Cancer Centers and Palliative Care.
“The state of palliative care in the United States is not very well known,” said lead author David Hui, MD, MSc, a medical oncologist currently completing a two-year clinical research fellowship in supportive and palliative oncology at the University of Texas M. D. Anderson Cancer Center. “Palliative care referral remains limited, and there remains much heterogeneity in the infrastructure and delivery of care.”
Speaking here at an AMA news briefing at the National Press Club, he noted that by the end of 2010 cancer is expected to be the number one cause of death worldwide and that about half of cancer patients die of their disease or related complications. “In about 10 years we should have palliative care for all cancer patients; more palliative care needs to be integrated into cancer care.”
The American Society of Clinical Oncology has recommended that palliative care be integrated into cancer care as a routine part of comprehensive cancer care by the year 2020.
“Almost all NCI-designated centers have palliative care programs,” said Dr. Hui. In fact, 98% of these NCI center centers said they have a palliative care program, 92% said they have at least one palliative care physician, and 92% said they have an inpatient palliative care consultation team. Figures were much lower for non-NCI centers.
But even NCI-designated cancer centers had a much lower rate for an outpatient palliative care clinic (59%) and relatively few centers—NCI-designated or not—had an institution-operated hospice or dedicated palliative care beds, he said.
The relative lack of available outpatient palliative care clinics can be a particularly high barrier to cancer patients receiving palliative care, since many who could benefit from such care are being treated as outpatients, Dr. Hui added.