Palliative Care Utilization in Patients with Newly Diagnosed, Incurable Solid Tumor Malignancies: Experience of an Institution New to Palliative Care

Palliative care (PC) is the medical specialty that focuses on improving quality of life through managing pain and other distressing symptoms of a serious illness [1]. Patients with advanced cancer are often candidates for PC and may benefit significantly from access to the multi-disciplinary approach employed by this specialty. In particular, PC has been shown to improve outcomes related to pain, depression, anxiety and other symptoms. Other identified benefits include caregiver satisfaction and decreased hospital admissions among patients with advanced cancer [2,3]. In the setting of metastatic non-small cell lung cancer, early PC referral is associated with improved overall survival [4]. Early initiation of PC is important in the management of advanced illness because it allows for a proactive approach in identifying and addressing distressing symptoms early in their development. Several studies have shown improved quality of life (QoL) outcomes for both patients and their caretakers, when this intervention is integrated early in the course of the disease process [4-6]. Increasingly, these benefits have been recognized by various professional bodies in the form of consensus statements and guidelines endorsing referral to PC [7,8]. However the definition of early PC referral is not well established. Temel at al. [4] defined early PC in their landmark study as referral to PC that is nearly simultaneous with initial oncologic evaluation. Patients were seen by a PC provider within three weeks of enrollment [4]. Another study defined “early” referral as within three months of diagnosis of advanced cancer or three months prior to death [9]. The most recent National Cancer Care Network (NCCN) Palliative Care Guidelines identify a diagnosis of metastatic solid tumor Volume 2 Issue 2 2018