title: Integrating Palliative Medicine into Comprehensive Breast Cancer Therapy - a Pilot Project.
abstract: BACKGROUND: To comply with the World Health Organization (WHO) recommendations, our institution's administrative directives were adopted to advocate the provision of palliative care (PC) early in the disease trajectory of breast cancer (BC). To assess the outcome of this recommendation, this study evaluated the effects of this approach. METHODS: A retrospective systematic chart analysis of a 2-year period was performed. The first PC consultation of patients was analyzed according to (a) physical condition, (b) symptom burden of the patients, and (c) reasons for PC consultation. RESULTS: Many patients were already in a reduced physical state and experienced burdening symptoms when first counselled by PC. After a 1-year experience with PC consultations, the number of burdening symptoms identified at first PC consultation decreased and senologists increasingly requested PC support also for non-somatic issues. CONCLUSIONS: A development towards a better understanding of PC competencies after a 1-year initiation period could be demonstrated, but BC patients continued to be in late stages of the disease at the time of first PC contact. Disease-specific guidelines may facilitate and optimize the integration of PC into breast cancer therapy.
authors.affiliation: Department of Palliative Medicine, University Hospital, Cologne, Cologne, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Gaertner
authors.forename: Rachel
authors.initials: R
authors.lastname: Wuerstlein
authors.forename: Ursula
authors.initials: U
authors.lastname: Klein
authors.forename: Dennis
authors.initials: D
authors.lastname: Scheicht
authors.forename: Sebastian
authors.initials: S
authors.lastname: Frechen
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wolf
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
authors.forename: Raymond
authors.initials: R
authors.lastname: Voltz