Module 11

1
The
EPEC-O
TM
Education in Palliative and End-of-life Care -
Oncology
Project
The EPEC-O Curriculum is produced by the EPECTM
Project with major funding provided by NCI, with
supplemental funding provided by the Lance
Armstrong Foundation.
2
EPEC - Oncology Education in Palliative and
End-of-life Care - Oncology

• Plenary 3
• Charting the Future

3
Overall message

• Palliative care can be integrated into
  comprehensive cancer care

4
Objectives

• List the important themes from the curriculum
• Identify challenges to integration
• Reflect on need for personal support

5
Video
6
EPEC-O themes

• Relief of suffering is part of comprehensive
  cancer care
• Palliative care knowledge is now extensive
• Role of families
• Teamwork
• Oncologist as patient advocate

7
Relief of suffering

• 4 dimensions
• Physical
• Psychological
• Social
• Spiritual
• Expected by patients, families

8
Palliative care

• Not the absence of care
• More powerful than ever in the history of
  medicine
• A positive, humanistic philosophy
• Technically sophisticated area of expertise

9
Families . . .

• Cancer involves the whole family
• Comprehensive care involves
• The chance to be close to family, friends
• Family / proxy assistance with decisions
• Good communication

10
. . . Families

• None of this is possible without good symptom
  management

11
Teamwork . . .

• The whole person has cancer, not just his / her
  physiology
• No one person can meet all the needs

12
. . . Teamwork

• Teamwork usually includes
• Oncologists
• Nurses
• Social workers
• Chaplains
• Others
• Palliative care can be integrated into mainstream
  practice

13
Advocacy

• Professional duty to patient care
• Professional duty to ensure availability of
  services
• Personal desire to be able to receive care that
  relieves suffering and improves quality of life

14
Challenges to integration

• Institutional
• Regulations
• Reimbursement
• Attitudes

15
Oncologists personal support needs . . .

• Patients are asking us to do better
• Find a forum for candid discussion of experiences
• Transference is powerful personal comfort is
  important

16
. . . Oncologists personal support needs

• Professional distance, empathic closeness must
  balance
• Know yourself

17

• Summary
• Palliative care can be integrated into
  comprehensive cancer care