Palliative chemotherapy: historical perspective, applications, and controversies

Area of Science:

• Oncology
• Palliative Care
• Public Health

Background:

• Cancer remains a significant public health issue, particularly for patients with advanced or refractory disease.
• While cure is the primary goal, many patients with advanced cancer do not achieve it.
• Chemotherapy offers palliative benefits like symptom control and improved quality of life (QOL) for incurable cancers.

Purpose of the Study:

• To highlight the palliative role of chemotherapy in advanced cancers.
• To identify the exclusion of patients receiving chemotherapy from essential palliative services like Hospice.
• To advocate for integrated palliative care services throughout the cancer continuum.

Main Methods:

• Review of recent research on chemotherapy's palliative role.
• Analysis of current palliative care definitions and limitations.
• Exploration of mixed management models for concurrent palliative and therapeutic care.

Main Results:

• Chemotherapy provides significant symptom management, complication prevention, and QOL improvement in incurable cancers.
• Existing palliative care frameworks often exclude patients undergoing chemotherapy or clinical trials.
• Mixed management models integrating palliative and therapeutic options show promise.

Conclusions:

• Palliative chemotherapy is crucial for patients with incurable cancers.
• Current palliative care access is limited for patients receiving active cancer treatment.
• A continuum of care model integrating palliative services from diagnosis to end of life (EOL) is needed.