ASCO issues statement to improve palliative care communication

In a new policy statement, the American Society of Clinical Oncology recommends steps to ensure that physicians initiate candid discussions about the full range of palliative care and treatment options soon after patients’ diagnosis with advanced cancer.

ASCO has also released a guide to help patients with advanced cancer broach difficult conversations about their prognosis, treatment, and palliative care options with their physicians.

"Studies show that palliative therapies not only improve patient quality of life, but can even extend life," said ASCO President George W. Sledge, Jr, MD. "Yet for many with advanced cancer, conversations about palliative and hospice options do not occur until the patients’ final weeks or days of life, if they happen at all. This not only hurts patients, but their caregivers as well."

The policy statement outlines essential elements of care for patients with advanced cancer and identifies the barriers that currently prevent advance cancer care planning conversations between physicians and patients. The elements identified by ASCO to individualize advanced cancer care include the following points:

• Physicians should initiate candid discussions about prognosis with their patients soon after an advanced cancer diagnosis. Such conversations currently occur with fewer than 40% of patients with advanced cancer.
• Quality of life should be an explicit priority throughout the course of advanced cancer care. Physicians must help their patients fully understand their prognosis, the potential risks and benefits of available cancer treatments, and quality of life considerations.
• Clinical trial opportunities should be increased. Currently, very few patients with advanced cancer participate in trials due to strict eligibility criteria, a dearth of trials that address quality of life issues, and other barriers.

The policy statement was published online in the Journal of Clinical Oncology (Jan. 24, 2011).