Patients with Advanced Cancer: When, Why, and How to Refer to Palliative Care Services

Palliative care (PC) is a fundamental component of the cancer care trajectory. Its primary focus is on “the quality of life of people who have a life-threatening illness, and includes pain and symptom management, skilled psychosocial, emotional and spiritual support” to patients and loved ones. Palliative care includes, but is not limited to, end-of-life care. The benefits of early introduction of PC services in the care trajectory of patients with advanced cancer are well known, as indicated by improved quality of life, satisfaction with care, and a potential for increased survival. In turn, early referral of patients with advanced cancer to PC services is strongly recommended. So when, how, and why should patients with advanced cancer be referred to PC services? In this article, we summarize evidence to address these questions about early PC referral: (1) What are the known benefits? (2) What is the “ideal” PC referral timing? (3) What are the barriers? (4) Which strategies can optimize integration of PC into oncology care? (5) Which communication tools can facilitate skillful introduction of PC to patients?