From evidence to practice: early integration of palliative care in a comprehensive cancer center

Document Type

Journal Article

Publication Date

12-14-2022

Journal

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

Volume

31

Issue

1

DOI

10.1007/s00520-022-07510-8

Keywords

Advanced cancer; Advanced practice providers; Metastatic cancer; Oncology clinic; Palliative care

Abstract

PURPOSE: The American Society of Clinical Oncology (ASCO) recommends that all patients with a diagnosis of advanced cancer be referred to a palliative care team within 8 weeks of diagnosis. The benefits of early integrated palliative care are well recognized; however, there is a lack of consensus to guide operational aspects of a palliative care service within a comprehensive cancer center. In this study, we explore current palliative care referral patterns at an academic cancer center and provide recommendations for operationalizing palliative care services as a program within comprehensive cancer centers in order to adequately meet the needs of patients with advanced cancer. METHODS: A retrospective chart review of patients with newly diagnosed metastatic cancer or advanced hematologic malignancy referred to the palliative care team at a comprehensive cancer center from January 1, 2021, to October 31, 2021, was conducted. Institutional Review Board (IRB) approval was obtained prior to the initiation of the chart review. RESULTS: A total of 243 patients with newly diagnosed metastatic cancer or advanced hematologic malignancy were included in this review. Patients with gastrointestinal (26%), gynecologic (19%), and thoracic (21%) malignancies constituted 66% of the total cohort. The most frequent reason for referral was pain (52%). In total, 39% of patients were referred within 8 weeks of an advanced cancer diagnosis. CONCLUSION: ASCO recommends that all patients with advanced cancer be referred to a palliative care specialist within 8 weeks of diagnosis. Of the newly referred patients with advanced cancer, only 39% were referred to the palliative care team within 8 weeks of their diagnosis. This considerable gap suggests the need for a consensus with regard to operationalizing the palliative care team.

Department

Health, Human Function, and Rehabilitation Sciences

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