Skip to main content
SpringerLink
Log in

Disease-Specific Oncology – Disease-Specific Palliative Care

  • Chapter
Palliative Care in Oncology

  • 1793 Accesses

Abstract

Cancer is a unique disease which requires special attention to the affected patients and families right from the time of diagnosis. These patients develop peculiar physical, psychological, social, and spiritual needs that require a multidimensional approach to address them. It is therefore important for clinicians to have background knowledge of such special needs when caring for these patients. The presentation of palliative care cases can be disease specific, just like in many other medical cases. The disease trajectory, symptom profile, and the needs of cancer patients may be different from those of non-cancer cases. Even among cancer cases, there may be differences based on specific disease types and patient demographics such as age, gender, and ethnicity. It is also known that although there may be some differences in the physical symptoms, the psychological, social, and spiritual needs of these patients are invariably similar. The ultimate goal of palliative care is to deliver care that is patient specific rather than disease specific, and therefore personalized care is key to the delivery of a successful palliative intervention. The concept of prognostication is very important to both clinicians and patients and family members, but, regrettably, it is not well understood even among clinicians.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abernethy A, Shelby-James T, Fazekas B, Woods D, Currow D (2005) The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice [ISRCTN81117481]. BMC Palliat Care 4(1):7

    Article  PubMed Central  PubMed  Google Scholar 

  • Addington-Hall JM, MacDonald LD, Anderson HR (1990) Can the Spitzer Quality of Life Index help to reduce prognostic uncertainty in terminal care? Br J Cancer 62(4):695–699

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ahmed N, Bestall JC, Ahmedzai SH, Payne SA, Clark D, Noble B (2004) Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals. Palliat Med 18(6):525–542

    Article  CAS  PubMed  Google Scholar 

  • American Cancer Society (2013) Cancer Facts & Figures 2013. American Cancer Society, Atlanta

    Google Scholar 

  • Anderson F, Downing GM, Hill J, Casorso L, Lerch N (1996) Palliative performance scale (PPS): a new tool. J Palliat Care 12(1):5–11

    CAS  PubMed  Google Scholar 

  • Auret K, Bulsara C, Joske D (2003) Australasian haematologist referral patterns to palliative care: lack of consensus on when and why. Intern Med J 33(12):566–571, doi:490 [pii]

    Article  CAS  PubMed  Google Scholar 

  • Bernabei R, Gambassi G, Lapane K, Landi F, Gatsonis C, Dunlop R, Lipsitz L, Steel K, Mor V (1998) Management of pain in elderly patients with cancer. SAGE Study Group. Systematic Assessment of Geriatric Drug Use via Epidemiology. JAMA 279(23):1877–1882, doi:joc71977 [pii]

    Article  CAS  PubMed  Google Scholar 

  • Bruera E, Miller MJ, Kuehn N, MacEachern T, Hanson J (1992) Estimate of survival of patients admitted to a palliative care unit: a prospective study. J Pain Symptom Manage 7(2):82–86

    Article  CAS  PubMed  Google Scholar 

  • Cheson BD (2002) Hematologic malignancies: new developments and future treatments. Semin Oncol 29(4 Suppl 13):33–45

    Article  PubMed  Google Scholar 

  • Christakis NA, Iwashyna TJ (1998) Attitude and self-reported practice regarding prognostication in a national sample of internists. Arch Intern Med 158(21):2389–2395. doi:10.1001/archinte.158.21.2389

    Article  CAS  PubMed  Google Scholar 

  • Delgado-Guay MO, Parsons HA, Li Z, Palmer LJ, Bruera E (2009) Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team. Cancer 115(2):437–445. doi:10.1002/cncr.24017

    Article  PubMed  Google Scholar 

  • Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, Cohen MH, Douglass HO Jr, Engstrom PF, Ezdinli EZ, Horton J, Johnson GJ, Moertel CG, Oken MM, Perlia C, Rosenbaum C, Silverstein MN, Skeel RT, Sponzo RW, Tormey DC (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69(4):491–497

