Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update.

Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer. Methods ASCO convened an Expert Panel of members of the ASCO Ad Hoc Palliative Care Expert Panel to develop an update. The 2012 PCO was based on a review of a randomized controlled trial (RCT) by the National Cancer Institute Physicians Data Query and additional trials.

Lessons From Early Implementation of a Patient-Centered Care Model in Oncology.

Purpose: Oncology practices may serve as the primary health provider for patients with cancer and the so-called neighbor during periods of transition and survivorship. New standards for patient-centered oncology practice articulate expectations for the primary health provider and neighbor roles. We report the implementation experiences of five oncology practices participating in a pilot of these standards.

American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care.

Purpose: An American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) offers timely clinical direction to ASCO's membership following publication or presentation of potentially practice-changing data from major studies. This PCO addresses the integration of palliative care services into standard oncology practice at the time a person is diagnosed with metastatic or advanced cancer.

Clinical Context: Palliative care is frequently misconstrued as synonymous with end-of-life care.

Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment.

A framework for cancer survivorship research and translation to policy.

Awareness has grown over the past few years that needs specific to cancer survivors have long been neglected. Clinicians and policy makers continue to struggle, however, with exactly how to address these needs. We present a comprehensive framework for survivorship research and couple it with a model for translating research into policy, using two examples for illustration.

Cancer Quality Alliance: Blueprint for a better cancer care system.

The Cancer Quality Alliance (CQA), a national alliance advocating for improvements in the quality of cancer care in America, presents a set of 5 case studies that depict a vision of quality cancer care and a "Blueprint" for actions to realize this vision. The CQA Blueprint case studies feature patients with soft tissue sarcoma, breast cancer, rectal cancer, and Hodgkin disease and focus on key phases in the cancer care trajectory: detection, diagnosis, treatment, post-treatment/survivorship, and end of life. Each case study begins with a patient summary, follows with a worst- and a best-case scenario, and concludes with a discussion section identifying "what went right" in the best case and "what went wrong" in the worst case.

Implementing palliative care studies.

This session focused on issues related to implementation of randomized clinical trials in palliative care studies. Topics discussed included what kinds of clinical sites and patient populations were suitable, what types of clinical investigators (clinical specialty) should be involved in or lead the studies, what multisite mechanisms could be used to conduct the trials, and what funding issues were related to these studies. A trial of operative versus nonoperative management for small bowel obstruction caused by recurrent intra-abdominal cancer was considered.

Survivorship perspectives and advocacy.

From the moment of diagnosis, a cancer survivor faces serious life-altering decisions. Survivors who are informed about their options and who feel they have personal control over decision making generally perceive a higher quality of life than those who feel less informed and less in control. Health care providers are in a unique position to define a survivor's cancer care and to guide a survivor through treatment and post-treatment care.

Cancer survivorship: a new challenge in comprehensive cancer control.

Cancer survivors are a growing population in the United States because of earlier cancer diagnosis, the aging of society, and more effective risk reduction and treatment. Concerns about the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public, private, and non-profit organizations. The purpose of this paper is to discuss how survivorship fits within the framework of comprehensive cancer control.

An analysis of advocacy: a collaborative essay.

Objectives: To review the development of advocacy and its influence on health policy from the perspective of AIDS, the American Cancer Society, the Cancer Leadership Council, and the Patient Advocacy Foundation.

Data Sources: Published articles, news articles, books and personal experience.

Conclusions: Advocacy on behalf of patients in the health care arena is a powerful force in modern life.