The transfer palliative care does not sign the death warrant of the cancer patient

The transfer palliative care is not necessarily a sign of impending death of the cancer patient and do not reflect the more disinterest professionals curative medicine to the sick, has insisted Dr. Luc Plassais (Cognac-Jay Foundation) in hope to end some misconceptions about palliative care.
There are many taboos to transfer palliative care unit (USP), the specialist said during a speech at the Day AESCO (European Association of comfort care in oncology) organized at the European Hospital Georges Pompidou (HEGP, Paris XV).

And cite the widespread notion that "the transfer USP means that cancer patients will die," as some are doing, or that "such a transfer means that curative medicine can not or does not want caring for the patient ", while many oncologists to take news of their patients once they left their service.

Returning to the definition of palliative care, Dr. Plassais recalled that it was "acute care to relieve pain and other physical symptoms, and take into account the psychological suffering, social and spiritual" in order "to ensure a certain quality of life to the end of the patient's life. "

Studies have also shown that "a significant percentage of cases, there is an improvement in the general condition for the entry into USP." This improvement comes in the days or 4-5 months after the arrival of the patient, and then stabilizes. The aim of carers is then to "try to stabilize this improved condition", for example by interrupting some explorations, said the doctor.

The other challenge for caregivers is to develop with the patient "a project of individual life, leaving the patient some freedom to decide its end of life, leaving the expert's own well-being."

But beware that the doctor is not divestment of its advisory role, warned Professor François Goldwasser (oncologist at Cochin Hospital, Paris), believing that the patient need not believe that the practitioner his expert opinion.

While the vast majority of patients die in the hospital after an average stay of three weeks in 10% of cases, they are able to leave the USP, "with a new project of life, not possible to admission ".

The outputs are possible, provided that the patient's wishes (the doctor to ensure that this desire is the domain of feasible and not the dream), that his condition permits and there is a commitment of his entourage and social worker, said Dr. Plassais.

A small study in France shows that nearly two-thirds of patients return home with adaptive aids, some return in oncology, are transferred to other institutions or another USP for family reunification, and still others return home to die.

Still, that "regardless of the patient's general condition for its entry into USP, there is unpredictable improvements," insisted the doctor, for whom "the USP must remain a place of life."