Dados do Trabalho

Título

How palliative care can improve patient care and quality of life in urologic oncology? : A systematic review

Resumo

Introduction: Most genitourinary cancers with an early-stage onset have favorable prognosis, but patients with metastatic disease or locally advanced face lifelong symptoms and limited survival. Patients with genitourinary cancer face a high burden of unmet needs and it affects physical, functional, psychological, and socioeconomic well-being. In many cases, cancer recurs even when using the best available treatments, patients suffer disease-related symptoms or loss of function, and death ultimately follows. Objectives:This study aims to describe how the incorporation of palliative care (PC) can help in the improvement of a patient's quality of life in genitourinary cancers. Methods: An systematic literature review was developed in 3 steps: Developing the research question, searching for scientific articles in the Pubmed database, and critically analyzing the included articles. The investigation was conducted in December 2023, and articles between 2013 and 2023 were selected, for a total of 59 articles, of which 21 were used. Results: Studies have shown that less than 30% of patients with metastatic genitourinary cancers have access to PC. A review of the National Cancer Database for patients with metastatic penile cancer revealed that only 11% of patients with locally advanced or metastatic disease received palliative care, as defined by pain management therapy, surgery, and radiation or systemic therapy aimed at palliation, it is perceived that PC is seldom discussed and underused in patients with genitourinary malignancies. Multiple trials published demonstrate the positive effects of early incorporation of PC into standard oncological care, particularly for patients with advanced disease. The Benefits of early concurrent PC include physical and spiritual well-being, improved quality of life, improved patient and caregiver satisfaction, and increased hospice use at the end of life. PC also enables the goals of comfort and coexistence until the cure is achieved, suffering is relieved or the disease progresses beyond control. Conclusions: The referral to a multidisciplinary palliative care team or use of palliative care principles when appropriate can help the urologist to care for patients at any cancer stage with unmet symptom, coping, and communication needs. As subspecialty palliative care is a scarce clinical resource, it is incumbent upon urologists to enhance their primary palliative care skills to provide the best care to our patients.

Palavras Chave

Palliative care; urologic cancer; improve