Early integration of palliative care into oncology: evidence, challenges and barriers

In the past three decades, improvements in prevention, early detection and treatment of cancer have dramatically changed cancer outcomes. The American Cancer Society estimated about 1.6 million new cancer cases and 58 thousand cancer deaths in the United States in 2015 (1). Those cancer patients and their families are experiencing tremendous physical and psychosocial issues during cancer treatment that have a huge negative impact on quality of life, the cost of care, and even survival (2). By WHO definition, palliative care is “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” (3). Palliative care is an essential component in cancer care and has been recognized by professional societies and healthcare providers. The American Society of Clinical Oncology (ASCO) strongly recommends involvement of palliative care early during oncology care given the robust evidence of improvement in quality of life, better symptom control; reduced caregiver burden; and possible survival benefit (2,4,5)