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donderdag 18 oktober 2018

The Lancet: [Lancet Oncology Commission] Integration of oncology and palliative care: a Lancet Oncology Commission

[Lancet Oncology Commission] Integration of oncology and palliative care: a Lancet Oncology Commission
Full integration of oncology and palliative care relies on the specific knowledge and skills of two modes of care: the tumour-directed approach, the main focus of which is on treating the disease; and the host-directed approach, which focuses on the patient with the disease. This Commission addresses how to combine these two paradigms to achieve the best outcome of patient care. Randomised clinical trials on integration of oncology and palliative care point to health gains: improved survival and symptom control, less anxiety and depression, reduced use of futile chemotherapy at the end of life, improved family satisfaction and quality of life, and improved use of health-care resources.
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[Comment] Oncology and palliative care: patients need a seamless service
In The Lancet Oncology Commission,1 Stein Kaasa and colleagues lay out their purpose clearly: "to show why and how palliative care can be integrated with oncology for adults with cancer, irrespective of treatment intention". The first part of this manifesto is more clearly fulfilled than the second. To marshal the modest, but accumulating, evidence for better patient outcomes when oncology and palliative care work in synergy is straightforward,2–6 but to say how integration between the specialties should be achieved is much harder, given the variations between countries in health-care organisation and culture.
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[Comment] Integration of oncology and palliative care: less-mentioned issues and a Japanese perspective
We welcome the comprehensive Lancet Oncology Commission1 by Stein Kaasa and colleagues, which clarifies a reliable pathway to achieve patient-centered care through the integration of oncology and palliative care.1
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[Comment] Integrating palliative and oncology care: paediatric considerations
Cancers that affect adults inflict a worldwide burden of suffering. Stein Kaasa and colleagues' Lancet Oncology Commission1 on the integration of oncology and palliative care highlights important developments in our understanding of the pivotal contributions of palliative care to person-focused adult cancer care. For children with cancer, additional and expanded constructs should be considered. Although childhood cancers are far less prevalent than cancers that affect adults, the need for integrated paediatric palliative care and oncology care is no less pressing.
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[Comment] Integrating palliative care into health systems is essential to achieve Universal Health Coverage
Palliative care and pain relief have been largely ignored in global health.1 The Lancet and The Lancet Oncology have taken up this gauntlet by releasing two Commission reports2,3 that provide roadmaps to close the growing abyss in access to palliative care and pain relief for large parts of the world.4,5
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