Keywords
1. Hematology Palliative Care
2. Palliative Medicine
3. Palliative Care Needs
4. Palliative Care Integration
5. Hematologic Neoplasms Therapy
The collaboration between hematology and palliative care has become increasingly important as healthcare providers recognize the unique needs of patients suffering from hematologic neoplasms. In a succinct yet impactful editorial by Josep Porta-Sales and Simon Noble, published in the May 2019 issue of Palliative Medicine, the authors address the unmet needs of these patients and the essential role palliative care has in providing comprehensive and holistic treatment.
The article, titled “Haematology and palliative care: the needs are out there,” underscores how the integration of palliative care in the treatment of blood cancers can significantly improve patient outcomes. This news piece will delve into the editorial’s key points, discuss the current state of palliative care in hematology, and explore future directions based on recent research and expert opinions. Additionally, we will reference key literature and provide the DOI for Porta-Sales and Noble’s editorial to facilitate further exploration by those interested.
Background and Context
Hematologic malignancies, which include cancers such as leukemia, lymphoma, and myeloma, are complex diseases requiring aggressive and often prolonged treatment. The trajectory of these diseases often involves considerable physical and psychological distress, making the provision of palliative care a critical component of comprehensive patient management.
However, the integration of palliative care into hematology has historically lagged behind other cancer specialties. There’s a false perception that palliative care is synonymous with end-of-life care, rather than a specialty focused on improving the quality of life throughout the illness trajectory, regardless of prognosis. Porta-Sales and Noble (2019) argue that this misunderstanding has prevented many patients with hematologic cancers from receiving the full spectrum of care they urgently need.
Unmet Needs in Hematology
Patients with hematologic malignancies face a unique set of challenges. For example, these patients often experience severe symptoms, such as pain, fatigue, and emotional distress, that stem directly from the cancer and its treatment (Porta-Sales & Noble, 2019). Additionally, the treatments, which may include chemotherapy, radiation therapy, and bone marrow transplantation, can significantly impact their quality of life.
The traditional delay in referring these patients to palliative care services has resulted in unmet needs that could otherwise be addressed through early palliative interventions. Palliative care teams are trained to manage complex symptoms, provide psychological support, and assist in navigating the healthcare system, which can be particularly intricate for patients with hematologic malignancies.
Current State of Integrative Palliative Care
The inclusion of palliative care early in the disease trajectory has been demonstrated to improve quality of life, symptom management, and even survival in some cases. Despite this, the integration of palliative services in hematology remains inconsistent. Porta-Sales and Noble (2019) point out that growing evidence supports early palliative care involvement, but widespread implementation has not yet been realized.
One reason for the slow integration may be the lack of awareness and understanding of palliative care among hematologists, which also affects referral patterns. There is a pressing need for educational initiatives aimed at both healthcare professionals and patients to dispel myths surrounding palliative care and to highlight its benefits outside of the end-of-life context.
Future Directions
Advancing the integration of palliative medicine into hematology requires concerted efforts from both fields. Porta-Sales and Noble (2019) suggest that clearer guidelines for palliative care referrals in hematology could prompt more consistent and timely involvement. Additionally, the development of specialized palliative care programs or clinics within hematology departments could facilitate a seamless integration of services.
Research is also essential to guide best practices and policies. There is an ongoing need for high-quality studies that explore the implications of early palliative care intervention for hematologic cancer patients. This research should also investigate models of care that best suit the needs of this particular patient population.
Furthermore, patient and caregiver education is paramount. By providing clear information about the benefits of palliative care and when it should be introduced, we can empower individuals to advocate for comprehensive, holistic care that addresses their needs throughout their illness.
Conclusion
The editorial by Porta-Sales and Noble is a testament to the increasing recognition of palliative care’s importance in comprehensive cancer treatment, particularly in the field of hematology. With the growing body of evidence supporting the benefits of early palliative care integration for patients with hematologic malignancies, it’s paramount that both specialists in hematology and palliative medicine work together to bridge the gaps in care.
By promoting education, research, and the development of integrative care models, the healthcare community can ensure that the needs of patients with hematologic cancers are not just met but anticipated, providing them with the best possible quality of life from diagnosis through to advanced disease.
References
1. Porta-Sales, J., & Noble, S. (2019). Haematology and palliative care: the needs are out there. Palliative Medicine, 33(5), 481-482. doi:10.1177/0269216319840604
2. Ferrell, B. R., Temel, J. S., Temin, S., et al. (2017). Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. Journal of Clinical Oncology, 35(1), 96-112. doi:10.1200/JCO.2016.70.1474
3. Odejide, O. O., Cronin, A. M., Condron, N. B., et al. (2016). Barriers to Quality End-of-Life Care for Patients With Blood Cancers. Journal of Clinical Oncology, 34(26), 3126–3132. doi:10.1200/JCO.2015.65.8843
4. Howell, D., Harth, T., Brown, J., Bennett, C., & Boyko, S. (2017). A Pan-Canadian Clinical Practice Guideline: Assessment of Psychosocial Health Care Needs of the Adult Cancer Patient. Journal of Pain and Symptom Management, 53(5), 944-960. doi:10.1016/j.jpainsymman.2017.01.013
5. Zimmermann, C., Swami, N., Krzyzanowska, M., et al. (2014). Early palliative care for patients with advanced cancer: A cluster-randomised controlled trial. Lancet, 383(9930), 1721-1730. doi:10.1016/S0140-6736(13)62416-2
6. Hui, D., & Bruera, E. (2016). Models of integration of oncology and palliative care. Annals of Palliative Medicine, 5(3), 209-219. doi:10.21037/apm.2016.04.03