Palliative Care Reduces Pain Trajectory in AYAs With Cancer

Researchers used healthcare database information to look for associations between palliative care use and symptom scores for 5,435 AYA patients aged 15–29 years with a primary cancer diagnosis in Ontario, Canada. They also analyzed palliative care use for patients who died within five years of diagnosis.

They found the five-year cumulative use rates were 26% for general palliative care and 19% for specialty palliative care. Among patients who died (13%), 90% received general palliative care and 85% received specialty palliative care. Notably, the researchers found that AYAs who reported moderate or severe symptoms were more likely to subsequently receive palliative care than those with mild symptoms. Among patients who died, palliative care was associated with improved pain scores but not improvement in other symptoms.

Although higher symptom burden was associated with more referrals to palliative care services, the authors said that overall referrals were limited and occurred late in the disease trajectory. The researchers called for routine early referrals for AYA patients because they “have high [end-of-life] symptom burden, experience high-intensity care, and frequently die in the hospital.” They suggested strategies such as frequent screenings and automatic triggers for referrals based on symptom scores or disease stage as opportunities to increase palliative care uptake.

Palliative care can be provided concurrently with curative treatment, and all patients with cancer can benefit (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/palliative-care-people) from palliative care beginning at the time of diagnosis to reduce symptom burden and improve quality of life throughout their cancer journey. Both patients and providers need more awareness of this important message. Raise your voice to support the Palliative Care and Hospice Education and Training Act ([PCHETA], S. 2243), which was reintroduced in the U.S. Senate but still needs bipartisan support. Share your palliative care stories via social media, email, or telephone and ask your U.S. senators (http://send.ons.org/link.cfm?r=Mcl31SunDl8M31mSImaRgw~~&pe=PDn3yHG4q0noTLlv6RXB6L3ht3HiaVajO2LofndekwH1XNOQX75hVmsMv1YpYnUBIQl8wR6pb9fdOw5k7xfLFQ~~&t=q67BaIni5swpm_RNCKOY-A~~) to cosponsor this critical piece of legislation.