E. Bruera et Cm. Neumann, Respective limits of palliative care and oncology in the supportive care of cancer patients, SUPP CARE C, 7(5), 1999, pp. 321-327
Advanced cancer patients develop a number of devastating physical and psych
osocial symptoms before death. In recent years, there have been great advan
ces in our knowledge on the appropriate assessment and management of many o
f the physical and psychosocial symptoms. There is also increasing understa
nding on the need for patients and families to receive appropriate follow-u
p and to have access to multiple settings for optimal care. Unfortunately,
both models developed on the basis of palliative care/hospice and those dev
eloped on the basis of supportive care/oncology have failed to achieve thes
e goals. Future models for the delivery of supportive cancer care will have
to consider the need to ensure that patients receive a consistent level of
assessment and management up to the time of death, that there is appropria
te flexibility, to allow patients to access multiple levels of care in the
trajectory of their illness, and that there is a significant contribution t
o the body of knowledge and future education of health care professionals.
These programs will need to develop individually for each country with due
consideration for the structure of the health care system, the structure of
the academic system, and the financing of health care in different regions
of the world.