    Article  CAS  PubMed  Google Scholar 

  • Escalante CP, Martin CG, Elting LS, Price KJ, Manzullo EF, Weiser MA, Harle TS, Cantor SB, Rubenstein EB (2000) Identifying risk factors for imminent death in cancer patients with acute dyspnea. J Pain Symptom Manage 20(5):318–325

    Article  CAS  PubMed  Google Scholar 

  • Evans C, McCarthy M (1985) Prognostic uncertainty in terminal care: can the Karnofsky index help? Lancet 325(8439):1204–1206. doi:http://dx.doi.org/10.1016/S0140-6736(85)92876-4

  • Fadul N, Elsayem A, Palmer JL, Zhang T, Braiteh F, Bruera E (2007) Predictors of access to palliative care services among patients who died at a Comprehensive Cancer Center. J Palliat Med 10(5):1146–1152. doi:10.1089/jpm.2006.0259

    Article  PubMed  Google Scholar 

  • Fadul NA, El Osta B, Dalal S, Poulter VA, Bruera E (2008) Comparison of symptom burden among patients referred to palliative care with hematologic malignancies versus those with solid tumors. J Palliat Med 11(3):422–427. doi:10.1089/jpm.2007.0184

    Article  PubMed  Google Scholar 

  • Fries JF, Ehrlich GE (1981) Prognosis: contemporary outcomes of disease. The Charles Press Publishers, Bowie

    Google Scholar 

  • Ganz PA, Lee JJ, Siau J (1991) Quality of life assessment. An independent prognostic variable for survival in lung cancer. Cancer 67(12):3131–3135

    Article  CAS  PubMed  Google Scholar 

  • Glare P, Virik K, Jones M, Hudson M, Eychmuller S, Simes J, Christakis N (2003) A systematic review of physicians’ survival predictions in terminally ill cancer patients. BMJ 327 (7408):195–198. doi:10.1136/bmj.327.7408.195, 327/7408/195 [pii]

  • Glare P, Sinclair C, Downing M, Stone P, Maltoni M, Vigano A (2008) Predicting survival in patients with advanced disease. Eur J Cancer 44(8):1146–1156. doi:http://dx.doi.org/10.1016/j.ejca.2008.02.030

  • Goldstein NE, Lynn J (2006) Trajectory of end-stage heart failure: the influence of technology and implications for policy change. Perspect Biol Med 49(1):10–18

    Article  PubMed  Google Scholar 

  • Hampton T (2007) New blood cancer therapies under study. JAMA 297(5):457–458. doi:10.1001/jama.297.5.457, 297/5/457 [pii]

  • Hui D, Elsayem A, Li Z, De La Cruz M, Palmer JL, Bruera E (2010) Antineoplastic therapy use in patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center: a simultaneous care model. Cancer 116(8):2036–2043. doi:10.1002/cncr.24942

    Article  PubMed Central  PubMed  Google Scholar 

  • Hui D, Kim SH, Kwon JH, Tanco KC, Zhang T, Kang JH, Rhondali W, Chisholm G, Bruera E (2012) Access to palliative care among patients treated at a comprehensive cancer center. Oncologist 17(12):1574–1580. doi:10.1634/theoncologist.2012-0192, theoncologist.2012-0192 [pii]

  • Langendijk H, Aaronson NK, de Jong JM, ten Velde GP, Muller MJ, Wouters M (2000) The prognostic impact of quality of life assessed with the EORTC QLQ-C30 in inoperable non-small cell lung carcinoma treated with radiotherapy. Radiother Oncol 55(1):19–25

    Article  CAS  PubMed  Google Scholar 

  • Llobera J, Esteva M, Rifa J, Benito E, Terrasa J, Rojas C, Pons O, Catalan G, Avella A (2000) Terminal cancer. Duration and prediction of survival time. Eur J Cancer 36(16):2036–2043

