Oncologists Should Consider Starting Palliative Care at Mesothelioma Diagnosis, According to New Research
Mesothelioma, a rare cancer caused by asbestos exposure, is one of the most difficult cancers to treat due to its aggressiveness and resistance to standard cancer therapies. With no known cure for the disease, the treatments are often aimed at managing the symptoms and improving the patients’ quality of life. Once patients near their end of life, doctors often shift to palliative care which is intended to control pain, stop bleeding, relieve pressure, and to allow patients to be at home with their loved ones.
According to several speakers at “The Science of Compassion: Future Directions in End-of-Life and Palliative Care” summit, however, it is time to reconsider the traditional palliative care timeline and begin palliative care as early as the first day of a patient’s cancer diagnosis.
Dr. Jennifer S. Temel, clinical director of thoracic oncology at Massachusetts General Hospital in Boston, presented findings from her recent study on the benefits of early palliative care in non-small-cell lung cancer patients. She found that by introducing palliative care early after diagnosis, patients “had improved quality of life, less depression and improved quality of care, which translated to survival benefits.”
Jamie H. Von Roenn, MD, Professor of Medicine at Northwestern University Feinberg School of Medicine, agrees that palliative care is appropriate at various stages throughout cancer care. However, she cautioned that not all oncologists are on-board with palliative care and tend to focus solely on the cancer treatment. She said, though, that in some cases the physicians need to say to their patients, “This [cancer] is treatable but not curable.” And, she adds, this conversation should be held early in the patient’s care.
While many speakers and attendees believe palliative care has come a long way and is becoming an integrated part of healthcare, they also believe more work and research needs to be done to better serve patients in need of end-of-life care. Dr. J. Randall Curtis, director of the Harborview/University of Washington End-of-Life Care Research Program, Seattle, called the summit “exciting,” and said it “really demonstrated that we’ve made tremendous advances in palliative care, but there is still a lot of work to be done.”
Palliative care advocates got a boost earlier this year from the American Society of Clinical Oncology (ASCO) when they released new guidelines regarding patient care. ASCO encourages physicians to discuss a patient’s treatment options and preferences, including end-of-life care, immediately after their terminal diagnosis so the treatment can be individualized from the start.
Mesothelioma is often not diagnosed until symptoms appear leaving patients with few treatment options. Once symptoms become apparent, mesothelioma may rapidly progress to cause life-threatening complications. Close to 3,000 Americans die of the incurable cancer each year.
The summit, which was sponsored by the NIH’s National Institute of Nursing Research (NINR), was held August 10-12 in Bethesda, MD. Nearly 1,000 medical professionals and patient advocates were in attendance.
