Michael Silbermann*


The field of palliative medicine has observed great progress in both
Oncology and Palliative Care  in the last twenty years.

In Onc, we have witnessed the establishment of multi-disciplinary
teams and meetings, centralization of care, especially in relation
to surgical oncology, the progress in Radiotherapy techniques from 2D to 3D conformal
and then intensity-modulated RT, image-guided RT, and stereotactic RT, to the revolution
of molecular biology, with the understanding of oncogenic addiction and the emergence
of targeted-therapy and now immunotherapy with checkpoint inhibitors.

In PC, essentially a new specialty was set up in many countries worldwide with
major steps made in capacity building leading up to integration
in a few countries (Lynch/Centeno).

Furthermore, there has been recognition of the important role
of PC in the palliation of patients with advanced illness,
whilst more recent evidence for the earlier integration of PC in
the disease trajectory has been produced (Smith, Temel).

However, despite the fact that the two disciplines often look
after the same patients, i.e. patients with advanced incurable cancer,
in most countries worldwide they have so far chosen to work independently
with little collaboration between them.

At best the collaboration between the two specialties is where one (Onc)
refers to the other (PC), and often this is late in the disease trajectory
sometimes as late as within the last three days prior to death (Earle).

For more information please visit: Palliative Medicine and Hospice Care

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