Integrating Palliative Care into Comprehensive Cancer Care
Two attendance options:
DMU faculty, staff, students, residents, and the medical community.
Over the past five decades, palliative care has evolved from serving patients at the end of life into a highly specialized discipline focused on delivering supportive care to patients with life-limiting illnesses throughout the disease trajectory. A growing body of evidence is now available to inform the key domains in the practice of palliative care, including symptom management, psychosocial care, communication, decision-making, and end-of-life care. Findings from multiple studies indicate that integrating palliative care early in the disease trajectory can result in improvements in quality of life, symptom control, patient and caregiver satisfaction, quality of end-of-life care, survival, and costs of care.
While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care.
- Distinguish hospice from palliative care.
- Identify system processes and structure which support the delivery of palliative care to patients and families.
- List communication techniques to facilitate delivering the prognosis involving palliative and hospice care.
Charles F. von Gunten, MD, PhD
Dr. von Gunten is the Vice President, Medical Affairs, Hospice and Palliative Medicine for OhioHealth, working to create a palliative medicine program that will set the standard for the integration of palliative care across the entire health system, while also establishing a comprehensive medical education program in palliative care for new physicians and staff to ensure and sustain OhioHealth’s program for the long term.
A leader in palliative medicine, Dr. von Gunten is known for developing an early model of hospital-based palliative care that has been the basis for those developed in the 60% of the nation’s hospitals that now report palliative care programs. In addition, he played a lead role in developing and achieving formal recognition of the subspecialty of palliative medicine. He is the Editor-in-Chief of the Journal of Palliative Medicine, the journal of record for the new medical subspecialty of palliative medicine.
Dr. von Gunten is the Chairman, Test Committee, Hospice & Palliative Medicine, American Board of Medical Specialties. He is a past President of the American Association for Cancer Education. He is Co-Principal for the Education for Physicians on End-of-life Care (EPEC) Project and its revision for oncology, EPEC-O. He received a life-time achievement award from the American Academy for Hospice and Palliative Medicine in 2011 when he was only 54 years old. In the same year, he was also named a ‘top doctor’ in U.S.News and World Report. Dr. von Gunten has been particularly interested in the integration of hospice and palliative care into academic medicine. He has published and spoken widely on the subjects of hospice, palliative medicine, and pain and symptom control.
Dr. von Gunten received his Bachelor of Arts Degree with honors from Brown University in 1978. He then earned a PhD in Biochemistry and his medical degree with honors from the University of Colorado Health Sciences Center in 1988. He subsequently pursued residency training in Internal Medicine, followed by subspecialty training in Hematology/Oncology at the McGaw Medical Center of Northwestern University in Chicago.
Dr. von Gunten indicated he has no financial relationships to disclose relevant to the content of this continuing educational activity.
- MD: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Iowa Medical Society (IMS). Des Moines University (DMU) is accredited by the IMS to provide continuing medical education for physicians. DMU designates this live activity for 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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- Other: This live activity is designated for 1.0 AMA PRA Category 1 Credit(s)™.
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Everyone in a position to control the content of this educational activity will disclose to the CME provider and to attendees all relevant financial relationships with any commercial interest. The speaker(s) will disclose if any pharmaceuticals or medical procedures and devices discussed are investigational or unapproved for use by the U.S. Food and Drug Administration (FDA). Determination of educational content and the selection of speakers is the responsibility of the activity director. Firms providing financial support did not have input in these areas.
The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The content of each presentation does not necessarily reflect the views of Des Moines University.
- 1.00 AMA PRA Category 1 Credits™
- 1.00 AOA Category 2A
- 1.00 CE Contact Hour(s)
- 1.20 IBON