Oncology practices have increasingly collaborated with palliative care providers — or built their own service lines — to better support cancer patients throughout their health care journeys.
Cancer patients can benefit from the interdisciplinary support of a palliative care team, but a main barrier to access is that oncology clinicians often lack insight around these services, according to Dr. Julie Gralow, chief medical officer and executive vice president of the American Society of Clinical Oncology (ASCO).
Integrating palliative care deeper into oncology practices “empowers” these providers to improve utilization and quality, she indicated.
“Not all cancer clinicians can be palliative care specialists, but palliative and supportive care is an important aspect of every patient’s treatment plan,” Gralow said in a recent announcement.
Having practical communication tools and educational resources available is a large part of integrating palliative and supportive care into oncology practices, according to Dr. Ramy Sedhom, co-leader of ASCO’s Palliative Care Communities of Practice program. He is also a medical oncologist and clinical director of palliative care at Penn Medicine Princeton Health.
“We all should be prepared to provide palliative and supportive care to all of our patients when appropriate,” Sedhom stated in the announcement.
Among the reasons is the impact that palliative care can have on patient outcomes. Early palliative care interventions led to higher quality of life and less depression among 350 lung and gastrointestinal cancer patients in an ASCO study published in the Journal of Clinical Oncology.
Cancer patients can have a wide range of different diagnoses that come with varying prognoses.
An estimated 1.9 million people in the United States were diagnosed with cancer in 2021, while roughly 608,570 individuals died from the disease that year, according to a report from the American Cancer Society.
Many of these cancer patients underutilize palliative care because their oncology teams do not understand the nature and capabilities of those services.
A lack of discussion with an oncologist was a common reason cited for not utilizing palliative care services by about 59% of advanced stage lung cancer patients in a recent survey from the National Cancer Institute. Furthermore, nearly half (49.4%) indicated they had never met with a palliative care physician or nurse (58.4%) as part of their overall cancer care experience.
More than half (58%) of these cancer patients indicated that an oncologist recommendation would have led them to seek palliative care.
Some oncology practices have deepened their ties to palliative care support in recent years.
Johns Hopkins Bayview Medical Center, for instance, has a team of palliative care providers “embedded” into its oncology clinic and ALS Center, according to David Wu, the program’s director. John Hopkins uses a training model across various fellowship programs, including oncology and geriatrics, that fosters improved conversations and patient care strategies using a palliative care approach.
Having staff trained in this approach can help seriously ill patients have greater “peace and presence” during critical times of suffering in their health, Wu previously told Palliative Care News.
Value-based oncology provider Thyme Care launched services in 2020 by a group of health professionals with experience in the field who increasingly recognized that cancer patients are in need of greater supportive services as their health trajectories lengthen and treatments advance, Dr. Samyukta Mullangi, the company’s medical director, previously told Palliative Care News.
The Nashville-headquartered organization recently secured a $60 million funding round to expand its health services for cancer patients, including palliative care and programs to address social determinants. The funds will also allow Thyme Care to deepen its partnerships with health care providers across the continuum, according to Mullangi.
Also in 2020 came the launch of partnership between Livio Health and cancer care provider Minnesota Oncology. The collaboration was developed to offer home-based palliative care to Medicare Advantage beneficiaries covered by Blue Cross and Blue Shield of Minnesota, parent company of Livio Health.
Through the partnership, Livio Health provides care to Minnesota Oncology patients in their homes through interdisciplinary teams including nurse practitioners, social workers and nursing care coordinators with a focus on symptom management and improving quality of life.
Minneapolis-based Livio Health was later acquired in 2022 by Lifespark, a senior health care company in the state.