Oncology Ny
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Twenty years of research in controlling symptoms such as pain and nausea have shown persistent suboptimal performance by the US oncology system. The data suggest that some of the tools of palliative care programs can improve physical symptoms of seriously ill patients at a cost society can afford. To fix these problems will require recognition of the symptoms or concerns, a system such as an algorithm or care plan for addressing each, measurement of the change, and accountability for the change. ⋯ Less concrete problems such as medically appropriate goal-setting, integrating palliative care into anticancer care sooner, and informing patients about the benefits and risks of chemotherapy near the end of life require more complex solutions. We review what is known about symptom control in oncology, how and why some programs do better, and make suggestions for practice. Finally, we suggest a practical plan for using symptom assessment scales, listing the problems, and managing them according to algorithms or other predetermined plans.