Palliative care for cancer patients: An interdisciplinary approach

Palliative care is increasingly recognized as an important component of quality care for cancer patients. Given an estimated 1,437,180 new patients diagnosed with cancer in the USA in 2008, and approximately 565,650 cancer-related deaths, care for those patients who are near the end of life is an essential aspect of cancer care. Palliative care is an interdisciplinary team approach to care, with a focus on comfort and quality of life rather than prolongation of life or "cure" for a patient and their loved ones. Depending on the palliative care issue, many various treatment approaches may be available to manage symptoms and complications of advanced cancer. Common palliative care problems include pain, cachexia, asthenia, and wound issues. Examples of frequent concerns that necessitate an interdisciplinary team approach include pain, dyspnea, and malignant bowel obstruction. It is imperative to consider invasive or minimally invasive approaches in addition to noninvasive approaches for each of these problems. Each of these issues may mandate the expertise of specialists beyond the palliative care practitioner or medical oncologist, including surgeons, interventional radiologists, gastroenterologists, radiation oncologists, or anesthesiologists. Often there is a lack of high-quality research related to the optimal approach. The absence of an established evidence base in many areas of palliative care, at least in part due to the major challenges investigators face in designing palliative-care trials, emphasizes the need to involve other specialists in the care of these patients. In this way, the optimal approaches can be offered at this time of distress for patients and families.