cancer
Tahereh Alsadat Khoubbin Khoshnazar (2016)
Early palliative care and its translation into oncology practice in Canada: barriers and challenges.
K. Fassbender (2015)
Integration of Palliative Care and Oncology Nursing.
K. Chow (2018)
MASCC/ESMO/EAPC survey of palliative programs
M. Davis (2014)
Joining together to improve outcomes: integrating specialty palliative care into the care of patients with cancer.
M. Vergo (2013)
Current status of integrating oncology and palliative care in Japan: a nationwide survey
Y. Uneno (2020)
Commentary: "the Lake Wobegon effect, a natural human tendency to overestimate one's capabilities" (Wikipedia).
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