Tom Smith, M.D., wants cancer patients to live well. Fewer side effects, better quality of life, more joyful time with family…these are among the primary goals, he says, of palliative medicine. Researchers have studied the impact of palliative medicine programs on patients’ outcomes, and results show that patients benefit, says Smith. “A lot of aggressive chemotherapy is given in the last six months of life, and only about 18 percent of these patients ever use hospice, so they are missing an important part of good cancer care.” says Smith, director of Palliative Medicine at Johns Hopkins Medicine and the Harry J. Duffey Family Professor of Palliative Care at the Johns Hopkins Kimmel Cancer Center. Professional organizations, including the American Society of Clinical Oncology (ASCO), have pointed to better treatment outcomes among patients who have six months or less to live and are in hospice programs. “They have better quality of life, better caregiver support and at least two studies have shown that cancer patients who use hospice live longer than those who don’t. There are multiple studies that show cancer patients who get palliative care alongside their usual care have better quality of life, fewer symptoms, can plan better, and live longer, too,” says Smith, who discussed an #ASCO16 presentation by researchers at the University of North Carolina, Chapel Hill.
So, how can more patients access palliative medicine programs? Smith says the concept of palliative medicine should be introduced early in cancer care -- for every patient -- through consultations with palliative medicine teams, apart from the primary oncologist. Smith suggests GetPalliativeCare.org for more information and PrepareForyourCare.org for tips on how to manage serious illness. He also says that doctors should encourage the concept of “prognostic awareness” sooner than later with their patients, by having specific and honest discussions about prognosis throughout their care.
Watch Smith discuss end of life care in this MedPage Today video and read his comments on the American Association for Cancer Research blog.