Pre-operative palliative care consultations for patients undergoing major cancer surgery are unwarranted, new evidence suggests.
A recent randomized controlled trial did not support routine integration of specialty palliative care in those cases.
Researchers found that the physical and functional quality of life at 90 days was essentially the same for patients who received those consults and those who did not. The study appeared in the journal JAMA Surgery.
Despite these results, palliative care has a role in surgical treatments, and surgeons should strive to learn more palliative care concepts and skill sets, according to an editorial that accompanied the study.
“Palliative care services for patients with inoperable cancer and end-stage chronic medical conditions have been shown to improve quality of life, reduce consumption of medical services, and overall increase long-term survival,” the authors wrote in the editorial. “In surgical populations, palliative care has grown in use, demonstrating improvement in outcomes with advocates suggesting that surgeons themselves should be proficient in primary palliative care skills for their patients.”
Researchers enrolled 235 adult patients scheduled to undergo cancer surgery at an academic medical center in Tennessee. These patients were randomly allocated to an intervention group and a control group. The intervention group received a preoperative consultation with palliative care specialists and postoperative inpatient and outpatient palliative care follow-up for 90 days.
The researchers cautioned that health care providers should not “throw the baby out with the bathwater” when it comes to palliative care for similar patients.
“Some of these patients may have more needs and would benefit from specialist palliative care, and the lack of adverse effects demonstrated in this study should reassure referring clinicians that specialist palliative care is unlikely to distress or harm patients,” the authors wrote.