    Article  CAS  PubMed  Google Scholar 

  • Loprinzi CL, Laurie JA, Wieand HS, Krook JE, Novotny PJ, Kugler JW, Bartel J, Law M, Bateman M, Klatt NE (1994) Prospective evaluation of prognostic variables from patient-completed questionnaires. North Central Cancer Treatment Group. J Clin Oncol 12(3):601–607

    CAS  PubMed  Google Scholar 

  • Lunney JR, Lynn J, Hogan C (2002) Profiles of older medicare decedents. J Am Geriatr Soc 50(6):1108–1112. doi:10.1046/j.1532-5415.2002.50268.x

    Article  PubMed  Google Scholar 

  • Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM (2003) Patterns of functional decline at the end of life. JAMA 289(18):2387–2392. doi:10.1001/jama.289.18.2387289/18/2387 [pii]

  • Lynn J, Adamson D (2003) Rand Corporation., Living well at the end of life: adapting health care to serious chronic illness in old age; white paper; Santa Monica CA; RAND; WP-137:iii, 19p. http://www.semeg.es/docs/docum/Rand_Health_White_Paper.pdf

  • Maltoni M, Pirovano M, Scarpi E, Marinari M, Indelli M, Arnoldi E, Gallucci M, Frontini L, Piva L, Amadori D (1995) Prediction of survival of patients terminally ill with cancer. Results of an Italian prospective multicentric study. Cancer 75(10):2613–2622

    Article  CAS  PubMed  Google Scholar 

  • Maltoni M, Pirovano M, Nanni O, Marinari M, Indelli M, Gramazio A, Terzoli E, Luzzani M, De Marinis F, Caraceni A, Labianca R (1997) Biological indices predictive of survival in 519 Italian terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manage 13(1):1–9

    Article  CAS  PubMed  Google Scholar 

  • Maltoni M, Nanni O, Pirovano M, Scarpi E, Indelli M, Martini C, Monti M, Arnoldi E, Piva L, Ravaioli A, Cruciani G, Labianca R, Amadori D (1999) Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. J Pain Symptom Manage 17(4):240–247

    Article  CAS  PubMed  Google Scholar 

  • Mander T (1997) Haematology and palliative care: an account of shared care for a patient undergoing bone marrow transplantation for chronic myeloid leukaemia. Int J Nurs Pract 3(1):62–66

    Article  CAS  PubMed  Google Scholar 

  • McGrath P (2001) Dying in the curative system: the haematology/oncology dilemma. Part 1. Aust J Holist Nurs 8(2):22–30

    CAS  PubMed  Google Scholar 

  • McGrath P, Holewa H (2007) Special considerations for haematology patients in relation to end-of-life care: Australian findings. Eur J Cancer Care (Engl) 16(2):164–171. doi:10.1111/j.1365-2354.2006.00745.x

    Article  CAS  Google Scholar 

  • Mor V, Laliberte L, Morris JN, Wiemann M (1984) The Karnofsky performance status scale: an examination of its reliability and validity in a research setting. Cancer 53(9):2002–2007. doi:10.1002/1097-0142(19840501)53:9<2002:AID-CNCR2820530933>3.0.CO;2-W

    Article  CAS  PubMed  Google Scholar 

  • Morita T, Tsunoda J, Inoue S, Chihara S (1999) Survival prediction of terminally ill cancer patients by clinical symptoms: development of a simple indicator. Jpn J Clin Oncol 29(3):156–159

    Article  CAS  PubMed  Google Scholar 

  • Morris JN, Suissa S, Sherwood S, Wright SM, Greer D (1986) Last days: a study of the quality of life of terminally ill cancer patients. J Chronic Dis 39(1):47–62. doi:http://dx.doi.org/10.1016/0021-9681(86)90106-2

  • Nikoletti S, Porock D, Kristjanson LJ, Medigovich K, Pedler P, Smith M (2000) Performance status assessment in home hospice patients using a modified form of the Karnofsky Performance Status Scale. J Palliat Med 3(3):301–311. doi:10.1089/jpm.2000.3.301

