[The Dutch Health Council report on palliative chemotherapy: possible confusion on ideas]

The Dutch Health Council has issued a report advising the government on the care of cancer patients and on palliative chemotherapy in particular. The term palliative chemotherapy is ambiguous and may lead to confusion because it does not mean intention of cure and because the Council makes the assumption that palliative chemotherapy is used to enhance the quality of life, which is not in fact the case. In daily oncological clinical practice, prolonging life is the main objective. The report should have focused on better objectives for the systemic treatment of cancer. Four recommendations are contained within the report: (a) participation in clinical trials should be encouraged; the current implementation of good clinical practice guidelines and the Medical Research (Human Subjects) Act do not provide much support for this recommendation; (b) medication for palliative chemotherapy should be assessed for cost effectiveness; this is a political assessment and the responsibility for its implementation should not lie with the medical profession; (c) the quality of palliative chemotherapy should be ensured, therefore its application should be restricted to the trained medical oncologists; (d) in view of the complexity of the treatment nationwide guidelines are needed.