Palliative care of patients with haematological malignancies: strategies to overcome difficulties via integrated care

Palliative care, hospice care, and end of life care have been the focus of increased attention over the past two decades; palliative care has shifted from being introduced only at the end of life to becoming an integrated part of routine care for patients. Currently, the timing and extent of the integration of palliative care into standard medical care practice depends on the underlying disease. Patients with haematological malignancies receive less palliative care initiated at a later disease stage compared with patients with other types of cancer. All patients in need of palliative care, hospice care, and end of life care should be given the chance to benefit from these types of care. Patients, their relatives, health-care professionals, and the health-care system can all benefit from the closer integration of palliative, hospice, and end of life care, even in combination with disease orientated treatment. Important factors to consider when introducing palliative care for patients with haematological malignancies are the different treatment strategies for each disease, the heterogeneous dynamics of the different haematological malignancies, the broad variance of therapeutic effects, and patients' dependence on the health-care system for the administration of transfusions and antimicrobial treatment, which is different from patients with solid tumours. Key areas that physicians should pay particular attention to are strategies for communication with patients to aid their understanding of their illness and prognosis and concepts to address special needs of patients with haematological malignancies (eg, transfusion requirements and symptom control). Because haematological malignancies mainly affect patients in advanced age, this Series paper integrates a special focus on age-associated topics.

Automated summary

Palliative care has shifted from being introduced only at the end of life to becoming an integrated part of routine care, with potential benefits for patients and their families. However, the timing and extent of integration should consider the specific disease characteristics and treatment strategies for individual patients.