Making difficult discussions easier: using prognosis to facilitate transitions to hospice.

Full Abstract

Patients with advanced cancer face difficult decisions regarding their treatment, and many will need to make difficult choices about end-of-life care because although cancer-directed therapies are increasingly available, few provide a cure. High-quality cancer care includes access to palliative care throughout the cancer care continuum, and increasing evidence suggests that timely enrollment in hospice can increase quality of life for patients dying from cancer. Therefore, clinicians must learn to recognize patients who are hospice-eligible and to develop prognostication and communication skills that enable honest provider-patient dialogue about end-of-life options. In this article, the authors review available tools for prognostication in advanced cancer and present a method for discussing prognosis by using the SPIKES acronym. In addition, by using patient-identified goals and service needs, the authors recommend a method for making a hospice referral after disclosure of poor prognosis.

Author information

Author/s: Finlay, Esmé (E); Casarett, David (D);

Affiliation: Medical Oncology and Palliative Care, Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. esme.finlay(-atsign-)uphs.upenn.edu

Journal and publication information

Publication Type: Journal Article

Journal: CA: a cancer journal for clinicians (CA Cancer J Clin), published in United States. (Language: eng)

Reference: -2009 Jul-Aug; vol 59 (issue 4) : pp 250-63

Dates: Created 2009/07/10; Completed 2009/08/04;

PMID: 19535791, status: MEDLINE (last retrieval date: 8/21/2009, IMS Date: )

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