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Invited Commentary
Health Care Reform
August 2016

The Team Approach to Advanced Cancer Care—Redefining the Gold Standard

Author Affiliations
  • 1Department of Medicine, School of Medicine, University of California, San Francisco
  • 2Division of Hematology/Oncology, Veterans Affairs Hospital, San Francisco, California
  • 3Outpatient Palliative Care Clinic, Veterans Affairs Hospital, San Francisco, California
JAMA Intern Med. 2016;176(8):1062-1063. doi:10.1001/jamainternmed.2016.2949

We empathize greatly with Dr Klepper for his loss. His compelling reflection on his wife’s care for peritoneal cancer highlights the struggles many cancer patients and their families face when battling incurable cancer. Dr Klepper advances 2 themes in his thought-provoking essay; the first addresses what is high-quality cancer care and the second is how best to inform and involve patients in shared decisions while planning their care.

In 2013, the Institute of Medicine (IOM) published the seminal report, “Delivering High Quality Cancer Care.”1 It starts with the central tenet that “engaged patients are at the center of the framework” for delivery of high-quality cancer care. In advanced, incurable cancers, there is no “gold standard treatment.” Thus, for patients with advanced cancers, it is especially important for providers to focus on the individual patient’s needs, preferences, and values. The key components of delivering patient-centered high-quality cancer care (adapted and modified from the IOM report) include:

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