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Cancers
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Integrating Palliative Care in Oncology
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Integrating Palliative Care in Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 2596

Special Issue Editor

Dr. Albert Tuca-Rodríguez

E-Mail Website
Guest Editor
Cancer Supportive and Palliative Care Unit, Department of Medical Oncology, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain
Interests: supportive care in cancer; palliative care; medical oncology; palliative medicine

Special Issue Information

Dear Colleagues,

The World Health Organization (WHO) calls for health services to be designed so that early palliative care is integrated into existing health services in a shared care model to provide appropriate support to those who need it.

Many randomised clinical trials have shown that early palliative care (EPC) in patients with advanced cancer improves symptom control, psychological distress, quality of life, and patient and family satisfaction. Some trials have also shown that EPC reduces the use of futile chemotherapy at the end of life and improves healthcare resource use and survival.

Based on consistent scientific evidence, many international scientific societies and expert commissions (American Society of Clinical Oncology, European Society of Medical Oncology, National Comprehensive Cancer Network, and The Lancet Commission) recommend that patients with advanced cancer should be managed by multidisciplinary teams specialising in EPC, parallelly with their cancer treatment.

Referral to early palliative care teams and the intensity of shared care with oncology not only depend on the extent of patients' disease and prognosis, but also on the individual complexity of their care needs. A key component of improving the care of patients with advanced cancer is increasing our knowledge in this area. That is why we are seeking your opinion and contribution (through narrative or systematic reviews, original research, etc.).

The aim of this Special Issue is to review the integration of early palliative care in oncology. The main topics for the Special Issue may include, but are not limited to: the integration of palliative care in oncology; complexity of palliative care needs; organisational models of shared care between oncology and palliative care; cancer pain; symptom control; end of life in cancer patients; advanced care planning, etc.

Dr. Albert Tuca-Rodríguez
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • early palliative care
  • advanced cancer
  • complexity of care needs
  • integration of palliative care in oncology
  • cancer pain
  • symptom control
  • end-of-life
  • advance care planning

Published Papers (3 papers)

