title: Early integration of palliative care into oncology: evidence, challenges and barriers.
abstract: Palliative care has proven to be an important component during the care of seriously ill oncology patients. In the past decade, early integration of both specialties demonstrated benefits in improving patient symptoms and pain, facilitating advance directive planning and reducing medical cost. Newer evidence also suggests it can prolong life. Several different integration models have been studied and all appear to work. Yet, palliative care is underused, and there are still many challenges and barriers preventing us from delivering the best care to our patients. In this review, we will summarize the available data from multiple randomized clinical trials, encountered challenges, and potential strategies to overcome them.
authors.affiliation: Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, USA.
authors.forename: Wanqing Iris
authors.initials: WI
authors.lastname: Zhi
authors.affiliation: Department of Medicine and Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, USA. tsmit136@jhmi.edu.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
mesh_terms: D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration*; D008962:Models, Theoretical; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D010166:Palliative Care / Q000458:organization & administration*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
keywords: Palliative care; medical oncology; overall survival (OS); prognostic awareness; randomized trials