Abstract
Dear Editor:
As a retired hematologist, and now a full-time board-certified palliative care physician at the University of Minnesota Medical Center – Fairview, and a palliative care patient, I was delighted to attend and participate in the inaugural Palliative Care in Oncology Symposium in Boston. We have come a long way!
As encouraging and hopeful as it was, and reflective of the efforts of so many for so long, I was disappointed with the frequent responses (giggles and applause) whenever an oncologist declared himself to be “recovered,” as if he or she were a miscreant. Similarly distressing were the occasional responses when it was reported that a patient declined therapy and accepted an earlier death, as if that is our goal.
We all know and recognize inappropriate and aggressive care and unrealistic expectations, but I wonder how our patients would react if they witnessed these sentiments. They do depend on all of us, oncologists and palliative care providers.
Now as a result of this inaugural symposium, there has been formally expressed a mutual respect and recognition between Palliative Care and Oncology. There should follow further efforts to improve the comprehensive care for our cancer patients.
I would suggest that Oncology fellowship programs require a mandatory rotation with a Palliative Care team and that Palliative Care fellowships include a rotation with Oncology. Both disciplines need to know more about each other's strengths and limitations, more than misguided misconceptions.
This brings me to my concept of a “Gleevec moment.” Chronic myeloid leukemia (CML) was an incurable, hematologic malignancy. One day after years of research, Gleevec appeared and overnight a fatal malignancy became a treatable illness. Is it not unreasonable for patients to hope for similar developments for their cancer? Considering the ongoing research and exciting results with targeted therapies, genetic markers, immunotherapy, and other novel therapies, we must be aware and supportive of these exciting discoveries and appreciate the power of these expectations for our patients. Good palliative care is good medicine.
And when undue enthusiasm and disappointment accompany these newer efforts, we in palliative medicine need to continue to support, comfort, and guide our cancer patients vigorously with skill and compassion.
Palliative Care and Oncology should be a team to provide the best care for our patients. Neither discipline has a monopoly on knowledge or compassion.