Abstract
Temel et al. 1 found that early palliative care along with standard oncologic treatment resulted in better quality of life, mood, and survival. Previous studies based on simple, inexpensive interventions were ineffective.2,3 This study strongly suggests that more sophisticated specialist-based interventions improved several outcomes. However, there are some methodological concerns such as the lack of information regarding the palliative care intervention limits, its generalizabilty, especially due to the variability of available palliative care structures and processes in cancer centers.4,5
While early referral appeared to be effective over 12 weeks, the important outcome of improved control and QOL until death cannot be learned from this study due to lack of follow up. The impact of the increase by 30 patients in the sample size on outcomes such as survival needs validation. This excellent study raises more questions than answers: How early should patients be referred? What is the best “dose” (frequency, interdisciplinary team members) of palliative intervention? How does early palliative care impact on cost of care, resource utilization and caregiver bereavement?