Author Affiliations: Center for Psychosocial Epidemiology and Outcomes Research (Dr Prigerson, Ms Zhang, and Mr Nilsson) and Division of Population Sciences, Department of Medical Oncology (Dr Prigerson), Dana-Farber Cancer Institute, and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School (Dr Prigerson), Boston, Massachusetts.
We agree with Dr Charalambous that the message of our findings is that to improve the quality of life for patients with advanced cancer at the end of life, there needs to be a reduction in the intensity of medical care (eg, the number of intensive care unit stays, use of ventilators) they receive, as well as heightened attention to their psychosocial and spiritual needs. Dr Charalambous has taken these results as evidence to support his recommendation that oncologists be trained in palliative care and psychologists, chaplains, and palliative care clinicians be involved in multidisciplinary care of the patient. This suggestion appears to be consistent with our findings, but there is an additional related “take-home” point.
Prigerson HG, Zhang B, Nilsson ME. End-of-Life Care: Where Does the Standard Oncology Care Fail Our Patients and What Do We, as Oncologists, Need to Do Differently?—Reply. JAMA Intern Med. 2013;173(6):474-475. doi:10.1001/jamainternmed.2013.2861