    Article  CAS  PubMed  Google Scholar 

  • Pirovano M, Maltoni M, Nanni O, Marinari M, Indelli M, Zaninetta G, Petrella V, Barni S, Zecca E, Scarpi E, Labianca R, Amadori D, Luporini G (1999) A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. Italian Multicenter and Study Group on Palliative Care. J Pain Symptom Manage 17(4):231–239

    Article  CAS  PubMed  Google Scholar 

  • Portenoy RK, Sibirceva U, Smout R, Horn S, Connor S, Blum RH, Spence C, Fine PG (2006) Opioid use and survival at the end of life: a survey of a hospice population. J Pain Symptom Manage 32(6):532–540. doi:10.1016/j.jpainsymman.2006.08.003

    Article  PubMed  Google Scholar 

  • Rosenthal MA, Gebski VJ, Kefford RF, Stuart-Harris RC (1993) Prediction of life-expectancy in hospice patients: identification of novel prognostic factors. Palliat Med 7(3):199–204

    Article  CAS  PubMed  Google Scholar 

  • Sinclair C (2007) Prognosis Links. Pallimed: a Hospice & Palliative Medicine blog. http://prognosis.pallimed.org/. Accessed 31 Mar 2014

  • Steyerberg EW, Harrell FE Jr (2002) Statistical models for prognostication. Symptom research: methods and opportunities. National Institute of Health, Bethesda

    Google Scholar 

  • Tranmer JE, Heyland D, Dudgeon D, Groll D, Squires-Graham M, Coulson K (2003) Measuring the symptom experience of seriously ill cancer and noncancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manage 25(5):420–429

    Article  PubMed  Google Scholar 

  • Vigano A, Bruera E, Suarez-Almazor ME (1999) Terminal cancer syndrome: myth or reality? J Palliat Care 15(4):32–39

    CAS  PubMed  Google Scholar 

  • Viganò A, Dorgan M, Buckingham J, Bruera E, Suarez-Almazor ME (2000) Survival prediction in terminal cancer patients: a systematic review of the medical literature. Palliat Med 14(5):363–374

    Article  PubMed  Google Scholar 

  • Wachtel T, Allen-Masterson S, Reuben D, Goldberg R, Mor V (1988) The end stage cancer patient: terminal common pathway. Hosp J 4(4):43–80

    CAS  PubMed  Google Scholar 

  • Walsh JS, Welch HG, Larson EB (1990) Survival of outpatients with Alzheimer-type dementia. Ann Intern Med 113(6):429–434. doi:10.7326/0003-4819-113-6-429

    Article  CAS  PubMed  Google Scholar 

  • Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 8(3):175–179

    Article  CAS  PubMed  Google Scholar 

  • Wolfson C, Wolfson DB, Asgharian M, M’Lan CE, Østbye T, Rockwood K, Hogan DB (2001) A reevaluation of the duration of survival after the onset of dementia. N Engl J Med 344(15):1111–1116. doi:10.1056/NEJM200104123441501

    Article  CAS  PubMed  Google Scholar 

  • Xie J, Brayne C, Matthews FE (2008) Survival times in people with dementia: analysis from population based cohort study with 14 year follow-up. BMJ 336(7638):258–262. doi:10.1136/bmj.39433.616678.25 10.1136/bmj.39433.616678.25

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    Joseph Anthony Arthur MD & Eduardo Bruera MD

Authors
  1. Joseph Anthony Arthur MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eduardo Bruera MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph Anthony Arthur MD .

Editor information

Editors and Affiliations

  1. Department of Palliative Medicine, University Medical Center, Göttingen, Germany

    Bernd Alt-Epping

  2. Department of Palliative Medicine, University Medical Center, Göttingen, Germany

    Friedemann Nauck

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Arthur, J.A., Bruera, E. (2015). Disease-Specific Oncology – Disease-Specific Palliative Care. In: Alt-Epping, B., Nauck, F. (eds) Palliative Care in Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46202-7_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-46202-7_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46201-0

  • Online ISBN: 978-3-662-46202-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation