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Standardizing integration of palliative care into comprehensive cancer therapy—a disease specific approach

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Background

Our comprehensive cancer centre adopted the WHO recommendation literally in the cancer care guidelines to implement the early integration (EI) of palliative care (PC). Evaluation of the first 2 years of this approach revealed that this guideline was too vague to trigger EI.

Objective

As a consequence, an interdisciplinary working group was set up to propose and implement a more effective concept.

Methods

An interdisciplinary (PC, oncology, radiotherapy, etc.) working group identified the need to (a) specify the timing of EI and (b) specify PC assignments by (c) providing more clear cut semantic and clinical definitions. As a result of repeated discussion in the different interdisciplinary working groups in charge of developing and consenting a once-yearly update of treatment guidelines [standard operating procedure (SOP)] for each malignancy, the need for disease-specific EI SOPs was identified.

Results

SOPs were developed for 19 malignancies (a) to identify a disease-specific point in each disease trajectory to initiate EI (“green flags”) and to provide (b) a clear delineation and semantic differentiation of PC assignments [“palliative care” vs. “supportive” or “palliative therapies” (“green” vs. “red flags”)].

Discussion

To date, ASCO and WHO recommendations for EI lack detailed information about timing and infrastructure. The guidelines presented here aim to provide the missing information by reporting our developed and consented interdisciplinary guidelines for EI.

Conclusion

With this concept, the authors provide a framework for realizing EI and hope to initiate a discussion about specific recommendations for EI.

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Notes

  1. The expression “standard operating procedure” is regularly used in Europe, especially German speaking countries as a description of standards or consented algorithms or guidelines in industrial- or admninistrative- or medical institutions. We are aware of the fact that in the US the term might sound odd or military

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Acknowledgment

The scientific work of the Department of Palliative Medicine, University Clinic of Cologne is supported by the Federal Ministry for Education and Science (BMBF 01KN0706 ). The clinical and academic activities of the Department of Palliative Medicine, University Clinic of Cologne, are substantially supported by the German Cancer Aid (Deutsche Krebshilfe e.V.).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Palliative Medicine, University Hospital of Cologne, 50924, Cologne, Germany

    Jan Gaertner & Raymond Voltz

  2. Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany

    Juergen Wolf, Michael Hallek & Jan-Peter Glossmann

  3. Center for Integrated Oncology, University Hospital of Cologne, Cologne/Bonn, Germany

    Jan Gaertner, Juergen Wolf, Michael Hallek, Jan-Peter Glossmann & Raymond Voltz

  4. Clinical Trials Center Cologne BMBF 01KN0706, Cologne, Germany

    Jan Gaertner & Raymond Voltz

Authors
  1. Jan Gaertner
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  2. Juergen Wolf
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  3. Michael Hallek
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  4. Jan-Peter Glossmann
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  5. Raymond Voltz
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Corresponding author

Correspondence to Jan Gaertner.

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Gaertner, J., Wolf, J., Hallek, M. et al. Standardizing integration of palliative care into comprehensive cancer therapy—a disease specific approach. Support Care Cancer 19, 1037–1043 (2011). https://doi.org/10.1007/s00520-011-1131-y

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  • DOI: https://doi.org/10.1007/s00520-011-1131-y

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