Early Integration of Palliative Care into Oncology Practice: Is It Still a Mirage?

Abstract For over a decade, “early integration” has become a slogan in the palliative care (PC) community. The care of cancer patients requires improvement, and the studies on the early integration of PC reveal its deficits in the oncological practice. Unmet needs in physical, psychological, spiritual, or social care need to be addressed. A “collusion of hope” in cancer treatment delays appropriate end-of-life care and complicates bereavement. Communicating prognosis and comprehending survival and discussion on measures to enhance the quality of life frequently do not occur simultaneously. Early collaboration between an oncologist and a PC specialist for those with advanced cancer improves symptoms and reduces aggressive cancer care at the end of life without shortening survival. Within the changing care environment and increasing time limitations, the multidimensional needs of a patient on therapy for advanced cancer will increase. A holistic approach to the patient and the family hence requires a multi-professional team. Consensus around palliative quality indicators is in its infancy and is often governed by cost-effectiveness. This is a real crunch for already resource-poor settings.