Palliative Care: An Approach for All Internists

Abstract

In 2010 Jennifer Temel and colleagues published what many feel is the most influential article in palliative care since the 1995 publication of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT).1,2 Temel and colleagues randomized 151 patients at the Massachusetts General Hospital with metastatic non-small cell lung cancer to receive early outpatient palliative care or standard care. Patients randomized to palliative care had significant improvement in quality of life and lower rates of depressive symptoms compared to standard care. These findings confirmed benefits that many clinicians suspected from anecdotal experience. What shocked many was the finding that despite receiving less aggressive end-of-life care, patients randomized to palliative care had a longer median survival than patients in the standard care group.