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[How do we get around the barriers to integrating palliative care in oncology?]
Marine Sahut d'Izarn1, Pascale Vinant2, Carole Bouleuc3
1CHU Ambroise Paré, service douleurs et médecine palliative, 92100 Boulogne-Billancourt, France.
Abstract:
Supported by numerous scientific publications showing its clinical benefits, early palliative care has become a gold standard in oncology since 2017, recommended for patients with advanced cancer by the major societies of oncology. Nevertheless, palliative care team integration is still too late in France and the intervention of palliative care teams in oncology is still often limited to the management of patients and their relatives at the end of life. First, we will look at the main obstacles: the lack of staff in palliative care teams and the complex functioning of palliative care identified beds; also, the difficulties of communication with the patient and his relatives for the introduction of palliative care. We will then discuss the prospects for development, moving from the concept of early palliative care (systematic from the advanced phase) to integrated palliative care (targeted to patients' needs). Standardization of the integrated palliative care pathway requires the description of referral criteria, screening modalities, different clinical missions, and collaboration modalities with oncologists. Palliative care and oncology teams, working together, can enable holistic medicine that focuses on the needs of patients and their loved ones, giving voice to their preferences and aiming to improve their quality of life.
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