More care, less pathway. . .More plans?

Treatment Escalation Plans (TEPs) risk becoming the next 'tick box exercise', if not supported by open and compassionate conversations by healthcare teams brave enough to adequately address the culturally taboo subject of death. This requires a wider system of ongoing support, education and clinical leadership to create a culture of open communication. While excellent to read the emphasis that palliative treatments should not be reserved for the terminally ill, further advancements would see 'Supportive Care' move from the lowest levels of escalation to becoming embedded as standard practice for all deteriorating patients.

Integration of a patient-centred MUO/CUP service within a new acute oncology service: challenges and rewards.

Background: Holistic approach to the clinical management pathway for malignancy of undefined primary origin (MUO)/carcinoma of unknown primary (CUP) patients remains an unmet clinical need. To address this, an MUO/CUP service was implemented during conception of a new acute oncology service (AOS).

Methodology: Over a comparable 17 months' duration, patient outcomes pre-MUO/CUP service implementation was retrospectively analysed and compared prospectively with post-service implementation database.