Role of Palliative Medicine in Cancer Patient Care

  • Charles F. von Gunten
  • Jeanne Martinez
Part of the Cancer Treatment and Research book series (CTAR, volume 140)


There continues to be an unexplained paradox in American cancer care. On the one hand, of all Americans who have cancer, only 50% will be cured.1,2 Most of these cures are due to surgical intervention. This proportion has remained relatively unchanged over the past 30 years. During the course of their illness for those patients whose cancer is not cured, most patients will experience considerable suffering. That suffering has physical, psychological (emotional), social (practical) and spiritual components. Multiple studies have demonstrated that these elements of patients’ and families’ suffering are not met by the current medical system.3,4,5


Palliative Care Ethical Decision Inpatient Unit Hospice Care Palliative Medicine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bailar JC III, Gornick HC. Cancer undefeated. N Engl J Med 1997;336:1569–74.PubMedCrossRefGoogle Scholar
  2. 2.
    Bailar JC III, Smtih EM. Progress against cancer? N Engl J Med 1986;314:1226–32.PubMedCrossRefGoogle Scholar
  3. 3.
    The SUPPORT Principal Investigators. A controlled trial to improve care for seriously ill hospitalized patients. JAMA 1995;274:1591–1598.CrossRefGoogle Scholar
  4. 4.
    Vachon ML, Kristjanson L, Higginson I. Psychosocial issues in palliative care. J Pain Symptom Manage 1995;10:142–50.PubMedCrossRefGoogle Scholar
  5. 5.
    Vachon ML. Caring for the caregiver in oncology and palliative care. Semin Oncol Nurs 1998;14:152–70.PubMedCrossRefGoogle Scholar
  6. 6.
    Doyle, D, Hanks GWC, MacDonald N. Introduction. In: Oxford Textbook of Palliative Medicine, 2nd edition. Eds: Derek Doyle, Geoffrey W.C. Hanks, Neil MacDonald. Oxford University Press, New York 1998.Google Scholar
  7. 7.
    Cassel EJ. The nature of suffering and the goals of medicine. Oxford University Press, New York, 1991.Google Scholar
  8. 8.
    Saunders C. Introduction-History and Challenge. In: The Management of Terminal Malignant disease. Eds: Cicely Saunders and Nigel Sykes. Edward Arnold Boston 19Google Scholar
  9. 9.
    Doyle D. Palliative medicine: a UK specialty. J Palliat Care 1994;10:8–9.PubMedGoogle Scholar
  10. 10.
    National Hospice Organization. 1901 N. Moore Street, Suite 901 Arlington, VA 22209.Google Scholar
  11. 11.
    Approaching death: improving care at the end of life. Committee on care at the end of life, Division of Health Care Services, Institute of Medicine, national Academy of Sciences, 1997.Google Scholar
  12. 12.
    National Institute of Nursing Research. National Institutes of Health 6701 Rockledge Drive Room 1040 MSC 7710 Bethesda, MD 20892-7710.Google Scholar
  13. 13.
    American Board of Internal Medicine. Caring for the Dying: identification and promotion of physician competency. Philadelphia 1996.Google Scholar
  14. 14.
    Cassel C. Palliative care is the real focus of end-of-life medicine. ACP Observer. 1996;July/August:2.Google Scholar
  15. 15.
    Task Force on Cancer Care at the End of Life. Cancer care during the last phase of life. Journal of Clinical Oncology 1998;1986-1996.Google Scholar
  16. 16.
    Good care of the dying patient. Council on Scientific Affairs. JAMA 1996;275:474–8.CrossRefGoogle Scholar
  17. 17.
    Donald N. The interface between oncology and palliative medicine. In: Oxford Textbook of Palliative Medicine, 2nd edition. Eds: Derek Doyle, Geoffrey W.C. Hanks, Neil MacDonald. Oxford University Press, New York 1998.Google Scholar
  18. 18.
    Goldstein P, Walsh D, Horvitz LU. The Cleveland Clinic Foundation Harry R. Horvitz Palliative Care Center. Support Care Cancer 1996;4:329–33.CrossRefGoogle Scholar
  19. 19.
    von Gunten CF, Camden B, Neely KJ, Franz G, Martinez J. Prospective evaluation of referrals to a hospice/palliative medicine consultation service. Journal of Palliative Medicine 1998;1(1):45–53.CrossRefGoogle Scholar
  20. 20.
    Kellar N, Martinez J, Finis N, Bolger A, von Gunten CF. Characterization of an acute inpatient Hospice Palliative Care Unit in a US teaching hospital. Journal of Nursing Administration 1996;26:16–20.PubMedCrossRefGoogle Scholar
  21. 21.
    Ng K and von Gunten C. Symptoms and attitudes of 100 consecutive patients admitted to an acute hospice/palliative care unit. Journal of Pain and Symptom Management (in press).Google Scholar
  22. 22.
    von Gunten CF, Martinez J. A program of hospice and palliative care in a private, non-profit US teaching hospital. Journal of Palliative Medicine 1998;l(3)(in press).Google Scholar
  23. 23.
    von Gunten CF, Von Roenn JH, Neely KJ, Martinez J, Weitzman S. Hospice and palliative care: evaluation of the attitudes and practices of the physician faculty of an academic hospital. American Journal of Hospice & Palliative Care. 1995;12(4):38–42.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Charles F. von Gunten
  • Jeanne Martinez

There are no affiliations available

Personalised recommendations