Palliative Care for Patients with Cancer

Publication Date: May 15, 2024
Last Updated: May 15, 2024

 Treatment

Treatment Recommendations

General Note: The following recommendations (strong or weak) represent reasonable options for patients, depending on clinical circumstances and in the context of individual patient preferences. Recommended care should be accessible to patients whenever possible.
Please note that ASCO used guideline methodology for the modified and new recommendations according to the current ASCO Methodology Manual, which was updated since the prior guideline.
The methodology for Recommendations 1a. and 1b. was developed by previous methodology (2016 methodology described here: ms_2016.701474.pdf (ascopubs.org)).

Recommendation 1

Clinicians should refer patients with advanced solid tumors and hematologic malignancies to specialized interdisciplinary palliative care teams that provide inpatient and outpatient care early in the course of disease, alongside active treatment of their cancer. (EB, , I, S)
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Recommendation 1a

Palliative care for patients with advanced cancer should be delivered through interdisciplinary palliative care teams, with consultation available in both outpatient and inpatient settings. (EB, , I, M)
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Recommendation 1b

Patients with advanced cancer should receive palliative care services, which may include a referral to a palliative care provider. Essential components of palliative care include:
  • Rapport and relationship building with patient and family caregivers
  • Symptom, distress, and functional status management (e.g., pain, dyspnea, fatigue, sleep disturbance, mood, nausea, or constipation)
  • Exploration of understanding and education about illness and prognosis
  • Clarification of treatment goals
  • Assessment and support of coping and spiritual needs
  • Assistance with medical decision making
  • Coordination with other care providers
  • Provision of referrals to other care providers as indicated
(IC, , I, M)
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Recommendation 2

Among patients with cancer with unaddressed physical, psychosocial, or spiritual distress, cancer care programs should provide dedicated specialist palliative care services to complement existing or emerging supportive care interventions. (IC, , L, W)
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Recommendation 3

Clinicians from across the interdisciplinary cancer care team may refer the caregivers (including family, chosen family, and friends) of patients with cancer to palliative care teams for additional support. (IC, , L, W)
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Recommendation 4

For patients with advanced cancer, the Expert Panel recommends early specialist palliative care involvement, especially for patients with uncontrolled symptoms and/or quality of life (QOL) concerns. (IC, , L, W)
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Recommendation 5

Clinicians should refer patients with hematologic malignancies to specialist palliative care. (EB, , M, W)
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Recommendation 6

Clinicians caring for patients in early-phase clinical trials, including phase I, may refer patients to specialist palliative care to assess and address the needs of patients with advanced solid tumors. (IC, , L, W)
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Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Palliative Care for Patients with Cancer

Authoring Organization

American Society of Clinical Oncology

Publication Month/Year

May 15, 2024

Last Updated Month/Year

November 10, 2024

Document Type

Guideline

Country of Publication

US

Document Objectives

To provide evidence-based guidance to oncology clinicians, patients, nonprofessional caregivers, and palliative care clinicians to update the 2016 ASCO guideline on the integration of palliative care into standard oncology for all patients diagnosed with cancer.

Target Patient Population

Adult patients with advanced cancer (solid tumor or hematological cancers) and family caregivers

Target Provider Population

Oncologists, physicians, advance practice providers, nurses, social workers, psychological professionals, palliative and home care clinicians, health care organizations, and researchers.

PICO Questions

  1. What are the most effective interventions to provide palliative care to patients with cancer (specialist palliative care services and/or generalist care by oncology clinicians)?

  2. How can palliative care services relate in practice to other existing or emerging supportive care services (including nurse navigation, lay navigation, community and home health care, geriatric oncology, psycho-oncology, pain, and telehealth services)?

  3. Which interventions are helpful for family caregivers, care partners, and communities?

  4. Which patients should be offered or referred to palliative care services and when in their disease trajectory; are there triggers that should be used to prompt specialty palliative care referrals?

  5. What are the strategies for integration of palliative care in the care of patients with hematologic malignancies?

  6. What is the role of palliative care for patients with cancer on phase I cancer clinical trials?

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Home health, Hospice, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Treatment

Diseases/Conditions (MeSH)

D010166 - Palliative Care, D064946 - Hospice and Palliative Care Nursing, D065126 - Palliative Medicine

Keywords

palliative care, Advanced cancer, advanced solid tumors, hematologic malignancies

Source Citation

Sanders JJ, Temin S, Ghosal A, et al. Palliative Care for Patients with Cancer: ASCO Guideline Update. J Clin Oncol. 2024 May 15. doi: 10.1200/JCO.24.00542  

Supplemental Methodology Resources

Data Supplement, Evidence Tables

Methodology

Number of Source Documents
94
Literature Search Start Date
January 1, 2015
Literature Search End Date
January 1, 2023