Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Northwest Health Communications, Edmonds, WA, USA.
University of Wisconsin Comprehensive Cancer Center, Madison, WI, USA.
Lancet Oncol. 2015 Mar;16(3):e137-47. doi: 10.1016/S1470-2045(14)70457-7.
Supportive care and palliative care are now recognised as critical components of global cancer control programmes. Many aspects of supportive and palliative care services are already available in some low-income and middle-income countries. Full integration of supportive and palliative care into breast cancer programmes requires a systematic, resource-stratified approach. The Breast Health Global Initiative convened three expert panels to develop resource allocation recommendations for supportive and palliative care programmes in low-income and middle-income countries. Each panel focused on a specific phase of breast cancer care: during treatment, after treatment with curative intent (survivorship), and after diagnosis with metastatic disease. The panel consensus statements were published in October, 2013. This Executive Summary combines the three panels' recommendations into a single comprehensive document covering breast cancer care from diagnosis through curative treatment into survivorship, and metastatic disease and end-of-life care. The recommendations cover physical symptom management, pain management, monitoring and documentation, psychosocial and spiritual aspects of care, health professional education, and patient, family, and caregiver education.
支持性和姑息治疗现在被认为是全球癌症控制规划的重要组成部分。在一些低收入和中等收入国家，已经提供了支持性和姑息治疗服务的许多方面。将支持性和姑息治疗充分纳入乳腺癌规划需要采取系统的、资源分层的方法。乳腺健康全球倡议召集了三个专家小组，为低收入和中等收入国家的支持性和姑息治疗规划制定资源分配建议。每个小组都专注于乳腺癌护理的特定阶段：治疗期间、有治愈意图（生存）后的治疗后、以及转移性疾病诊断后。小组的共识声明于 2013 年 10 月发表。本执行摘要将三个小组的建议合并为一个单一的综合文件，涵盖了从诊断到治愈治疗到生存、转移性疾病和临终关怀的乳腺癌护理。建议涵盖了身体症状管理、疼痛管理、监测和记录、心理社会和精神方面的护理、卫生专业人员教育以及患者、家庭和照顾者教育。
