Guidelines Seek to Mainstream Palliative Ca Care.

FORT LAUDERDALE, FLA. -- Palliative care needs to be a standard component of treatment for cancer patients, according to new practice guidelines released at the annual meeting of the National Comprehensive Cancer Network.

The guidelines integrate palliative care into routine cancer therapy Management approaches now frequently place patients and physicians in the position of abruptly shifting from treatment to palliation.

"We don't want patients being given a choice between cancer therapy or palliative care," said Dr. Sharon M. Weinstein, director of the pain medicine and palliative care program at the Huntsman Cancer Institute in Salt Lake City and a member of the panel that wrote the guidelines.

"Palliative care is part of cancer care. It is much more than end-of-life care," added Dr. Michael H. Levy director of the supportive oncology care program at the Fox Chase Cancer Center in Philadelphia and chairman of the guidelines panel. "We want to make it as easy to give palliative care as to give chemotherapy"

The guidelines formally kick in when a patient meets any of three criteria: The patient has advanced or progressive disease that does not have an effective, curative therapy; his life expectancy is 1 year or less; or he requests palliative care. This means that palliative care can be used by itself or alongside disease-specific treatments, Dr. Levy said.

Specific palliative care interventions are tailored to the patient's life expectancy: months to weeks, weeks to days, or days to hours. Clinical assessment and prognostic tools are generally most accurate for estimating a life expectancy of weeks to days-up to about 30 days.

Care also must be tailored to the patient's life goals. This means that when a patient's life ...