Integrating palliative medicine into comprehensive breast cancer therapy-a pilot project

Abstract

Background: To comply with the World Health Organization (WHO) recommendations, our institution's administrative directives were adopted to advocate the provision of palliative care (PC) early in the disease trajectory of breast cancer (BC). To assess the outcome of this recommendation, this study evaluated the effects of this approach. Methods: A retrospective systematic chart analysis of a 2year period was performed. The first PC consultation of patients was analyzed according to (a) physical condition, (b) symptom burden of the patients, and (c) reasons for PC consultation. Results: Many patients were already in a reduced physical state and experienced burdening symptoms when first counselled by PC. After a 1year experience with PC consultations, the number of burdening symptoms identified at first PC consultation decreased and senologists increasingly requested PC support also for nonsomatic issues. Conclusions: A development towards a better understanding of PC competencies after a 1year initiation period could be demonstrated, but BC patients continued to be in late stages of the disease at the time of first PC contact. Diseasespecific guidelines may facilitate and optimize the integration of PC into breast cancer therapy. Copyright © 2011 S. Karger AG, Basel.