More Palliative Care Training Needed

(Ivanhoe Newswire) -- By better educating surgeons about palliative care, researchers from the University of California, Davis, say more standards may be reached for treating patients with advanced cancer and other common conditions. Because each surgical intervention has its own risks and benefits, choosing the best treatment and finding a balance can be challenging for even experienced surgeons. The difficulty in this decision making is often exacerbated in patients for whom there is little hope for a cure and in cases where surgery is focused on symptoms instead of the disease.

Palliative care is intended to relieve symptoms and improve quality of life rather then searching for a cure or extended survival. Many studies indicate surgeons receive little training in this area, leading to challenges in determining the best course of treatment for some patients.

For the study, 124 surgeons were surveyed about the type and extent of their postgraduate training in palliative surgery. Additionally, study participants were asked to select the single best treatment option from four clinical scenarios, to identify the goals of the selected intervention and the three most important factors influencing their decisions.

Joseph Galante, M.D., and colleagues uncovered significant deficiencies in education. More than 80 percent reported not receiving any palliative care training in their residency, and more than 44 percent lacked continuing medical education. Also, in three of the four given scenarios, a consensus on treatment was not reached. The respondents, though, were able to agree on the goal of treatment for their recommendations.

Dr. Galante writes, the reason for the deficiencies in palliative education may be that physicians receive their training and experience from different sources and in different stages of their careers.

Researchers say the study results suggest, "A more focused effort in training surgeons in palliative care may allow for the more uniform and standard provision of palliative surgical care to patients with advanced cancer." Based on these findings, Dr. Galante and colleagues advocate improved training and a nationwide program to standardize palliative surgical care.

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SOURCE: Archives of Surgery, 2005;140:873-880