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Research

10 pages, 526 KiB  
Article
How Do Quality of Life (QoL) and Symptom Burden Evolve in Inpatient Palliative Care (PC) Patients following One Week of Care in a Specialized Palliative Care Unit (PCU)? A Comparison of Two Groups, with One Receiving Specialized Outpatient Palliative Care Prior to Admission
by Hanna Salm, Florian Doberschütz, Franziska Hallmann, Philipp Munzert, Johannes Rahm, Sarah Uhlig and Daniel Pink
Cancers 2024, 16(8), 1612; https://doi.org/10.3390/cancers16081612 - 22 Apr 2024
Viewed by 275
Abstract
Purpose: This study sought to investigate changes in quality of life (QoL) and symptom burden among palliative care patients undergoing one week of inpatient care in a specialized palliative care unit (PCU). The patient population was stratified into two groups, with one group [...] Read more.
Purpose: This study sought to investigate changes in quality of life (QoL) and symptom burden among palliative care patients undergoing one week of inpatient care in a specialized palliative care unit (PCU). The patient population was stratified into two groups, with one group pretreated from pre-admission palliative care (PC) provided by an outpatient multidisciplinary PC team, while the other group did not receive such support prior to admission. Although the average duration of treatment at a PCU in Germany is 1–2 weeks, the question also arises as to whether a significant improvement in symptom burden and QoL can be expected after just one week of PC in a PCU. Methods: PC patients with various cancer entities were prospectively included in a non-randomized study. Patients in group 1 received outpatient specialized PC prior to admission, while patients in group 2 did not. Over an 8-month period, we gathered data from one academic cancer center, utilizing the EORTC QLQ-C30, one of the most widely used patient-reported outcome (PRO) instruments to assess health-related QoL in cancer patients. Patients completed the QLQ-C30 at T0 (admission or one day later) and T1 (one week later), enabling the assessment of potential changes in their QoL and symptom burden over time. Results: A total of 103 patients (51.5% male) were enrolled (group 1: 42%, group 2: 58%). At T0, there were no significant differences regarding QLQ-C30 scores between groups 1 and 2, except from global health/QoL (group 1 mean 20.7, group 2 mean 25.6, p = 0.026). Over the course of one week several significant and clinically relevant changes were found: Emotional functioning demonstrated an uplift in both groups (group 1: mean 41.5 IQR 33 vs. 53.1 IQR 50, p = 0.014, group 2: mean 48.2 IQR 46 vs. 56.8 IQR 58, p = 0.029), as did the global health status (group 1: M 20.7 IQR 17 vs. 36.2 IQR 33, p < 0.001, group 2: M 25.6 IQR 25 vs. 35.3 IQR 33, p < 0.001). Nausea and vomiting showed a reduction (group 1: M 29.9 IQR 17 vs. 6.8 IQR 0, p < 0.001, group 2: M 22.6 IQR 17 vs. 8.2 IQR 0, p < 0.001), along with a notable decline in pain (group 1: M 67.4 IQR 67 vs. 25.3 IQR 17, p < 0.001, group 2: M 73.1 IQR 83 vs. 29.7 IQR 17, p < 0.001). A decrease was observed in insomnia (group 1: M 63.6 IQR 67 vs. 27.6 IQR 33, p < 0.001, group 2: M 60.1 IQR 67 vs. 27.6 IQR 33, p < 0.001). There were no significant differences between groups 1 and 2 in the extent of improvement in the various symptom scales from T0 to T1. Conclusion: The findings of our study demonstrate that QoL and several symptoms prevalent in cancer patients cared for in the PCU experienced significant enhancement over the span of just one week. Both groups, patients receiving specialized outpatient PC prior to admission and those without, equally benefited from inpatient PC. All mentioned changes from T0 to T1 are considered not only significant but clinically relevant. Full article
(This article belongs to the Special Issue Integrating Palliative Care in Oncology)
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11 pages, 468 KiB  
Article
Fear of Recurrence in Advanced Cancer Patients: Sociodemographic, Clinical, and Psychological Correlates
by Caterina Calderon, Marina Gustems, Rocio Galán-Moral, Maria M. Muñoz-Sánchez, Lorena Ostios-García and Paula Jiménez-Fonseca
Cancers 2024, 16(5), 909; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers16050909 - 23 Feb 2024
Viewed by 611
Abstract
Fear of cancer recurrence significantly impacts advanced cancer patients, prompting emotional distress and increased healthcare utilization. This present study aims to analyze the fear of recurrence among patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. [...] Read more.
Fear of cancer recurrence significantly impacts advanced cancer patients, prompting emotional distress and increased healthcare utilization. This present study aims to analyze the fear of recurrence among patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. A multicenter cross-sectional study was conducted in 15 oncology departments across Spain, involving patients with locally advanced, unresectable, or metastatic cancer eligible for systemic treatment. Participants provided demographic information and completed instruments such as the Cancer Worry Scale, Brief Symptom Inventory, Mishel Uncertainty in Illness Scale, and the Duke–UNC-11 Functional Social Support Questionnaire (DUFSSQ). A total of 1195 participants participated: median age 66, 56% male, mostly metastatic cancers (80%), and common tumor sites. Two fear groups emerged: 28% low and 72% high levels of fear. High fear was associated with being female, being younger, lower levels of education, and worse survival estimates. High fear correlated with more depression, anxiety, somatic symptoms, uncertainty, and stronger social support. Multivariate analyses indicated that younger patients, those with shorter survival estimates, higher depression and anxiety scores, more uncertainty, and stronger social support had a greater likelihood of experiencing fear of recurrence, while the opposite was true for older patients. This study underscores distinct fear of recurrence profiles in advanced cancer patients, emphasizing the need for targeted interventions and support. Future research should delve deeper into understanding their repercussions for improving patient care and well-being. Full article
(This article belongs to the Special Issue Integrating Palliative Care in Oncology)
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16 pages, 2133 KiB  
Article
Validation Study of the PALCOM Scale of Complexity of Palliative Care Needs: A Cohort Study in Advanced Cancer Patients
by Margarita Viladot, Jose-Luís Gallardo-Martínez, Fany Hernandez-Rodríguez, Jessica Izcara-Cobo, Josep Majó-LLopart, Marta Peguera-Carré, Giselle Russinyol-Fonte, Katia Saavedra-Cruz, Carmen Barrera, Manoli Chicote, Tanny-Daniela Barreto, Gemma Carrera, Jackeline Cimerman, Elena Font, Ignacio Grafia, Lucia Llavata, Javier Marco-Hernandez, Joan Padrosa, Anais Pascual, Dolors Quera, Carles Zamora-Martínez, Ana-Maria Bozzone, Carme Font and Albert Tucaadd Show full author list remove Hide full author list
Cancers 2023, 15(16), 4182; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers15164182 - 20 Aug 2023
Viewed by 1413
Abstract
Background: In a patient-centred model of care, referral to early palliative care (EPC) depends on both the prognosis and the complexity of care needs. The PALCOM scale is a 5-domain multidimensional assessment tool developed to identify the level of complexity of palliative care [...] Read more.
Background: In a patient-centred model of care, referral to early palliative care (EPC) depends on both the prognosis and the complexity of care needs. The PALCOM scale is a 5-domain multidimensional assessment tool developed to identify the level of complexity of palliative care needs of cancer patients. The aim of this study was to validate the PALCOM scale. Patient and methods: We conducted a prospective cohort study of cancer patients to compare the PALCOM scale and expert empirical assessment (EA) of the complexity of palliative care needs. The EA had to categorise patients according to their complexity, considering that medium to high levels required priority attention from specialist EPC teams, while those with low levels could be managed by non-specialist teams. Systematically collected multidimensional variables were recorded in an electronic report form and stratified by level of complexity and rating system (PALCOM scale versus EA). The correlation rank (Kendall’s tau test) and accuracy test (F1-score) between the two rating systems were analysed. ROC curve analysis was used to determine the predictive power of the PALCOM scale. Results: A total of 283 advanced cancer patients were included. There were no significant differences in the frequency of the levels of complexity between the EA and the PALCOM scale (low 22.3–23.7%; medium 57.2–59.0%; high 20.5–17.3%). The prevalence of high symptom burden, severe pain, functional impairment, socio-familial risk, existential/spiritual problems, 6-month mortality and in-hospital death was significantly higher (p < 0.001) at the high complexity levels in both scoring systems. Comparative analysis showed a high correlation rank and accuracy between the two scoring systems (Kendall’s tau test 0.81, F1 score 0.84). The predictive ability of the PALCOM scale was confirmed by an area under the curve in the ROC analysis of 0.907 for high and 0.902 for low complexity. Conclusions: In a patient-centred care model, the identification of complexity is a key point to appropriate referral and management of shared care with EPC teams. The PALCOM scale is a high precision tool for determining the level of complexity of palliative care needs. Full article
(This article belongs to the Special Issue Integrating Palliative Care in Oncology)
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