Journal of the National Comprehensive Cancer Network : JNCCN
-
J Natl Compr Canc Netw · Mar 2013
Barriers and approaches to the successful integration of palliative care and oncology practice.
As management of patients with cancer is evolving, an increased focus is being placed on individualized patient-centered care. Early integration of palliative care into the overall management of patients with cancer can help achieve this paradigm shift. ⋯ Survey studies have indicated a significant need for increased education regarding palliative care for both medical undergraduates and postgraduate physicians. Key issues in the early integration of palliative care include relationship-building across multiple health systems and specialties; development of a standardized definition of palliative care, making clear that it should be fully integrated with cancer-directed therapy; identification of physician and nonphysician champions; standardization of tools for patient assessment; education programs designed to meet the needs of health care professionals; and ongoing evaluation to assess program benefits and limitations.
-
J Natl Compr Canc Netw · Mar 2013
Early implementation of palliative care can improve patient outcomes.
Patients with cancer experience many complex issues throughout the trajectory of the disease. These range from the physical consequences of cancer and treatment to the psychological, social, and spiritual issues associated with living with the disease. An individualized, comprehensive, and interdisciplinary approach is needed to reduce patient suffering and ensure appropriate symptom management and support from the time of first diagnosis to end of life. ⋯ Professional organizations such as ASCO have begun to develop recommendations that integrate palliative care into standard oncologic care from the time a person is diagnosed with metastatic or advanced cancer. NCCN has a palliative care guideline that recommends early and ongoing assessment of palliative care needs and referral to specialist palliative care services in more complex cases. In turn, oncologists need to consider how best to screen patients and integrate early palliative care with routine oncologic care, within the context of their busy clinics, to ensure that patients, families, and caregivers receive timely support.
-
J Natl Compr Canc Netw · Dec 2012
ReviewStereotactic ablative radiotherapy for non-small cell lung cancer: rationale and outcomes.
Stereotactic ablative radiotherapy (SABR), also known in older reports as stereotactic body radiation therapy, represents an evolving and expanding radiation treatment option for many forms of local malignancy, from primary tumors to metastatic and recurrent disease. It involves the precise delivery of higher doses of external-beam radiation per treatment over a shortened treatment course compared with traditional regimens. ⋯ Although SABR is being used for the treatment of primary and metastatic disease in many sites of the body, such as the central nervous system, liver, pancreas, spine metastases, and isolated nodal disease in the mediastinum and abdomen, this article focuses on treatment of NSCLC in the thorax. Specifically, this review provides the rationale, evidence, and indications for treating early-stage lung cancers with SABR.