Washington, DC (UroToday.com) Gary Winzelberg, Associate Director of the University of North Carolina Palliative Care Program, discussed how urology can improve implementation and dissemination of palliative care. There are tremendous advances in cancer care that also bring challenges including prognostications with expanding treatment options, cancer pain management in the opioid epidemic, goal discordant concerns, financial toxicity and inequities associated with race/ethnicity. With this in mind Dr. Winzelberg discussed in detail how palliative care can be incorporated in the outpatient setting, inpatient setting and specifically in advanced bladder cancer.
In outpatient palliative care, the focus is on living well but also acknowledging death and dying so this does not weigh on patients on a daily basis. It’s important to emphasize with the cancer patients for both patients, significant others and health providers. There is a lack of understanding regarding cancer treatments and cure with up to 70% of patients not understanding that chemotherapy was not going to cure their disease. Improved patient counseling and multidisciplinary care are important to include for all components of the patient care journey with their disease. All of this can be applied in the inpatient setting and especially those with advanced bladder cancer. There is a lack of research and use of palliative care in advanced bladder cancer with marked underuse (3-4%) in bladder cancer care. This further stresses the importance of incorporating palliative care in the multidisciplinary bladder cancer team.
Presented by: Gary Winzelberg, MD, MPH, Associate Professor, Division of Geriatric Medicine, Associate Director, UNC Palliative Care Program, Director, Hospice and Palliative Medicine Fellowship Program, The University of North Carolina
Written by: Stephen B. Williams, MD, Medical Director for High Value Care; Chief of Urology, Associate Professor, Director of Urologic Oncology, Director Urologic Research, The University of Texas Medical Branch at Galveston, TX and Ashish M. Kamat, MD, Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 2019 Bladder Cancer Advocacy Network (BCAN) Think Tank August 8-10, 2019 – the Capital Hilton, Washington, DC, USA