The aging population, improvements in diagnosis, and better treatment options for patients are increasing the number of cancer survivors in the United States, with the estimated 15,533,220 survivors in 2016 expected to increase to approximately 20,208,770 by 2026.1 Given this, and coupled with the increasing complexity of cancer treatment, palliative care during survivorship has become a critical component of the oncology contiuum.
A patient is considered a cancer survivor beginning at the time of cancer diagnosis and extends throughout the duration of their life, according to the National Cancer Institute, National Comprehensive Cancer Network (NCCN), and the American Society of Clinical Oncology (ASCO).2,3 This includes patients with advanced cancer, all of whom, according to the ASCO’s 2017 guideline update on palliative care, should receive dedicated palliative care services starting early in the disease course.3
Palliative care is patient- and family-centered care that provides management of symptoms and distress, while also providing services supporting patient and caregiver’s psychosocial needs and education.4 According to the NCCN, the ultimate goal of palliative care is to anticipate, prevent, and reduce suffering so that patients and their families can enjoy the best possible quality of life during survivorship.
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The palliative care specialty has evolved to include not only patients who are dying, but to provide assistance in effectively managing symptoms, psychosocial care, caregiver support, and aiding in difficult conversations and decisions regarding prognosis, treatment, and expectations.5 Recent guidelines reflect this modern approach to palliative care, and ASCO recommends that all patients with advanced cancer receive palliative care, whereas the NCCN guideline provides an outline of criteria for eligibility.3,4 Both guidelines agree that palliative services should begin early, and should not be reserved for patients at the end of life.
