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  • Updated 04.27.2023
  • Released 08.19.2022
  • Expires For CME 04.27.2026

Palliative and end-of-life care for neuro-oncology patients

Introduction

Overview

Palliative care is defined by the World Health Organization as an approach that improves the quality of life of patients and their caregivers as they face challenges, whether physical, psychological, social, or spiritual, associated with life-threatening illness (28). People living with central nervous system cancer have evolving palliative needs throughout their illness trajectory as they often have a high burden of complex symptoms, worsening functional impairment, and psychosocial distress that significantly impact their quality of life and that of their caregivers. These palliative care needs can be assessed and managed by the primary team, or the assistance of specialty palliative care may be appropriate. Hospice is a highly specialized type of palliative care that specifically provides end of life care. The provisions of primary and specialty palliative care and hospice care, including their respective care concepts and practices, are discussed in this article.

Key points

• Palliative care is a person-centered approach that focuses on expert assessment and management of symptoms and caregiver needs to improve quality of life and relieve suffering arising from the physical, functional, psychological, practical, and spiritual consequences of serious illness.

• Palliative care is appropriate at any stage of serious illness and can be delivered concurrent with treatments of either curative or life-prolonging intent.

• Core principles and practices of palliative care can be delivered by any clinician across all specialties and levels of training for the seriously ill in any setting.

• Primary palliative care is palliative care delivered by clinicians who are not palliative medicine specialists.

• Specialty palliative care is palliative care delivered by board-certified or subspecialty-trained clinicians, or those with significant clinical experience and expertise.

• Hospice provides high-quality, compassionate end of life care to those whose life expectancy is measured in months, irrespective of illness, age, religion, race, or ethnicity.

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