A female patient in her forties was diagnosed with a recurrence of leukemia. She was struggling through several issues as a single mother of 4 children, 2 of whom were disabled, before she found out about her cancer returning.
Palliative care has a serious identity problem. Seventy percent of Americans describe themselves as “not at all knowledgeable” about palliative care, and most healthcare professionals believe it is synonymous with end-of-life care.1 This perception is not far from current medical practice, because specialty palliative care—administered by clinicians with expertise in palliative medicine—is predominantly offered through hospice care or inpatient consultation only after life-prolonging treatment has failed. This means that the majority of patients who could benefit from palliative care are not receiving it until they are very close to death. To ensure that patients with metastatic breast cancer receive the best cancer care throughout their disease trajectory, palliative care should be initiated alongside standard oncology care, and it should be implemented early.
One of the most important studies presented at ASCO 2018 showed that endocrine therapy alone was noninferior to endocrine therapy plus chemotherapy in women with estrogen receptor–positive, HER2-negative, node-negative early-stage breast cancer and an intermediate risk score (score, 11-25) on the Oncotype DX gene expression assay for breast cancer.