Department of Oncology-Pathology, Karolinska Institutet, Regional Cancer Centre in Stockholm - Gotland, and R & D Department, Stockholm's Sjukhem Foundation, Sweden.
Mol Oncol. 2022 Oct;16(19):3399-3409. doi: 10.1002/1878-0261.13278. Epub 2022 Aug 12.
New therapeutic approaches can produce promising results even in severely ill cancer patients. But they also pose new challenges with respect to prognostication, as patients who were once not eligible for treatment, due to age or comorbidities, now are. Palliative oncology constitutes a major part of oncological care, with life prolongation and quality of life as its main goals. Palliative care specialists are experts in symptom control and psychosocial and existential support, and the integration of their expertise early on in patient care can prolong survival. In this article, I discuss the need to integrate specialist palliative care into early cancer treatment plans to achieve quality of life for patients. I also discuss the ways in which palliative care specialists balance the benefits of novel treatments against their adverse effects for patients, particularly for the elderly, the frail and those in advance stages of disease. I highlight the need to ensure equal access to palliative care to improve cancer patients' quality of life but also why futile, burdensome treatments should be avoided especially in the frail, elderly patients. Further, I discuss benefits and problems related to nutritional support in patients with cachexia and exemplify why translational research is needed to link basic research with clinical oncology and effective symptom control.
新的治疗方法即使在重病癌症患者中也能产生有希望的结果。但它们也带来了新的预测挑战，因为以前由于年龄或合并症而不适合治疗的患者现在可以接受治疗了。姑息治疗是肿瘤学护理的主要组成部分，延长生命和提高生活质量是其主要目标。姑息治疗专家是症状控制以及心理社会和存在支持方面的专家，在患者护理的早期整合他们的专业知识可以延长生存期。在本文中，我讨论了将专科姑息治疗纳入早期癌症治疗计划以实现患者生活质量的必要性。我还讨论了姑息治疗专家如何平衡新治疗方法对患者的益处及其对患者的不良反应，特别是对老年人、体弱患者和疾病晚期患者的影响。我强调了确保获得姑息治疗的平等机会以提高癌症患者生活质量的必要性，但为什么特别是体弱、年老的患者应该避免无效、负担沉重的治疗。此外，我还讨论了与恶病质患者的营养支持相关的益处和问题，并举例说明了为什么需要转化研究将基础研究与临床肿瘤学和有效的症状控制联系起来。
