Reseña del editor:
In early stages of cancer, patients are often presented with treatment options and encouraged to have shared treatment decisions with their oncologists. Shared decision making becomes particularly important, as several treatment options with different possible outcomes and adverse events exist. For example, women with early breast cancer are counseled on the options of mastectomy versus lumpectomy and radiation. The same principle should also apply in late stages of cancer, where cure is usually not possible in patients with widespread metastases. In these cases, the aim of treatment should be to relieve symptoms and suffering. Improving quality of life (QOL) rather than tumor control takes priority in palliative care. QOL has also been identified as an important endpoint for new cancer drugs, as determined by the Food and Drug Administration (FDA); as such, cancer drug approval can be based on improvement of QOL. The use of patient-reported QOL instrument tools help clinicians determine if certain treatments improve QOL. The research of palliative interventions should have QOL assessment to assist clinicians, patients and their family members in shared decision making.
Biografía del autor:
Breanne Lechner, MD(C) is a clinical research assistant in the Rapid Response Radiotherapy Program at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada and also a medical student at the University of Toronto. She was the recipient of the J Frank Brookfield Scholarship from the University of Waterloo in 2012 for excellence in biology. Joav Merrick, MD, MMedSci, DMSc, born and educated in Denmark is professor of pediatrics, child health and human development, Division of Pediatrics, Hadassah Hebrew University Medical Center, Mt Scopus Campus, Jerusalem, Israel and Kentucky Children's Hospital, University of Kentucky, Lexington, Kentucky United States and professor of public health at the Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, United States, the medical director of the Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services, Jerusalem, the founder and director of the National Institute of Child Health and Human Development in Israel.
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