Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Palliative care in mesothelioma (#40)

Fraser Brims 1
  1. Curtin University, Perth, WA, Australia

Specialist palliative care (SPC) is the active, total care of patients with advanced, progressive malignant and non-malignant life-limiting illnesses, and those who care for them. SPC involves the management of physical symptoms and is also concerned with the provision of psychological, social and spiritual support.


A recent Cochrane review examining early palliative care in the context of advanced cancer included seven randomised studies (five examining mixed cancer types, one pancreatic cancer and one non-small cell lung cancer). The review concluded that there is evidence of a small increase in health-related quality of life (HRQoL) with early integrated SPC provision, but the level of certainty of current evidence is low to very low. An additional single centre randomised study of mixed advanced tumour types also reported a small to moderate improvement in HRQoL.  


More recently, the RESPECT-Meso study examined the role of specialist early palliative care for patients with mesothelioma, soon after diagnosis. This study did not demonstrate any significant differences in HRQoL or mood in patients, or their carers, when compared with standard care alone in the UK and Australia.


With limited therapeutic options, the challenges for managing mesothelioma are complex and frequently require a multidisciplinary approach to support patients and their families effectively. There is increasing interest and evidence supporting the roles of specialist cancer nurses in the care for patients with advanced cancer. Before a more clearly defined role for SPC can be defined, research should now focus on what aspects of care are currently being provided as part of standard cancer care in Australia, and better establishing which mesothelioma patients are at risk of decline with potential need for early SPC.