Palliative Cancer Care Should Focus on Symptoms, Not Diagnoses

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Results of a cross-sectional study determined that symptoms and care needs dictate palliative care needs of patients with cancer.
Results of a cross-sectional study determined that symptoms and care needs dictate palliative care needs of patients with cancer.

Focus and treatment in palliative care for patients with cancer should be based on symptoms instead of specific cancer diagnoses, according to a follow-up study published in Supportive Care in Cancer.

Palliative care is an important facet of treating patients with cancer. Although advancements have been made, palliative care is not yet easily accessible and many patients must depend on acute care hospitals as their only option.

This population based, cross-sectional study was performed in 2007 and 2012 in 2 hospitals. Nurses and doctors completed questionnaires assessing patients with cancer in various hospital wards to provide data on demographics, symptoms, care needs, and diagnosis. In 2007 and 2012, 2972 and 2843 questionnaires, respectively, were completed.

Results showed that of all hospitalized patients during the study period, 10% were palliative cancer patients. The most commonly diagnosed cancers were lung, colorectal, and prostate cancers.

The average number of symptoms and care needs reported as cause for hospitalization was 2.9 per patient.

Deterioration and pain were the most frequently reported symptoms at 42% each in both men and women. Nausea was a top 4 symptom for women, but it wasn't included in the top 5 symptoms for men (P <.01). Different symptoms were associated with different cancers: infections and blood transfusions for hematologic cancers (P <.001), pleurocentesis with breast cancer (P =.002), and nausea with stomach/intestinal cancers (P <.001).

The study authors concluded that “the fact that symptoms and care needs were not strongly associated with certain diagnoses implies that care should focus on symptoms rather than the specific diagnosis.”

Reference

1. Sandgren A, Strang P. Palliative care needs in hospitalized cancer patients: a 5-year follow-up study [published online July 20, 2017]. Support Care Cancer. doi: 10.1007/s00520-017-3831-4

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