J Cancer 2016; 7(14):1968-1978. doi:10.7150/jca.14634 This issue

Research Paper

Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

Vittorina Zagonel1✉, Riccardo Torta2, Vittorio Franciosi3, Antonella Brunello1, Guido Biasco4, Daniela Cattaneo5, Luigi Cavanna6, Domenico Corsi7, Gabriella Farina8, Luisa Fioretto9, Teresa Gamucci10, Gaetano Lanzetta11, Roberto Magarotto12, Marco Maltoni13, Cataldo Mastromauro14, Barbara Melotti15, Fausto Meriggi16, Ida Pavese17, Erico Piva18, Cosimo Sacco19, Giuseppe Tonini20, Leonardo Trentin21, Paola Ermacora19, Antonella Varetto2, Federica Merlin22, Stefania Gori23, Stefano Cascinu24, Carmine Pinto25, AIOM Simultaneous & Continuous Care (SCC) Task Force-ESMO-DCs

1. Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology IOV - IRCCS, Padova;
2. Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, Turin;
3. Medical Oncology Unit, University Hospital, Parma;
4. “LA Seragnoli” Department of Hematology and Oncology Sciences, S. Orsola-Malpighi Hospital, Bologna;
5. European Institute of Oncology, Milano;
6. Department of Hematology and Oncology, Medical Oncology Unit, Piacenza Hospital, Piacenza;
7. Medical Oncology Unit, Fatebenefratelli - Isola Tiberina Hospital, Roma;
8. Medical Oncology Unit, Fatebenefratelli Hospital, Milano;
9. Department of Oncology, S. Maria Annunziata Hospital - AUSL 10, Bagno a Ripoli (FI);
10. Medical Oncology Unit, SS. Trinità Hospital, Sora (FR);
11. Medical Oncology Unit INI Grottaferrata, Roma;
12. Oncology Department, Sacro Cuore-Don Calabria Hospital, Negrar (VR);
13. Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola (FC);
14. Medical Oncology Unit, SS. Giovanni e Paolo Hospital, Venezia;
15. Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna;
16. Medical Oncology Unit, Fondazione Poliambulanza Hospital, Brescia;
17. Department of Oncology, San Pietro Fatebenefratelli Hospital, Roma;
18. Medical Oncology Unit, S.Anna Hospital, Ferrara;
19. Medical Oncology Unit, S. Maria Misericordia Hospital, Udine;
20. Medical Oncology Unit, Campus Bio-Medico University, Roma;
21. Palliative Care Unit, Veneto Institute of Oncology IOV - IRCCS, Padova;
22. Medical Oncology Unit, San Bonifacio Hospital, San Bonifacio (VR);
23. Oncology Department, Sacro Cuore-Don Calabria Hospital, Negrar (VR);
24. Department of Hematology and Oncology, University Hospital, University of Modena and Reggio Emilia, Modena, Italy;
25. Department of Medical Oncology, IRCCS - Arcispedale S. Maria Nuova, Reggio Emilia, Italy.

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Zagonel V, Torta R, Franciosi V, Brunello A, Biasco G, Cattaneo D, Cavanna L, Corsi D, Farina G, Fioretto L, Gamucci T, Lanzetta G, Magarotto R, Maltoni M, Mastromauro C, Melotti B, Meriggi F, Pavese I, Piva E, Sacco C, Tonini G, Trentin L, Ermacora P, Varetto A, Merlin F, Gori S, Cascinu S, Pinto C, AIOM Simultaneous & Continuous Care (SCC) Task Force-ESMO-DCs. Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey. J Cancer 2016; 7(14):1968-1978. doi:10.7150/jca.14634. Available from https://www.jcancer.org/v07p1968.htm

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Background: Early integration of palliative care in oncology practice (“simultaneous care”, SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. Patients and methods: A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Results: Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. Conclusion: SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field.

Keywords: early palliative care, simultaneous care, medical oncology, advanced cancer, research.