Researchers from the M. D. Anderson Cancer Center and the National Cancer Institute have reported: “Most cancer centers reported a palliative care program, although the scope of services and the degree of integration varied widely.” The details of this study were published in the March 2010 issue of the Journal of the American Medical Association.[1]

Palliative care refers to care that is intended to provide comfort to the patient, such as reducing pain and discomfort, with no intent to prolong survival or provide a cure. Many patients with advanced cancers or those deemed terminal will be admitted to the hospital for palliative care. However, many of these patients will still undergo extensive laboratory or other tests and/or may be admitted to the intensive care unit for “usual” care without consideration of palliation. These tests or procedures may ultimately lead to significantly increased medical costs without improved palliation. Researchers involved in the Palliative Care Leadership Centers’ Outcomes Group have previously reported that consultation with palliative care teams significantly reduces costs for patients undergoing palliative care.

Researchers involved in the current study sought to determine the “current state of palliative care in cancer centers.” They compared the availability and degree of integration of palliative care services between 71 NCI-designated cancer centers and 71 non-NCI cancer centers. Data was collected from questionnaires completed by executives and program leaders involved in palliative care programs.

• 98% of NCI-designated cancer centers had a palliative care program compared with 78% of non-NCI-designated cancer centers.
• 92% of NCI-designated cancer centers had at least one palliative care physician compared with 74% of non-NCI-designated centers.
• 59% of NCI-designated cancer centers had an outpatient palliative care clinic compared with 22% of non-NCI-designated centers.
• 23% of centers had dedicated palliative care beds.
• 37% had institution-operated hospice centers.
• “Research programs, palliative care fellowships, and mandatory rotations for oncology fellows were uncommon.”

Comments: This study suggests that there is much room for improvement in palliative care for cancer patients in most cancer centers.

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