Journal of Medical Oncology and Therapeutics

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Short Communication - Journal of Medical Oncology and Therapeutics (2024) Volume 9, Issue 6

Barriers to Palliative Care in Oncology: Addressing the Gaps in Patient-Centered Care

Rupert Aapro *

Department of Oncology, Queen's University, Canada

*Corresponding Author:
Rupert Aapro
Department of Oncology, Queen's University, Canada
E-mail: aapro.rupert@queensu.ca

Received: 2-Nov-2024, Manuscript No. JMOT-24-151235; Editor assigned: 4-Nov-2024, PreQC No. JMOT-24-151235 (PQ) Reviewed:18-Nov-2024, QC No. JMOT-24-151235Revised:25-Nov-2024, Manuscript No. JMOT-24-151235; Published:30-Nov-2024, DOI: 10.35841/jmot- 9.6.237

Citation: Aapro R. Barriers to palliative care in oncology: Addressing the gaps in patient-centered care. J Med Oncl Ther. 2024;9(6):237

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Introduction

Palliative care is an integral component of oncology, aimed at improving the quality of life for cancer patients by addressing symptoms, pain, and emotional distress. Despite its proven benefits, palliative care remains underutilized in many oncological settings. This article explores the barriers to integrating palliative care into cancer treatment and proposes strategies to overcome these obstacles to provide more comprehensive, patient-centered care [1].

One of the primary barriers to palliative care is the lack of awareness among healthcare providers and patients. Many oncologists and specialists are trained to focus on curative treatments and may not fully understand the benefits of early palliative care intervention. This gap in education leads to delayed referrals, often when the patient is in the advanced stages of disease progression, reducing the potential impact of palliative care on their quality of life [2].

Both patients and healthcare providers often hold misconceptions about palliative care, equating it with end-of-life or hospice care. Many patients fear that accepting palliative care means giving up on curative treatments. This misunderstanding can lead to resistance from both patients and families when palliative care is suggested early in the treatment journey. Overcoming this misconception requires clear communication about the role of palliative care in improving symptom management alongside active cancer treatment [3].

In oncology, care is often fragmented across various specialists, such as medical oncologists, radiation oncologists, and surgeons. This multidisciplinary approach can sometimes hinder the integration of palliative care, as communication between teams may be limited. The lack of a coordinated care plan can result in delays in palliative care referrals, with patients missing out on opportunities for comprehensive symptom management [4].

Another significant barrier to palliative care is the shortage of trained palliative care specialists. Many healthcare systems, particularly in low- and middle-income countries, lack the resources and infrastructure to support dedicated palliative care teams. In these settings, oncologists may need to fill the gap, but without adequate training, they may not be equipped to provide the level of symptom management and psychosocial support that palliative care specialists offer [5].

Cultural and societal attitudes toward death and dying also play a role in limiting palliative care. In some cultures, discussing death and end-of-life care is considered taboo, leading to reluctance in engaging with palliative care services. Additionally, societal pressure to "fight" cancer may lead patients and families to reject palliative care, viewing it as a sign of surrender rather than a supportive component of care that enhances quality of life [6].

Financial constraints are a major barrier to accessing palliative care. In many healthcare systems, palliative care services are not reimbursed at the same rate as curative treatments, which can discourage hospitals from offering them. Additionally, the cost of medications and therapies used in palliative care, such as pain management drugs, may not be fully covered by insurance, making it difficult for patients to afford this essential aspect of their care [7].

Oncologists often refer patients to palliative care only in the final stages of cancer, when curative treatment options are exhausted. This late referral limits the benefits that palliative care can provide in terms of symptom relief and psychological support. Studies show that early integration of palliative care leads to better outcomes, including improved quality of life and even extended survival in some cases. Changing referral patterns requires a shift in oncologists’ understanding of when and how to introduce palliative care [8].

Healthcare providers may experience emotional difficulty when discussing palliative care with patients. Talking about symptom management and end-of-life care can be emotionally taxing for oncologists, who may feel that they are taking away hope from their patients. This emotional burden can lead to delayed conversations about palliative care or avoidance of the topic altogether, further perpetuating late referrals [9].

In many healthcare systems, national policies do not prioritize palliative care as part of standard oncology treatment. The lack of government support, including insufficient funding and training programs for palliative care professionals, contributes to the underdevelopment of these services. Advocacy for policy change is crucial to ensure that palliative care becomes a fully integrated component of cancer care pathways [10].

Conclusion

The integration of palliative care into oncology faces numerous barriers, ranging from misconceptions and cultural influences to systemic issues such as workforce shortages and inadequate policy support. Addressing these gaps requires a multi-faceted approach, including better education for healthcare providers, enhanced communication strategies, and stronger advocacy for policy changes. Early and effective palliative care can significantly improve the quality of life for cancer patients, and overcoming these barriers is essential to ensuring all patients receive the comprehensive, patient-centered care they deserve.

References

  1. Tirodkar MA, Roth L, Fuld Nasso S, et al. Facilitators and barriers to implementing a patient-centered oncology care model. JCO Oncol Pract. 2020;16(12):e1441-50.

    2. Indexed at, Google Scholar, Cross Ref

  2. Malhotra S, Christopher M, Chowdry RP, et al. Barriers, blocks, and barricades: Disparities to access of palliative care in cancer care. Curr Probl Cancer. 2023:101024.

    3. Indexed at, Google Scholar, Cross Ref

  3. Temel JS, Petrillo LA, Greer JA. Patient-centered palliative care for patients with advanced lung cancer. J Clin Oncol. 2022;40(6):626-34.

    4. Indexed at, Google Scholar, Cross Ref

  4. Sacca L, Lobaina D, Burgoa S, et al. Using patient-centered dissemination and implementation frameworks and strategies in palliative care settings for improved quality of life and health outcomes: A scoping review. Am J Hosp Palliat Med. 2024;41(10):1195-237.

    5. Indexed at, Google Scholar, Cross Ref

  5. Glare P. A person-centered approach to oncology and palliative care. International Journal of Person Centered Medicine. 2018;8(1).

    6. Indexed at, Google Scholar, Cross Ref

  6. Wittenberg-Lyles E, Goldsmith J, Ferrell B. Oncology nurse communication barriers to patient-centered care. Clin J Oncol Nurs. 2013;17(2).

    7. Indexed at, Google Scholar, Cross Ref

  7. Hobden B, Turon H, Waller A, et al. Gaps in patient-centered follow-up cancer care: A cross sectional study. J Psychosoc Oncol. 2021;39(2):161-72.

    8. Indexed at, Google Scholar, Cross Ref

  8. Aldridge MD, Hasselaar J, Garralda E, et al. Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliat Med. 2016;30(3):224-39.

    9. Indexed at, Google Scholar, Cross Ref

  9. Chen L, Sleeman KE, Bradshaw A, et al. The use of person-centered outcome measures to support integrated palliative care for older people: A systematic review. J Am Med Dir Assoc. 2024;25(8):105036.

    10. Indexed at, Google Scholar, Cross Ref

  10. Mayeda DP, Ward KT. Methods for overcoming barriers in palliative care for ethnic/racial minorities: A systematic review. Palliative & supportive care. 2019;17(6):697-706.

    11. Indexed at, Google Scholar, Cross Ref

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