Introduction: Integration between oncology and palliative care


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Irene Higginson1

1King’s College London, London, UK

Abstract

Earliest models for palliative care and oncology integration had these as separate entities. When a person was seen as having a terminal diagnosis, and potentially curative treatment ended, then they could be referred to palliative care. This approach saw palliative care and oncology as separate rectangles in the illness journey. Gradually over the course of many years this model has changed, at least in much contemporary palliative care, and we now see palliative care and oncology needing to be more integrated. The level of integration should be orientated to the needs of the person, not some medically defined boundaries. Patients have symptoms and complex problems earlier in the course of illness, where palliative care can help, but then perhaps withdraw until symptoms recur. The advances in cancer treatments and care, and the demographic changes in our society, also demand this. There is empirical evidence to support this approach, including randomised trials, showing benefit on patient outcomes including symptoms, quality of life and possibly also survival. So the question is now not whether palliative care and oncology should integrate, but how it is best achieved. This session considers the latest developments and evidence about palliative care and oncology integration, from different viewpoints.

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