Improving Care for Patients Living with Prolonged Incurable Cancer

Abstract

The number of patients that can no longer be cured but may expect to live with their cancer diagnosis for a substantial period is increasing. These patients with 'prolonged incurable cancer' are often overlooked in research and clinical practice. Patients encounter problems that are traditionally seen from a palliative or survivorship perspective but this may be insufficient to cover the wide range of physical and psychosocial problems that patients with prolonged incurable cancer may encounter. Elements from both fields should, therefore, be delivered concordantly to further optimize care pathways for these patients. Furthermore, to ensure future high-quality care for this important patient population, enhanced clinical awareness, as well as further research, are urgently needed.

Keywords: care coordination; palliative care; primary care; survivorship.

Figure 1

Proposed care model for patients with prolonged incurable cancer. Model adapted from original model by Lynn & Adamson [40]. Within this model, cancer-targeted care focuses on treatment of the tumor and/or metastases. Survivorship care is characterized by surveillance (for disease flare-ups), management of long-term physical and/or psychosocial symptoms, late treatment effects and general healthcare. Symptom-centered palliative care addresses acute or other physical and/or psychological symptoms as well as problems that may arise from the social or existential domain.