Davis Mellar P, Bruera Eduardo, Morganstern Daniel
From Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, and Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH; The University of Texas MD Anderson Cancer Center, Houston, TX, Harvard Medical School and Breast Oncology Center, Dana Farber Cancer Institute, Boston, MA.
Am Soc Clin Oncol Educ Book. 2013:144-50. doi: 10.14694/EdBook_AM.2013.33.144.
Palliative care has become synonymously associated with hospice care in the minds of patients and physicians. Supportive care is a more acceptable term and leads to earlier referral. Miscommunication and a "collusion of hope" centered on cancer treatment is detrimental to care at the end of life and results in complicated bereavement. Patients, despite being told prognosis, may not comprehend the news even if delivered in an empathetic manner. There are resource and policy barriers to palliative care. However, integration of palliative care early in the management of advanced cancer has demonstrated multiple benefits without reducing survival.
在患者和医生的观念中，姑息治疗已与临终关怀同义。支持性治疗是一个更易被接受的术语，能促使更早转诊。以癌症治疗为中心的沟通不畅和“希望的共谋”对临终护理有害，并导致复杂的丧亲之痛。患者即便被告知预后情况，即便信息是以共情的方式传达的，也可能无法理解。姑息治疗存在资源和政策障碍。然而，在晚期癌症管理中尽早整合姑息治疗已显示出诸多益处，且不影响生存率。
