Survey of NCI-designated cancer centers on the utilization of palliative care in patients with pancreatic cancer.

Abstract

248 Background: Pancreatic cancer, known as one of the deadliest cancers, has a high demand for palliative care. However, there remains a considerable amount of uncertainty regarding the nature of palliative care treatment to this specific patient demographic across the United States. This study aims to assess the utilization of palliative care in pancreatic cancer patients and explore the variations in timing and emphasis of palliative care involvement. Methods: We conducted a survey assessing utilization of palliative care in pancreatic cancer patients. We targeted palliative care directors at all 65 National Cancer Institute (NCI) cancer centers. The physicians were invited to voluntarily participate in the study. Responses were collected by email between May 30, 2023, and June 22, 2023. 1) Does your palliative care and/or oncology team have a policy to get involved with every pancreatic cancer patient (yes or no)? 2) When palliative care is involved with pancreatic cancer patients, in what setting are you typically/primarily first asked to be involved (early in the patient’s treatment journey, focusing more to assist with symptom management, or later in the patient’s treatment journey, focusing more on end-of-life discussions such as explaining hospice)? Results: We received responses from palliative care leaders at 65 NCI-designated palliative care centers, and thus 100% of the targeted population sample. Out of these centers, 64 indicated that there was no established policy for palliative care involvement with every pancreatic cancer patient. Among the respondents, 38 centers started intervention early, primarily focusing on symptom management, while 15 centers started palliative care late in the treatment process, with a focus on end-of-life discussions. Additionally, 12 centers reported that they first intervene both early and late when treating pancreatic cancer. Conclusions: The utilization of palliative care services improves various outcome measures. Pancreatic cancer has one of the lowest survival rates and is associated with significant morbidity. Our findings suggest an increasing recognition among medical centers of the need for palliative care services for pancreatic cancer patients. However, there is variation in the timing and emphasis of palliative care involvement, suggesting a need for further exploration in this area. Notably, there is a growing trend to integrate palliative care at an early stage. Future research should explore barriers to accessing palliative care, distinguish between inpatient and outpatient services, and compare outcomes of early versus late palliative care intervention. By addressing these areas, healthcare providers can enhance the quality of care and improve outcomes for pancreatic cancer patients.