From Evidence to Practice: Early Integration of Palliative Care in a Comprehensive Cancer Center

Abstract

Abstract Purpose The American Society of Clinical Oncology (ASCO) recommends that all patients with a diagnosis of advanced cancer be referred to a palliative care team within 8 weeks of diagnosis. The benefits of early integrated palliative care are well recognized, however, there is a lack of consensus to guide operational aspects of a palliative care service within a comprehensive cancer center. In this study, we explore current palliative care referral patterns at an academic cancer center and provide recommendations for operationalizing palliative care services as a program within comprehensive cancer centers in order to adequately meet the needs of patients with advanced cancer. Methods A retrospective chart review of patients with newly diagnosed metastatic cancer or advanced hematologic malignancy seen by the palliative care team at a comprehensive cancer center from January 1, 2021, to October 31, 2021 was conducted. IRB approval was obtained prior to the initiation of the chart review. Results A total of 243 patients with newly diagnosed metastatic cancer, or advanced hematologic malignancy were included in this review. Patients with gastrointestinal (26%), gynecologic (19%), and thoracic (21%) malignancies constituted 66% of the total cohort. The most frequent reason for referral was pain (52%). Thirty-nine percent of patients were referred within 8 weeks of an advanced cancer diagnosis. Conclusion ASCO recommends that all patients with advanced cancer be referred to a palliative care specialist within 8 weeks of diagnosis. Of the newly referred patients with advanced cancer, only 39% were referred to the palliative care team within 8 weeks of their diagnosis. This large gap suggests the need for a consensus with regard to operationalizing the palliative care team.