Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
Medical Oncology Division and Palliative Care Division, Department of Internal Medicine, University of Kansas Medical Center, Westwood, KS, USA.
Nat Rev Urol. 2021 Oct;18(10):623-635. doi: 10.1038/s41585-021-00491-z. Epub 2021 Jul 26.
Palliative care - specialized healthcare focused on improving quality of life for patients with serious illnesses - can help urologists to care for patients with unmet symptom, coping and communication needs. Society guidelines from the American Society of Clinical Oncology and the National Comprehensive Cancer Network recommend incorporating palliative care into standard oncological care, based on multiple randomized trials demonstrating that it significantly improves physical well-being, patient satisfaction and goal concordant care. Misconceptions regarding the objective and ideal timing of palliative care are common; a key concept is that palliative care and treatments seeking to cure or prolong life are not mutually exclusive. Urologists are well positioned to champion the integration of palliative care into surgical urologic oncology and should be aware of palliative care guidelines, indications for palliative care use and how the field of urologic oncology can adopt best practices.
姑息治疗——专注于提高严重疾病患者生活质量的专业医疗保健——可以帮助泌尿科医生照顾有未满足的症状、应对和沟通需求的患者。美国临床肿瘤学会和国家综合癌症网络的社会指南建议将姑息治疗纳入标准肿瘤学护理,这是基于多项随机试验的结果,表明姑息治疗显著改善了身体舒适度、患者满意度和目标一致的护理。对于姑息治疗的目标和理想时机存在普遍的误解;一个关键概念是,姑息治疗和寻求治愈或延长生命的治疗并不相互排斥。泌尿科医生非常适合倡导将姑息治疗纳入手术泌尿科肿瘤学,并应该了解姑息治疗指南、姑息治疗使用的适应症以及泌尿科肿瘤学领域如何采用最佳实践。